Tuesday, March 27, 2007

All of Grace

Today is our daughter, Gracie's, birthday.

A year ago Grace and I were pretty sure we were going to name our new baby Madeleine. Then it happened. The bathroom birth.

Little Gracie's first thoughts were probably, "Ahhh, that was easier than I was expecting."

In the hospital room when Grace and I finally had a chance to reflect on all the craziness of the bathroom delivery, we were so incredibly thankful for the Lord's mercy upon our family. Praise God that my precious wife was okay and that our baby was born with no complications. So many things could have gone wrong that morning, but by God's grace things worked out perfectly.

Grace and the baby did just fine that morning. In fact, the doctors thought that the baby was exceptionally healthy. So we started to sing this song called All of Grace, and that's when we decided that her name had to be a reminder of God's abundant grace. Her middle name, Olivia, comes from the word, "olive," which is a symbol of abundance. Also, since Grace was named after her mom, we decided to continue the tradition and name our daughter Grace as well with a nickname of Gracie.

I remember cuddling with Gracie the evening after she was born and telling a handful of visitors that I couldn't imagine actually being able to love another child as much as I love AJ. She was such a little bundle of joy, and I was so thankful to be able to hold her tiny body in my arms. Gracie and I bonded that night.

Here's a video of her birthday party. After Gracie blew out her candle I looked around the room and saw everybody's smiles. I was reminded of how each of our friends and family members have shared in our laughter and our tears this past year, and how God used each of them uniquely to bless us. Praise the Lord for His faithfulness and His abundant mercy!

Sunday, March 25, 2007

Dr. Little and Dr. Jiang


I plan to start Radiation and Chemotherapy on the same day - either April 2 or April 9th. They'll finalize the date this week.

Dr. Little - Radiation Oncologist
So after much answered prayer we concluded that Dr. Little at the Flynn Cancer Center in Everett would be the best choice for my radiation treatment over Dr. Takamiya at the Swedish Cancer Institute and Dr. Wisbeck at the Flynn Cancer Center. For those who are interested in knowing our reasons...here goes.

We were first referred to Dr. Wisbeck by my surgeon, as they have worked together for many years. I really liked Dr. Wisbeck when I met him and he seemed to have a lot of experience to back up his title as Director of the Flynn Cancer Center. When I went to see Dr. Takamiya at the Swedish Cancer Institute he told us that if we wanted to be treated at the Flynn Cancer Center we should go see Dr. Little instead since they went to school together at UCSF and trained on the new Intensity Modulated Radiation Therapy (IMRT) machines, which have become the standard for head and neck cancer over the past 5 years. So I went back and politely asked Dr. Wisbeck if he has had enough experience using the new technology to treat me properly. To my surprise he told me that he has Dr. Little look over all his treatment plans for IMRT, and that if I wanted to switch and be treated by Dr. Little he wouldn't be offended at all. So we were able to get a short notice appointment with Dr. Little and he assured us that he and Dr. Wisbeck will both look at my treatment plans. So we decided to be treated by the younger doctor who knows new technology, with older doctor looking over his shoulder. By the way, we had two other opinions from Radiation Oncologists in Seattle, be chose not to be treated by them because it would be too far to drive every weekday for six weeks.

Dr. Jiang - Medical Oncologist
Dr. Wisbeck referred us to Dr. Jiang for my chemotherapy treatment. This decision was an easy one and we didn't feel like we needed multiple opinions for this since it is simply a drug administered by IV at the hospital. The chemotherapy treatment plan will for the most part be indentical to a clinical trial done in Europe in the late 1990's. Even if I had a more complex treatment plan or needed experimental drugs I would definately still go to Dr. Jiang. He's a very nice guy, but more than that he is the biggest nerd in all of Everett.


Not much to say here....
By the way, Happy 27th Birthday to my sister, Jen!

Wednesday, March 21, 2007

Famous Quotes of the Week


Dr. Wisbeck’s Consultation meeting
Nurse: “Andrew, have you ever been exposed to toxins growing up?”
Grace: “Well, he grew up in New Jersey, and we lived in Los Angeles.
Nurse: “I meant for example my cousin used to chase the fertilizer sprayers and now he has all sorts of cancer”

Dr. Barnett’s Consultation meeting
Dr. Barnett
: “You’ll probably need a gastric feeding tube to keep your calories up. Its not like you’re a tub of la—I mean, its not like you weigh 350 pounds and you can afford to not eat for a couple of months.”

The kitchen table
Andrew: “AJ, it’s a train with people on it. Do you see all the people?
AJ: “Yea, da poopoo, da poopoo! “

The kitchen table
Grace: “AJ, please pick up you food off the floor and put it in the trash..No-No! don't eat it! “

The bathtub
Grace: “Oh no! AJ’s peeing on Gracie!”

