Psalm 40

9 I have told the glad news of deliverance
    in the great congregation;
behold, I have not restrained my lips,
    as you know, O Lord.
10 I have not hidden your deliverance within my heart;
    I have spoken of your faithfulness and your salvation;
I have not concealed your steadfast love and your faithfulness
    from the great congregation.

11 As for you, O Lord, you will not restrain
    your mercy from me;
your steadfast love and your faithfulness will
    ever preserve me!
12 For evils have encompassed me
    beyond number;
my iniquities have overtaken me,
    and I cannot see;
they are more than the hairs of my head;
    my heart fails me.

13 Be pleased, O Lord, to deliver me!
    O Lord, make haste to help me!

Psalm 40:9-13

Hi everyone, sorry for not posting for a while.  I tell myself that I just haven't had much to say (which is partly true), but in reality I just haven't been disciplined enough to sit down and write an update.

I was reflecting on the above passage for a few days.  I think Psalm 40:9-13 can be my new life verse.  God has delivered me in many ways.  While it's possible that He may not ultimately deliver me from this cancer, I have seen His steadfast love and faithfulness time and time again.

It's hard to imagine that it's been almost a year exactly from the point where I was diagnosed.  I've spent much time over the past few weeks reflecting on how my cancer journey started.  I still marvel that God would use the adoption process that Jenn and I were going through to finally cause me to see a doctor for a physical (having avoided doctors since high school) - a physical that would lead to an abnormal blood test which would eventually lead doctors to a cancer diagnosis.  

I've read stories of so many myeloma patients that had no idea they had this cancer until they broke a bone or wound up in the hospital for diseases which their weakened immune system couldn't fight off.  Yet for me, God in His goodness would allow doctors to catch the cancer while I was in good health and asymptomatic.

Thinking back on all of the treatment I've had, God delivered me from experiencing any major discomfort from the drugs.  My doctor would frequently tell me that I was his first myeloma patient not to experience any side effects from my initial therapy.  Praise God!

God not only has been sustaining me physically over the past year, but He's encouraged my soul with the love, prayers, and thoughtfulness of countless friends and family members.  

I wish I could speak with the Psalmist and say that I have never hidden God's deliverance from others.  I haven't intentionally; but there have been several times where neighbors or coworkers have asked how I'm able to handle things so well, and out of laziness or tiredness I have failed to point to the steadfast love and faithfulness of my God which preserves me.

Friends, please pray that I would not cease to speak of all the ways that God has been good to me and my family, even in the midst of cancer.  Pray that even when I'm physically tired of talking about how I'm doing that I would never grow weary in pointing everyone to the one who sustains me.

Soli deo gloria.

Retrospective

Happy 2016!  I'm told that the new year is a good time to pause and reflect on the year gone by.  For those of you following this blog, I don't need to tell you what a roller coaster of a year it's been.  It would be easy to look back at 2015 and call it a year worth forgetting.  Or, if I were to make a movie of my 2015, I could call it "Bryan and the Horrible, Terrible, No Good , Very Bad Year" (credits to Judith Viorst).  It would be wrong to make those statements though.

As I sit at my desk reflecting,  I can't help but see all of the blessings that came in 2015.  Yes, the year was marked by trials and sadness, but there's no denying that the goodness of God was ever present.  Here are some of the lessons I learned (much of which is a repeat of things I've posted here in the past).

• God's ways are not our ways.
  The year started out with such excitement (the good kind).  Jenn and I had made the decision to start the adoption process, and while the process was overwhelming and stressful at times, we were thrilled to move forward with starting a family.  I never would have thought at the start of the year that God would have other plans.
  
  All things to that point seemed to be pointing us to adoption.  After years of not being able to conceive, we had a new church pastor move just a couple of miles away who had two adopted boys.  We became enamored with Jenn's cousin's adopted boy.  Plus, God just laid on our hearts the desire to give a family-less child a family.
  
