Remembering and Anticipating

This was me a year ago with my eyelids taped, neck brace to keep my head up and using a walker to prop myself up when I walked. I was in the 55% who have major side effects from Opdivo/Yervoy immunotherpary combination. Extremely high liver distress numbers were the invisible and much more serious problem. Thankfully all that receded by mid March and I started Opdivo (only) which has been effective treatment with no side effects. I had an infusion on Wednesday and am scheduled for two more infusions at the beginning and end of March. Then Dr. Mashru thinks I will be done with treatment.

In the meantime I work at full strength teaching Western classes, serving on the elder and preaching teams at Grace, doing a good bit of teaching/preaching in other churches (Cove Church in Anahiem last week and Capitol Church in Boise this Sunday and Alderwood Church, Saturday Feb. 11) along with pastoring pastors and checking in with grand children.

Sherry and I celebrated birthdays at Salty’s on the Columbia, our favorite celebration spot by far. After enjoying the marvelous dinner and sharing their complimentary white chocolate mousse cake, the server asked if we had a few minutes – another patron wanted to treat us to Mocktails. I had never heard of such a thing, but we found them delightful.

It is a great joy to be alive, strong and able to serve many in the years ahead.

Year-end update and prognosis

Three doctor report

Dr. Frager, my radio-oncologist, released me from care since the melanoma in my brain is gone.  I remember the Green Mask and the multi-member team controlling the CyberKnife that did the ultra-precise zap on the two nodules.

Dr. Burt, my urologist, removed the bladder cancer with “ordinary surgery” a year ago. He just took another look and showed me the inside of my bladder: no sign of cancer visually. The urine cytology lab test confirmed: “Negative for High Grade Urothelial Carcinoma”

Dr. Mashru, my medical oncologist, after reviewing my last CT scan and blood tests explained that the infusions of Nivolumab every four weeks for treating the melanoma that metastasized into my lungs. The good news is that he expects to end those treatments in April, which is a year after they began.

I asked for clarification, and he confirmed that since there has been no activity in the cancer over the last 15 months of treatment, he expects it is dead. Follow up CT scans will monitor to confirm

No cancer?? I will admit that it is hard to wrap my mind around that prognosis. But with prayers of thousands and cutting-edge treatment, that seems likely.

UPDATE: I had my pre-infusion blood tests (all good) and conversation with the Nurse Practitioner. She was pleased to hear how well I was doing which led me to do a bit of research on response to nivolumab treatment for Melanoma, If I read this article correctly, the overall survival rate is 42% and the disease progression-free survival rate is 36%. Mine was detected early and even more importnatly covered with prayers of many.  

New News

Nicole & Colton are engaged!

Colton formally proposed and slid the ring on Nicole’s finger. This means two upcoming weddings: Joy and Nathaniel in late April and Nicole and Colton on July 1.

We had a Thanksgiving celebration – at Red Robin, of course!

Christmas in Kansas City

We are spending a week with Donn, Susan, Elizabeth and Michael through Christmas Day. We got a blizzard to highlight our time! You can see Michael’s sled trip in sub-zero weather here. Michael also went high to top the Christmas tree decorations as you can see here

Our visit will include a Saturday Chiefs game. With temperature in the low teens, wind chill in low single digits, Donn purchased Mobile Warming Heated Wool Socks. I get to use Elizabeth’s pair!

The visit will culminate with Christmas Eve and Christmas morning services at their church. I am excited that Elizabeth will be doing readings on Christmas Eve, but a bit disappointed that their children’s Christmas program occurred last week.

Visit to Spring Branch Cemetary & Wheatland

Sherry and I traveled to Spring Branch Cemetary, outside the church I grew up in and where we will be gathered to our fathers, to introduce Michael to his ancestors, going back to grandparents, great-grandparents, and great-great-grandparents!

His great grandparents
It was cold!
His great-great-grandmother
His great-great-great-grandfather

Then we drove south to Wheatland and had a marvelous lunch at Gigi’s Cafe.

Infusions and Scans – November

The results of my Wednesday CT scan are back and the news is very good: (1) No evidence of disease progression. (2) Stable to slightly smaller pulmonary nodules. There is a lot of detail but that’s the bottom line.

I will continue having Opdivo (Nivolumab) infusions every 4 weeks and scans every three months, the next in January and another in April. The only side effects is an itchy back so Sherry anoints it each evening. But next week I will be in Denver for Evangelical Theological Society National Meetings Monday-Friday and then at Grace Pointe Church in Las Vegas for the week end. I may ask Andrew, my roomie, to do some unusual duty

I have been at all the national meetings of the Evangelical Theological Society will be since 1977. This will be the first time since 1986 that I will be I will have no leadership role. It’s going to feel very strange! But I will enjoy meeting many old and new friends as well has hearing some fine papers.

The NEW news is that Joy sprouted an engagement ring thanks to Nathanael! He joined the Dojo where Samantha teaches. After a couple of sessions, Sam asked Joy to come “help” her. The rest to the story is summed up in “happily ever after”!