The past week has been a busy one as we have been trying to decide where to have radiation treatment, and whether or not to do chemotherapy at the same time. For those who have not been up to date on my situation, the post-surgical analysis of my tumor showed that the tumor invaded the deep muscle tissue of the tongue as well as a single lymph node. This would make it a T4, N1, M0 tumor, which is categorized as a stage 4a cancer. According to my doctors people with stage 4 disease are at a higher risk for recurrence even with negative surgical margins. With this information my doctors are recommending radiation therapy as the primary way of treating any additional cancer on the molecular level that may be in my body. They are also recommending Chemotherapy as it is often used in more advanced cancer cases such as mine since it enhances the radiation’s ability to kill cells that divide. Grace and I decided that we'll do whatever treatment it takes to increase my chances of survival now, even if the short and long term side effects are worse.

The decision to do radiation and chemotherapy became pretty clear when Dr. Takamiya showed me an article from the New England Journal of Medicine that shows significant improvement in the survival rates of patients who use a combined chemoradiotherapy treatment over patients who use radiation therapy alone. For post-surgical treatment of stage 3 and stage 4 squamous cell carcinoma of the head and neck the overall survival rates increase from 40% to 53% with a combined chemoradiotherapy. I was advised to take these statistics with a grain of salt since my cancer case may be less severe than many of the cases in the trial and that most of the patients were between 50-70 years old. The downside to combined chemoradiotherapy is a significant increase in short term discomfort and side effects. Only 49% of the patients in the study were able to complete the chemotherapy treatment. So pray that I will be able to complete it.

1) It was such a blessing to see Erik today. He is capable of walking with a walker and able to eat a little. His voice sounds pretty good too! He’s a walking talking bubble of encouragement and answered prayer. God really is not bound by chances and statistics. Erik survived childhood Leukemia and a couple relapses, and he survived this infection and coma and he’s recovering faster than his doctors expected! Oh, how the Lord is faithful to those He chooses.
2) Praise the Lord for providing 5 opinions from radiation oncologists that all basically agree.
3) Praise the Lord for providing all those appointments in a short time frame so I can stay on track to begin treatment in a week or two.
4) Praise the Lord for making it clear that I should do chemotherapy.
5) Praise the Lord for lots of moments of laughter this week that got our minds off the tough decisions.
6) Praise the Lord for helping our family get over a nasty cold bug. I had the fewest symptoms out of everybody and they went away in a day or two. Praise the Lord for allowing me to stay healthy to make it to all my doctor’s appointments this week.
7) Praise the Lord for allowing me to start working again last Friday, and that my bosses and co-workers are so flexible and understanding. One person said this, “You make sure you have the time to make the right medical decisions. If you can’t finish the work its okay. Nothings more important than you getting healthy again.”

Please Pray
1) That we will make the right final decision on radiation oncologists. Its between Dr. Little and Dr. Wisbeck at the Flynn Cancer Center in Everett.
2) That we would be able to choose the right oncologist to do my chemotherapy treatment.
3) That the insurance will cover my radiation and chemotherapy. Right now my insurance company says that they will cover certain doctors, but not others in the same clinic. In fact, the Medical Oncologist clinic says they cancelled the contract with my insurance company when my insurance company says they're still contracted! There seems to be a mix up with the contracts between my treatment centers and my insurance company.
4) Pray that Erik will be encouraged and that his kidneys will work completely so he can get off dialysis.

Wednesday, March 14, 2007

"So Doc, will I glow?"

"No, " he said, "but you will feel like you have a bad sunburn on the inside of your mouth and throat for a while. Oh yeah, and if you like steak now, you might find that it tastes like cardboard when your taste returns. By the way, did you want to add chemotherapy as well?"

"Hmm, then if I eat cardboard will it taste like steak?"

On Monday afternoon we had our first visit with a radiation oncologist at the University of Washington. We're not sure where we're going to have my radiation treatment as we're consulting with doctors from UW, Swedish, and the Flynn Center in Everett.

When we met with Dr. Parthanini, the radiation oncologist at UW, we were surprised to hear that the pathology report showed that my tumor was much more aggressive than anybody expected. It turns out that my tumor was a T4, the most advanced stage, rather than a T2, which is what they thought before surgery, based on the size. The cancer had actually spread from the tongue to the nerves and muscle tissue in the floor of my mouth, as well as to a single lymph node on the right side of my neck.

The good thing is that they were able to get the whole tumor out with negative margins all around. The bad thing is that with tumors with this type of aggressive behavior, they recommend radiation treatment and possibly concurrent chemotherapy.

I've been struggling a little bit just thinking about all the side effects of the radiation and how my life will change as a result. I wonder how hard life will be, or even how long it will be. Sometimes I think about death, but thats not a bad thing to contemplate, since it is our inevitable fate. It is so true that we must walk by faith and not by sight (2Cor. 5). Sometimes I wish I could see what is right around the corner in life, but we just don't know. One thing the Lord has been teaching me lately is to hope not in this life, but the life to come. It's really going to be so awesome to live on the new earth where God Himself will dwell among us and wipe away our tears. And there will be no more death, mourning, crying or pain (Rev 21).