  Still, even when we were thinking that God was going to move us along the path of having a family, we instead were reminded that we can't understand the mind of God (Is. 40:13-14, Is. 55:8-9).  Little did I know that the adoption process would be God's means for getting my cancer diagnosed.  This is not the way I would have scripted 2015, but God in His perfect wisdom decided to give us a detour.  Jenn and I pray that it's a temporary detour on our journey to starting a family, but we recognize that God alone is wise and in control.
• Health should not be taken for granted.
  I always took pride in the fact that I never seemed to get seriously sick.  Sure, I'd get a cold every now and then, but I never had any serious ailments that required prescriptions or trips to the doctor.  Being diagnosed with cancer was a glimpse into a world I had never seen - x-rays, biopsies, cat scans, waiting rooms, exam rooms, pharmacies ... it was all so foreign to me.
  
  Yet, through the whole process, God was reminding me that health is a gift not to be taken for granted.  And it wasn't my own condition that reminded me of this.  2015 allowed me to witness a church family's own struggle with their child's cancer.  Both my grandmas had struggles with their health - one of which almost passed away and had to have a pacemaker installed.  Jenn's grandpa also had an incident which left him hospital-ridden and us wondering whether he would make it.  My parents had battles with health ailments.
  
  We are finite, frail, and feeble creatures.  For as much as we try to exercise, eat healthy, take vitamins and supplements, we ultimately cannot buy or maintain good health.  2015 has taught me to be grateful for the seasons of good health while also mourn and empathize with those that are struggling with various ailments.
• Count your blessings.
  Even in times of darkness and trials, it's important to take a step back and thank God for His blessings.  For me, 2015 was a reminder of how God continues to provide for me and Jenn.  My job at Google is a huge gift and wholly undeserved.  I learned that we have amazing health insurance, and I've had to pay very little out of pocket through my various medications and medical procedures.  I'm blessed to have access to nutritious food at work.  (I also have access to a lot of junk food and desserts, but that's a different story, haha.)  I have coworkers who have been incredibly encouraging and supportive during my medical leave.  I'm blessed to have several Christian coworkers who encourage me with prayer and Scripture even in the work setting.
  
  God's blessed us with a home that we love.  By His grace we haven't had to do much to maintain it so far.  He's given us neighbors that we're forming relationships and even friendships with.
  
  I'm blessed with a wonderful church with wise and shepherding pastors and elders.  Jenn and I could not have gotten through this year without the support of our church family.  They have offered us shoulders to cry on, constant prayer, and have given us wise counsel.
  
  Even beyond our church family, I'm blessed to have the prayers of so many friends (and friends of friends).  It's so encouraging to hear from people I haven't seen for months (or even years), telling me that they're thinking and praying for me often.  I'm so grateful for those people that truly realize that prayer is powerful and that God uses those prayers in a mysterious way.

I'm not sure what 2016 holds, but I'm reminded that God is the same yesterday, today, and forever.  Just as He proved Himself to be good and faithful during this past challenging year, I can trust that He will continue to do so in the upcoming year.  I'm grateful that I start 2016 with my cancer in remission, but I'm also painfully aware that this is not the end of my cancer journey.  Maintenance chemo will begin in a few weeks, followed by regular tests to see when the cancer comes back.  

I may not update this blog as regularly as things will hopefully be relatively uneventful for a while.  Nonetheless, only God knows what's in store for me.  In the meantime, I'll walk by faith and not by sight.

Happy new year, everyone!

Some good news

https://www.washingtonpost.com/news/to-your-health/wp/2015/12/02/for-multiple-myeloma-community-a-november-to-remember/

Exciting.  Keep praying for myeloma researchers and that God would allow them to discover a cure!

-b

Day 30!

It has been 30 days since my transplant, and that means ... I'm FREE!  A bunch of restrictions get lifted today.  I'm able to leave the house without a mask (though I still have to wear it in hospital settings), and I no longer have to follow my low microbial diet (though I have to avoid raw meat/fish for another month).

I feel like I should be more introspective on the process, but at the moment I'm just grateful for my health and for being able to enjoy some independence.  I'm grateful for the prayers of friends and family and the love of my wife who took care of me.  More than anything, I'm grateful for God's sustaining grace.

