Unusual Thanksgiving Blessings

I had a nasty gall bladder attack very early last Wednesday morning. I was directed to the ER where they found a 6mm gall stone in the neck of the gallbladder. I was admitted to the hospital with surgery to remove my gall bladder on Thursday, which was truly a Thanksgiving blessing, if an unusual one. I certainly don’t want another attack! One friend noted that I was like the Thanksgiving turkey with its giblets being removed.

While I was in the ER, I did my phone appointment with Dr. Mashru, my oncologist. He officially confirmed that I am done with immunotherapy and both cancers (bladder and melanoma). I will continue blood tests and periodic CT scans for a while. One very happy result is that I am no longer on the blood thinner which a couple of small blood clots in my lungs necessitated, so the all to common bruises on my forearms will be a thing of the past – I hope!

I am doing well, by God’s good grace. All my systems are functioning normally. My only discomfort is where they punched the four holes in me and that is minimal. I opted out of preaching at Grace last Sunday which made Sherry very happy. I went back to normal life, traveling to Boise on Tuesday for the last session of that cohort and to visit grandkids. Then I returned home Wednesday for all day classes Thursday and Friday, hosted 5 cohorrt students, went to the children’s musical at Grace Friday and Handel’s Messiah on Saturday.

The other Thanksgiving event was that my niece and nephew, Rashelle and Mike McKim were waiting for their son, Connor, to get home from his station in Corpus Christi. They didn’t get to greet him – he was killed in a head on crash. Sherry and I will go to Austin this weekend for his memorial which will be the family reunion we’ve been wanting but for a very different reason. He was an outstanding young man, baptized as a young adult, an academy graduate, a marine, committed to his family and his girlfriedn, full of life and hope. Connor’s obituary is here.

My Cancer is Gone

Dr. Mashru: “Good news. Pet scan continues to show no evidence of melanoma recurrence”. Looks like I am done with immunotherapy and with cancer. 🙏✨

This summary is from my PET scan on November 2 taken to look for metabolic hot spots. Those spots would likely be active cancer. The tech injected the radioactive material and I marinated in it for 77 minutes and then the full body scan. The technical summary goes like this: “The previously seen hypermetabolic pulmonary nodules are resolved or markedly decreased. No other metabolic pulmonary nodule is present. The previously seen FDG avid nodule near the gallbladder neck is no longer visualized. There is no abnormal FDG uptake in the abdomen and pelvis.”

When I did the same scan two years ago, it pointed to three hot spots: lungs, brain and gall bladder. That is all gone now.

The bladder cancer was removed surgically two years ago. I had some subsequent difficulty with blader infections but none for more than six months.

The scans taken two years ago show the melanoma in my lungs

and in my brain:

The team needed to determine exactly what kind of melanoma I had so they poked a needle into one of the tiny nodules in my lung. The doctor was a straight shooter and hit it but I developed a pneumothorax, air inside my chest, so I had to give up the final day of co-teaching Providence and Prayer with Todd Miles. But when my computer was delivered to the hospital room, I relieved my boredom by logging into the Zoom link, to the total surprise of the class, and taught from my hospital bed. The picture is inconic!

The immunotherapy treatments began with the combination of Opdivo and Yervoy. But after three infusions, I developed major reaction: My liver distress numbers which should top out at 40 were over 400. I had major muscle weakness and ended up with one eye almost closed, my should/neck muscles unable to hold my head up. So I taped my eyelids open, wore a neck brace and leaned heavily on a walker. I did one all day Boise Cohort class my our family room. After that I traveled to the teaching sites in Portland, San Jose, Costa Mesa and finally to Boise. A friend recently told me he was going to call in sick but remembered me and went to work.

After a three month reversal of the immunotherapy with 80 mg. of Prednisone, I restarted immunotherapy with Opdivo only. I have had minimal side effects. That treatment is finished now. I will be doing monthly blood panels and CT scans at 3-4 month intervals.

I am deeply grateful to the oncology team at Kaiser headed by Dr. Mashru and for an uncountable number of people who prayed and supported me.

October Updates

The end of my immunotherapy treatment is in sight! Dr. Mashru has confirmed that he expects to finish infusions as of November 29. The big step between now and then is a PET/CT scan on November 2. Assuming that comes out as he expects, we will stop at the end of two years.

The Nivolumab has been effective to stop the melanoma. We are praying and hoping that it is dead and the nodules in my lungs are just clumps of cells. I will have monthly blood tests and scans every 3 or 4 months after treatment ends.

Men’s Round-Up

David and I have made Men’s Round-Up at Camp Tadmor a father-son event for the last decade. It is a very special place for him since that’s where he met and courted Samantha. This spring, Joy married Nathaniel and Nicole married Colton so this year I was very proud to add two new grandsons-in-law to the event. We had a great time with stories, sessions, disk golf (not me), and lots of food.