Scans and Infusions

My seventh and eighth infusions were wonderfully unremarkable! The only drama was no results from my early morning blood draw showing up in my medical record. Those results are required before the infusion could begin. I called Trish, my oncology case manager. She put me on hold and called around, discovered that the blood chemistry machine that serves all the labs at Kaiser Interstate was non-functional. She also discovered that someone had driven my blood (and doubtless others) to the big central lab. Happily, the results came up as Kathy, the nurse of the day, was finishing the pre-infusion questions. So the eighth infusion proceeded in a wholly unremarkable way 😊

The MRI of my brain confirmed that the radio surgery had killed the melanoma cells in my brain. One of the two remaining pockets of dead cells is completely gone and the other much smaller. I like the idea my brain healing!

The final event of the day was CT scan of my torso, looking particularly at the melanoma nodules in my lungs. The conclusion is that the nivolumab (trade name “Opdivo”) has stopped the cancer. There are no new nodules which means the normal metastasis of the very aggressive melanoma is not happening. Neither are the nodules growing. Of course, I would like them to be smaller, something the two med treatment accomplished but with terrifically impacting side effects (see January-March posts).

The next steps will be to slow the infusion cycle from every two weeks to every four weeks with scans every three months. If all goes well, Dr. Mashru will pause the treatments after the April scans to see what is happening.

I deeply appreciate the prayers and encouragement of so many. I continue feeling fine with no effects from the cancer or side effects from the nivolumab. Now if I can just get my grades done . . .

Sherry, Cyndee and I spent a week at Clydehurst Christian Ranch in the mountains of South Central Montana. It is the place where Robert Redford filmed “A River Runs Through It.” I found my curiosity, which is always huge, kicked into an even higher gear with all the beauty and all the stories of people. As I was doing a pre-marital with Erik and Cynthia tonight, my eyes went once again to a cross stitched picture which a friend who sees my soul made for me many years ago.

Infusion #6

The bi-weekly infusions continue to be uneventful, I am glad to say. The blood panels I do before each infusion show the liver distress numbers (AST and ALT). The graph shows before, during and after the two med infusions back in December/January that caused all the huge spike and the other nasty side effects. The numbers continue to run in normal range, actually declining a bit, during the one med infusions

Ann and Jack, my sister and brother in law, came for a short visit. We went to the coast to hang with Cyndee and then to the Columbia Gorge and on to The Dalles to see David, Samantha, Nicole and Joy. There are more pictures on my Facebook page.

Infusion #5

The infusions are getting to be totally routine. Blood panel numbers are nominal, infusion nurses are friendly and wonderfully professional, the actual infusion takes 30 minutes and I walk out feeling fine in about an hour. The only change is what work I do while the infusion is going. Liz Ditty is one of my Leadership Cohort students who did a study on Elijah last term which is now contracted as an Intervarsity Book entitled “Prayers God Answers.” I get to go through it, appreciate the insights and make some suggestions for the final edits.

I have infusions scheduled every two weeks through the middle of September with an MRI and a CT scan scheduled for August 1. The scans will confirm no active melanoma in my brain and hopefully much reduced nodules in my lungs. I wouldn’t be too upset if they were absent all together. I don’t think I’d miss them since they have not made their presence known to me other than through the scans.

The other new event in my life is catching my first river salmon. Vinnie Sylvia loves to share fishing in his 14 foot boat. We have gone on the Columbia twice. This time we went on the Willamette near the St. John’s Bridge. After a wonderful morning on the river – fishless to be sure – Vinnie announced we’d head back in a half hour. Three minutes later my rod went crazy. It took a while to land the 14.5 pound salmon. It was VERY tasty.

Infusion #4 & Elizabeth’s Baptism

Infusion #4 happened Thursday afternoon. As I was preparing to go to a lunch appointment, Jennie, who was my nurse again, called to ask about the blood panel labs. I stuttered out that Dr. Mashru said I didn’t need to do them every time. Turns out I had misunderstood his “we don’t need to talk everytime” and skipped the required labs. So I hustled to get them done so the infusion could progress. Happily the last three labs were almost identical so the infusion proceeded without incident. I have had no side effects or fatigue. The only change is that I am weaning off Pyridostigmine, my “stand up straight” steroid pills and that is going well. Boring report 😊🙏

Sherry, David and I went to Kansas City last weekend for Elizabeth’s baptism at Good Shepherd Community of Christ which has been their church home for several years. It was a marvelous family event with all four of her grandparents along with Uncle David, Aunt Nancy (behind her in the picture) and Uncle Brian present, and great grandmother joining by Zoom from the LA area. The whole service was dedicated to the two baptisms and the confirmation the two along with Donn’s confirmation.

Elizabeth’s baptism was done by her sponsor (video here). Her confirmation (video here) and Donn’s confirmation (video here) were wonderfully personal and deeply moving for us. We all went to Donn and Susan’s home for some food and celebration. Susan took her parents to the airport, and then the rest of us went to Jack’s Stack for their wonderful BBQ with the Hickory Pit Beans – without doubt, the best beans in the whole wide world!!