I guess it's time to start trying to get back into a work mindset.  I'm excited, but I'm extremely nervous since I've been out for so long.  The plan is to go back on 12/7, pending confirmation from my doctor that that's a good idea.

-b

Post-Transplant Day 16

Today is another momentous day.  I had my last appointment at the Stanford ITA (Infusion Treatment Area)!  My white blood cell count is 4.9 K/uL (the normal range is 4 - 11).  My platelets were also high enough where they're confident I won't need a blood transfusion, so they removed my central venous catheter.  This means no more covering myself in saran wrap before showering, no more flushing the lines every night and changing the dressing every week, and it means I can finally go back to sleeping on my stomach.  :)

I have a follow-up appointment after Day 30 with my Bone Marrow Transplant doctor.  He'll review everything and ultimately see whether I'm fit to go back to work.

In the meantime, I'm still on my strict low microbial diet, and I still can't leave the house without my mask, but praise God for getting me through thus far.  I'm feeling pretty strong, though still tired from time to time.  I'm eager to go back to work, but I'm going to spend the time I have off focusing on recovery.

Thanks for the continued prayers!

I've engrafted!

My stem cells have engrafted.  Praise God!  This means I'm no longer neutropenic (when you don't have enough stem cells to fight off infection).  As a result, they disconnected me from the fanny pack of hydration that I had to carry around everyone.  Additionally, I no longer have daily trips to Stanford.  My next appointment is on Wednesday where they will remove my catheter if my platelets are high enough.  

They say that while I have a functional immune system, it's very young, like a baby's.  I'm still on the low microbial diet for another ~20 days, but it should mean that the worst of things is over.

God is good!

Post Transplant Day 9

Just a quick update - I'm still neutropenic, meaning I'm still at risk of not being able to fight off infections.  My white blood cell counts turned up today though, so hopefully in the next few days I'll be on the mends.  They also said that next week I might be able to switch to MWF appointments instead of daily appointments.  Fingers crossed!

Healthwise I still feel pretty good.  The sores on my head are getting better, and my stomach - while still unsettled - isn't causing me intense pain.  Praise God!

Day 5 Post Transplant

Hi friends,

I know many of you have been wondering how the transplant has gone.  Sorry for the lack of posting; I can't seem to concentrate on anything for too long, and writing down thoughts seemed to be a laborious task.

To recap:

• Last week I spent a night in the hospital for BCNU chemo treatment.  I had my own room in the hospital, which was awesome.  My buddy, Jon, also visited me as his mom was getting treated at Stanford that same day.  The treatment itself wasn't too bad.  I was a little light headed, but it was pretty uneventful.  The hardest part was not being able to sleep well.  Oh, and there was the awkward part of having two nurses inspect my whole body for skin issues.
• A couple of days later, I came in for Melphalan (mustard gas) chemo treatment.  For that treatment, they had me sucking on ice while the medicine was being infused.  Apparently it limits blood going into the mouth which means the medicine doesn't collect there.  Melphalan is known to cause mouth sores, so the ice aims to reduce the mouth pain I'll be in in the days to come.
• This past Monday, I had my transplant.  The transplant itself was pretty anticlimactic.  They gave me some premeds (benadryl) to make sure I didn't have an allergic reaction to the preservative.  They then thawed my collected stem cells and sent it through my catheter.  They gave me mints to suck on because apparently the preservative tastes and smells of creamed corn.  (Jenn and I didn't notice, but nurses that walked by kept commenting on it.)

So what's happening now?  I'm waiting for my white blood cells / red blood cells / platelets to bottom out (reach zero).  Usually at that point, the stem cells we re-infused will engraft and those numbers will recover.  I'm told I'll feel progressively worse as those numbers go down to zero.

I know people wonder how I'm feeling.  Let me say off the bat that I'm doing really well and God has been answering prayers.  The nurses are really impressed with how well I'm doing.  I thank God for sustaining me thus far.  With all that being said, there have been side effects I'm dealing with.  I'll list them below, but know that I'm not complaining or suffering terribly.  Of note, I haven't had to deal with nausea/vomiting so far - praise God!