After the Saturday morning session, David and Colton were in deep conversation so Nathaniel and I joined them. It turned out Colton was pondering joining in the Sunday morning baptisms! We explored options and he committed. So at 8:30 they were at the lake (sadly, I was teaching my workshop to another 100 men) and David baptized Colton. You can watch the video here.

David sent the video to Nicole, saying “take a look at this.” She opened it expecting some disk golf event only to realize it was her new husband being baptized and promptly burst into sobs of joy. We all joined together for lunch an hour later.

July Melanoma Update

For context (see the April 25 post below), my last CT scan revealed one new small nodule in my lung which the radiologist assessed as a new melanoma nodule. Dr. Mashru was unconcerned, thinking it was inflammation rather than melanoma. I committed to following his lead and wait for my July scan. But there was still the nagging “what if the radiologist is right?”

The good news is that when the radiologist assessed the July scan, he concluded the nodule is “compatible with benignity and likely inflammatory in nature.”

This the radiologist’s summary impression: (1)  No evidence of new or progressive disease. (2)  Stable small noncalcified pulmonary nodules.(3)  Interval resolution of previously-seen right lower lobe subsolid nodule, compatible with benignity.

That is as good as news can possibly be. Dr. Mashru has not uploaded his assessment yet. I’ll edit this post when he does.

Commencement & Cancer Update

I had an in office appointment with Dr. Mashru, my medical oncologist today. That’s the first time we have been in the same room in many months. My blood work has been fine for all those months which is wonderful. My recent scans showed one new small melanoma nodule in my lung. That new nodule prompted him to change from pausing immunotherapy after Wednesday’s session to continuing them through the end of June. Then there will be another scan and another consultation.

I am still trying to assess my reaction to this new nodule. It doesn’t really concern me, but any new growth must get serious attention, which Dr. Mashru is giving it.

At Sherry’s request I had Dr. Mashru take a look at a rough spot on my back. He looked carefully, gave a initial suggestion that the skin lesion was a skin cancer of some kind (not melanoma), took a picture and sent it to my Dermatologist. She soon messaged me saying it looks like a “seborrheic keratosis” which is a scary phrase. But she also noted that Dermatologists refer to these benign growths as “barnacles” 😊 So I laughed, thanked her, telling her I am looking forward to my July appointment where she will give me a complet skin check.

I have to admit my bigger emotion is toward Joy Love’s Saturday wedding in Stanfield with Donn and Elizabeth coming from Kansas City and Cyndee coming from Cannon Beach.

My 42nd Western Seminary commencement on Friday and Saturday was a wonderful event. As MABL program founding director, I get to hood all the graduates in the program. There are so many stories in this group of men and women, including two babies born to students this semester. Very productive time.

Anniversary Infusion

We celebrated our anniversary in a different way: I got out of town early so we never talked face to face! We did talk by phone as I headed off to participate in the Exiles in Babylon Conference in Boise, part of the pre-conference conversation on Women in Church Leadership. You can hear my view on Preston Sprinkle’s Theology in the Raw podcast: here. I have a lot of material on this website in the “Exiles in Babylon” and “Women in Leadership” buttons.

We headed to Salty’s on the Columbia for our anniversary dinner as soon as I arrived at the airport on Saturday. It was marvelous as usual, though the rainy day meant no beautiful sunset for our dining pleasure.

We headed to the coast Sunday morning, to the Ester Lee Motel (of course!!). It’s been our spot for many anniversaries. This time they had all the paper work including our car and license plate number already filled out when we arrived! It has a wonderful cliffside view of the rocky coastline and the ocean. The problem is that the ocean is eroding the cliff and I have to wonder how long it will survive (!!)

We did a lot of relaxing as well as looking. I was able to go down to the Yaquina Head Lighthouse tide pools at a very low tide and see the ocean critters – including a bunch of seals who have moved into the neighborhood.

One of the very fun things is to see our name in lights!! Well, not exactly in lights, but out on the main highway so everyone can rejoice with us

We had our special coast dinner at Gracie’s Sea Hag on a sunny Tuesday evening over looking Depoe Bay. It was marvelous. The celebration ended with breakfast at Otis Cafe

Infusion and Cancer Prospects

We drove back to Portland and I went to my afternoon immunotherapy infusion. All my blood numbers were great and the infusion went quickly and without any problems of any kind.

I have an in office appointment with Dr. Mashru on Monday, April 24 and final infusion scheduled on Wednesday, April 26. He used the word “done” in our last conversation. There will be follow up blood work, scans, and appointments. Hopefully they will confirm that I am in the 30% of patients for whom the Nivolumab immunotherapy eradicates the melanoma. In the meantime, I have full energy and strength and love what I do!

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 three more infusions at the beginning and end of March and the final one on April 26. 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.