Sherry, Susan, Elizabeth, Donn, Michael, David, Gerry, Nancy, Brian

Infusion #3

Sherry was in the room where it was happening for infusion #3 of the second round this afternoon. I am glad to say there is no drama or side effects. My liver numbers are well within the normal range as are all the other blood numbers. All that is good – though I will admit that I have a bit of nervousness since the side effects hit after the third treatment back in January. But doing only one med, no elevated blood numbers and feeling normal gives me lots of hope. I will have another blood panel on May 31, CT/MRI scans in late July, and have infusions scheduled through mid August

We went to see Dr. Burt to see the inside of my bladder in live color. He looked all around and only saw healthy tissue. The deeper urinalysis showed no cancer cells which is exactly what we’d hoped.

I will head for Costa Mesa on Monday for my four all day classes Tuesday through Friday. Then Sherry, David and I will fly to Kansas City for Elizabeth’s baptism on Sunday. Susan’s parents will also be there, so all four grandparents will join the celebration. We are beyond excited!

We got to celebrate with David and Samantha for the 50th anniversary for her parents. It was casual with lots of fun, followed by supper for the four of us along with Nicole and her close friend Colton. Joy was not able to join since she was visiting her close friend, Nathaniel’s parents for the first time.

Marianne & Max Burch

Infusion #2

Infusion #2 is history – no side effects so far, I am glad to say. The whole process took less than an hour, half of which was preparing leading up to the actual infusing. So I didn’t have a lot of time to read my book on Eastern Orthodox theology. I had a 2:00 appointment but the center called me yesterday and asked if I could move to 4:00 since they were really busy at 2. I was glad to accommodate and did my recliner time in an almost empty infusion center. But the view of the west hills and the flowered tree in the foreground was great!

The week before was assessment week. The MRI showed that the melanoma nodules in my brain are taken care of and there are no new ones. The best news! The CT scan on Friday showed that the melanoma nodules in my lungs, which the first three infusion had reduced by about a third, have not progressed. Again, the best possible result. It also showed two “incidental pulmonary edema” so I am injecting a blood thinner in my abodmen for a total of seven days. I gave David allergy shots back when he was a little guy, so I have some experience. But it’s different pushing needle into my own skin.

Liz and Tom, Sherry’s sister and brother in law, spent the weekend with us. We went to the Columbia Gorge and had dinner at Multnomah Falls Lodge on a beautiful day before we went to see the big fish at Bonneville. When I told Liz we were going to the Oregon coast, she immediately ordered oysters. So I did a search and found the Oyster Bar at JAndy Oyster Company at Tillamook. Liz was ecstatic!

JAndy Oyster Bar, Tillamook

Resuming Infusions – 2022 Commencement

I resumed infusions on Friday after a three month break to get over the side effects. This time it was a shorter process since I am only doing one medication (Opdivo). Our prayer is that the side effects were caused by the discontinued Yervoy. My nurse was super – and I confirmed that she is a believer, so we shared stories as she was prepping me. I write this 24 hours later so I can say there is more fatigue this time. I keep thinking a nap would be nice – but there is so much good stuff to do that I don’t really want to. I will have an MRI on Tuesday and a CT scan on Thursday to establish a base line for this round of treatment.

Western celebrated our 95th commencement – my 42nd. There was no way we could be sure we could gather anywhere for our normal grad banquet so began with a reception in a huge tent on our lawn. It started with sun, turned to a downpour and ended with more sun. It was pure Portland. the meet and greet was full of connections with students with whom I had close relationships. There were countless photos, of course. This one is some of my Costa Mesa Cohorters: John Hwang, Richard Cimino, Garrett Baker standing tall, and a Portland photo bomber, Jordan Grimms.

Saturday’s ceremony highlighted a presidential citation and commencement address from Dr. Than Le, a Vietnamese pastor who came to Western in the early 80’s after escaping the fall of South Vietnam in a small boat with about 70 people packed in. Than and I had many meals together in addition to class conversations. His moving address was a pastoral lesson around his story from boat to pastorate to teaching and coaching pastors from Vietnam to Ukraine. It is unfortunate that I did not get a picture of us together.

A personal highlight was hooding the very first Master of Applied Biblical Leadership graduates. The stories they represent were running through my mind as we exchanged a warm hug as they left the place of hooding to receive their diplomas – well just a cover to be accurate. They all have one more class to complete this summer.

Costa Mesa Cohort: Ty Orr, Richard Cimino, Matt Valencia, John Hwang, Casey Shirley, Sam Woods, Bre Golden,Scott Cunningham, Pete Nelson, Garrett Baker, Angie Woods, Drew Enos, Joseph Pfeifer, Brian Manley (I think I have them right)
Portland Cohorters: Jesse Willams Josh Argubright, Jordan Grimms, Gabriel Webb, Heath Hardesty, Peter Vorhees, Hakeem Bradley, Rob Steinbach

Line up to go to the ceremony

This picture with Bre Golden shows the stoop comes back as I get tired