In increasing order of annoyance:

• Frequent urination (they hook me up to hydration fluids until my stem cells engraft.  I also drink a lot to preserve kidney function.)
• Light-headedness / tiredness (I feel a bit of the tiredness/fatigue I'm told to expect, but so far it hasn't been overwhelming.  Oddly, urinating is something that makes me tired / short of breath.  Still, I'm able to take daily walks, which I'm grateful for.)
• Decreased appetite / weight loss (I've lost roughly ten pounds over the past week or so, but the number isn't as bad as it seems.  At my peak, I had several pounds of water weight as they were loading me up with four liters of liquid a day.  I had also been trying to put on weight before the transplant knowing I'd lose some.  All that being said, I'm a couple of pounds below my average weight, which isn't terrible.  The appetite comes and goes, but I have some Ensure to help with the nutrition when I'm not hungry.)
• Mental cloudiness (I can't seem to concentrate on anything for too long.  I have to read the same paragraph multiple times to figure out what something is saying)
• Skin issues (I'm having some skin issues - a rash behind my ear, some acne popping up, a rash on my head.  These are all expected to clear up as my white blood cells rebound.  Still, I do look pretty gross right now.)
• Stomach pain (to date, the stomach pains have been the worst part of the transplant process.  My doctors think it's acid reflux, and yesterday they prescribed some additional medication which should help control it.  The pain luckily doesn't last very long, but it's often 10-15 minutes of really intense pain.  It seems to happen in the early mornings and sometimes after eating.)

Anyway, my apologies again for the infrequent updates, but I'm still alive and kicking.  I haven't been able to binge read/watch/play anything in particular, but I'm still grateful for that health that I currently enjoy.  Jenn has also been amazing in faithfully driving me to Stanford every day (the drive home from Stanford has been taking 1.5 hours every day). I'm also grateful for all the prayers, emails, texts, and thoughts being sent my way.  

Melphalan done!

The Melphalan (mustard gas) was pretty uneventful.  I had suck on ice chips for an hour which will hopefully prevent mouth sores.  Michelle from my church mixed the drugs (she does oncology pharmacy at Stanford), so it was nice seeing a friendly face.  It looks like we're still on track for transplant on Monday.  Praise God for everything going so smoothly so far.

Discharged!

So yesterday's overnight stay at Stanford was pretty uneventful.  I got admitted at 2 in the afternoon.  They put me on hydration fluids for four hours to make sure the BCNU drug would constantly be flushed from my system via frequent urination.  At around 10pm they started the BCNU drug.  Praise God, I didn't feel any of the facial pain / intense headaches they described.  Rather, it felt more like a warm buzz / fogginess similar to how I feel after drinking wine.

Sleeping at the hospital is a bit challenging.  The nurses came in every couple of hours to check my vitals.  At 4am, the fire alarms went off for 10 minutes.  I also didn't know how to turn off the lights in the room, but I asked the nurse at 5am when she checked in on me.  Apparently the room was also set to 60 degrees, and I didn't know I could request to turn it up.  It wasn't until a new nurse came in shivering did the thermostat get adjusted.  It wasn't all bad though; I had my own room which was a huge blessing.  Also, my buddy Jon visited as his mom had an appointment at Stanford at the same time.

Anyway, they sent me home with the rolling backpack filled with 4 liters of hydration fluids.  They'll be sending roughly four liters of fluid through my body for the next three days or so.  I can't wait to see how much water weight I put on.  :)

Tomorrow I'll be doing the Melphalan drug.  It should be a two hour infusion which most people tolerate pretty well.  However, several days after the Melphalan, I should feel like I've "been hit by a truck", according to my nurse.  We'll see how it goes.

Today's nurse again said I'm an extreme case of handling treatment really well.  I told her I felt totally normal this morning and that I could probably go for a jog if I wanted.  She said that most people are pretty run down after the BCNU.  I think this is a huge answer to everyone's prayers, so thanks for faithfully upholding me.  Keep 'em coming.  :)

-b

Last day of freedom

Hello, friends!  I went to Stanford on Monday for an xray, blood test, and a meeting with my doctor / nurse coordinator.  Praise God, the x-ray and blood tests all look good.  The doctor and nurse talked me through what would come next.  I'll be going for an overnight stay at the Stanford hospital on Thursday for BCNU treatment.  They want me overnight there because it can sometimes cause severe pain, especially in the head/face.  It only lasts while the treatment is going on (3-4 hours), but they want you at the hospital so they can administer pain meds if necessary.  The next day I'll be discharged with a rolling backpack full of IV fluids which I'll have to keep with me for the next day or two.  On Saturday I go into the hospital for Melphalan (a derivative of mustard gas).  Apparently that medication is usually handled well, but they'll have me suck on ice to prevent (or minimize) mouth sores.  If all goes well, I'm still on track for my transplant on Monday!

So, tomorrow marks my last day of freedom before the health precautions kick in.  I'm grateful for these past two weeks of being able to go outside, eat out, run errands, visit friends ... it will definitely be challenging not being able to have the windows open, not being able to eat out, having to wear a mask whenever I go outside.  Still, God has been incredibly gracious to me.  I'm thankful that I'll get to be at home while recovering from the transplant instead of at the hospital.  I'm grateful that Jenn has gotten to take time off  to be my caretaker.  I'm blessed that Google has an awesome short term medical leave policy.

Onward!

-b

Thank you!

Someone bought me a beanie, but I'm not sure who (there wasn't an invoice / note).  If it was you, my bald head and I thank you!

It's begun ...

The hair is falling out, haha.  It's not too noticeable yet, but this is what I see whenever I run my fingers through my hair.

Once my hair gets patchy, I'll shave it off.  I'm not worried about shaving my head, but I do know I don't have the head shape to pull it off well.  Sadly, I don't think I can pull off hats either.  We'll see.  ;)

-b

Lots of stem cells

Praise God, it turns out they were able to collect stem cells today.  More than that, they collected a super abundance of stem cells!  They were looking to collect 4 (not sure what unit) of stem cells, but they collected 13.4!  Praise God.  This means I don't have to go back later this week for follow-up collections.

I guess I just wait now to find out when the next rounds of chemo are and the actual transplant.  I should find out sometime this week.  In the meantime, I'm going to celebrate a few days of freedom!

-b

Huzzah!

So my white blood cell count jumped from .6 yesterday to 4-point-something today.  This means a few things:

• I no longer have to follow the low-microbial diet (until the chemo before the transplant).  Woohoo!
• I can go outside (though I have to wear a mask in crowded places).  Woohoo!
• I don't have to take antibiotics anymore (until after the transplant).  Woohoo!
• I can go to Stanford tomorrow where they'll actually determine if I have enough stem cells to begin collection.  If I do, they'll do a collection tomorrow and for subsequent days until they've collected enough.

Praise God!

Waiting

So I'm waiting for my white blood cell count to go up to 3.  Apparently it crashes to near zero before bouncing back up.  Once it goes up to about 3 or so, they think you have enough stem cells for collection.

My bones started hurting today.  Apparently that's a sign that the drugs are working (the bone marrow produces so many stem cells that it starts leeching into the blood, causing the pain).  It's not very fun, but tylenol seems to be helping!

-b

Fearfully and Wonderfully Made

For you formed my inward parts; you knitted me together in my mother’s womb. I praise you, for I am fearfully and wonderfully made. Wonderful are your works; my soul knows it very well. My frame was not hidden from you, when I was being made in secret, intricately woven in the depths of the earth. Your eyes saw my unformed substance; in your book were written, every one of them, the days that were formed for me, when as yet there was none of them. -Psalm 139:13-16

As an emo teen full of angst, I remember clinging to the words often repeated by youth group leaders and Sunday school teachers.  "You are fearfully and wonderfully made."  

There were a lot of things I didn't like about myself; I was always the shortest one in the room, I had really bad skin, I was never very athletic, and the list went on and on.  Intellectually, I knew that God had planned out exactly how I would be from before time began.  I knew in my head that God didn't make mistakes, and yet there were countless tears shed wishing that I could be just a little taller, just a little more outgoing, just a little different.

I don't know when I finally came to accept the man that God has made me to be, but I do know that eventually I had to concede that God is omniscient and makes no mistakes.  He has given me exactly what I need to fulfill His good purposes for me.

This is true of my cancer as well.  When I was first diagnosed with cancer, I constantly questioned why I was 'defective'.  For the past several years, I strove to live a healthy, active life, so it was a bit hard to accept that I had cancer.  And yet, even with cancer I know that the words of Psalm 139:13-16 are true.  I am wonderfully and fearfully made, cancer and all.  I don't fully know how God is using this cancer for His purposes, but I will continue to cling to the fact that He is a good and wonderful Creator.

Purpose

"The Lord will fulfill his purpose for me; your steadfast love, O Lord , endures forever. Do not forsake the work of your hands." Psalm 138:8

When I go to see my Bone Marrow Transplant Doctor at Stanford, I'm always asked to fill out a questionnaire beforehand.  The questions range are general ones about my current health and mental state.  One question always stands out though.  I'm asked to rate how true the following statement is both before my diagnosis and today: My life is meaningful and full of purpose.

It's an interesting question, and I know why they need to ask it.  Cancer seems to put the brakes on any sort of plans you had for your life.  Prior to my diagnosis, Jenn and I were going down the road of adoption.  I felt that my purpose at that time was to put all my time and energy into that process as we prepared to start a family.

After the shock of the cancer diagnosis wore off, I did go through periods of questioning what my purpose now was.  Since the adoption process had to be on hold, my life did feel a bit empty.  I thank God that He didn't allow me to sit in that pit of despair for too long, especially since so many people struggle with this lack of purpose, as the Stanford questionnaire would indicate.

Over the past few months, God has been reminding me of His purposes for me.  There are the obvious purposes that haven't changed with the diagnosis - He desires that I be a loving husband, a productive member of my local church, and a good steward of all the good gifts and responsibilities He's entrusted me with.  Furthermore, God's purpose is for me to mature and to become more like Christ (Phil 1:6).  Through my journey with cancer, He is fulfilling those purposes to strengthen my faith and produce perseverance (James 1:2-4)

There are, however, purposes that God has for me that are not immediately obvious.  Words that He would have me say at an opportune time, people He would have me meet, things He would have me do.  I don't fully know what God's purpose for me is, but I found comfort in reading Psalm 138:8 today.  God will fulfill all His purposes for me.  This means that God will leave me here on earth until everything He has wanted me to do has been fulfilled.

How comforting to know that when my life on earth is done, God will have kept his promise to fulfill all of His purposes for me.  How humbling it is to be used by the King of Kings for His good purposes.

No more IV!

I have to say that carrying around a rolling backpack full of fluids has been the hardest part of the past few days.  The thing is just unwieldy, not to mention you also have to keep it plugged in so the battery doesn't die.  This makes it challenging to use the restroom at night as you have to reorient yourself, unplug the backpack, wheel the thing around obstacles to do your business, and then fumble around again to try to plug the thing in the dark while not electrocuting yourself.

Anyway, today I turned in the backpack!  I put on ten pounds of water weight in two days.  (And it's definitely all water weight since I ate pretty much nothing due to the nausea.)  I feel pretty bloated.  :)

Praise God I'm feeling my appetite pick back up, and I think the anti-nausea meds are working.  All in all, it's been a good day!

-b

Chemo update

Wow, so chemo knocked me out yesterday.  I was pretty dizzy and nauseous, but praise God I didn't vomit.  I only ate a brownie and a slice of pizza yesterday due to the nausea, but I'm feeling much better this morning!  The nurses said I ended the session in much better shape than most patients, so I'm grateful for that.

I'm also super grateful that I'll get to turn in my iv pump today.  It's been a pain wheeling that around everywhere, especially at night when the fluids make me use the restroom every hour.  :)

Thanks for your continued prayers and encouragement!

-b