By faith I love, worship and am satisfied with the sweetness and goodness of God in this life, but after I die how much more satisfied I will be when I truly see Him face to face!

When I was a young kid growing up in New Jersey I went through phases where I would be so afraid of what would happen after I died. "Would I just be forever lonely without my family? Will it be black and dark and empty? I don't want to give up my life here, I'm comfortable." I remember times when I couldn't sleep at night and just stared at the ceiling thinking about what happens after we die. Those nights I felt so terrified of it being dark, and lonely forever. One time I got up and went to my parents room and woke them up and told them that I was scared, but I didn't tell them what I was scared of. Then I went back to my room and tried to just not think about it. Then one summer in middle school I remember being gripped by fear of life after death for several weeks. I felt like I could die or the world could end at any time, and I was just so afraid of that happening because I feared the possibility of feeling such emptiness and loneliness forever. Needless to say it made me miserable thinking about it, so I just tried really hard not to think about it for the next several years.

Looking back on those terrifying and uncertain years, I now know why I felt like it would be so lonely if I died. It's because I had no hope of life after death. At that time in my life I didn't have a personal relationship with the Lord and I didn't believe the truth that Jesus died for my sins. In fact, I barely knew anything about the bible or who God is. So those feelings of loneliness were real, and they were right. If I had died back then, I would have been destined to spend eternity empty and alone and without God in hell, where there will be weeping and knashing of teeth forever.

I'm so thankful that I don't have to fear death like I used to when I was a kid. Sometimes I still struggle with fearing death, but not nearly as much as I did a couple months ago. I fear the pain that leads to death more than death itself.

Anyhow, enough about death. Pray that I'll live and that the Lord will heal me completely with radiation treatment.

No guilt in life, no fear in death—
This is the pow'r of Christ in me;
From life's first cry to final breath,
Jesus commands my destiny.
No pow'r of hell, no scheme of man,
Can ever pluck me from His hand;
Till He returns or calls me home—
Here in the pow'r of Christ I'll stand.
Keith Getty & Stuart TownendCopyright © 2001 Kingsway Thankyou Music

Please pray:
1) For wisdom in choosing the right Radiation Oncologist
2) That the Lord would heal me completely no matter how aggressive the cancer
3) For strength to make it through 6 weeks of radiation
4) If the Lord wills that He would minimize the side effects of the radiation and that no other cancer would be induced by it.

Saturday, March 10, 2007

Sunshine amidst cloudy days


Though it is winter here in Seattle, last week was full of sunshine.

My brother, Jon, and my dad came last weekend. Though I was still recovering from the surgery, I was able to get out a bit and spend some time with my brother. One of the days Jon and I took a walk up to blockbuster and rented a video, then stopped by Dairy Queen and walked back with hot fudge sundaes. Walking by all the houses and peeking into their backyards brought back memories of when my brother and I used to play catch in our backyard on warm spring days in New Jersey. He's 5.5 years older than me, so I learned so much from him when I was a kid. I was always the tag-along with the older kids when we used to play baseball in our old court in California or at Vista Grande school down the street. I didn't much care that I was just Jon's little brother. At least I had somebody to look up to.

When Jon and Dad left Monday night I missed them immediately. It's been a really long time since Jon and I spent much time together. I'm glad he made the time to come because his visit brought sunshine amidst some cloudy days.

With all the doctors appointments, the surgery and recovery, it it felt like forever since we've been able to get out and just have some good fun and laughs with my wife and the kids.

When I woke up on Tuesday morning I could already tell I was in for a treat. There was a yellow tint rather than a gray tint to the beam of light between the curtains. As Tuesday's are typically family days, we decided to go out for lunch instead of dinner since there's no guarantee that the sunshine will last more than 2 minutes. So off we ran to the park on the Snohomish and Pilchuk rivers.

It was Grace, AJ, Gracie, mom, Boaz (mom's dog) and I eating fish and chips in 70 degree weather in Snohomish. AJ just loved being able to run around and play on all the playground equipment. Gracie kind of just hung out looking cute. Grace gave AJ a tour of the place, then hung out with Gracie. Mom took Boaz for a long walk around the park, and I just enjoyed watching AJ sort of tumble his way down the tall spiral slide with his deep belly laughs. AJ seemed small for such a tall, steep, spiral slide, but we let him go down anyways. Since the slide was enclosed I couldn't see what was happening, but the sounds he made before popping out the bottom sounded painful. "Haha - thump, thump, thump - haha!" The funny thing is that he wanted to do it again and again. I kept thinking to myself, "so AJ whats it like to be invincible?"
God has really blessed me by surrounding me with wonderful people. As wonderful as they are, how much more wonderful is our perfect God! He sticks closer than a brother, wife or friend.

Friday, March 09, 2007

Erik's Journal

Awesome news! Erik is improving and he's slowly coming out of his coma. He is able to make hand signals and respond to his wife, Roxanne. Read the latest journals written by his sister at the link below.

Gto http://www.caringbridge.org/cb/visitAPage.do and type erikgreene for the site name.

Some specific prayer requests:

Pray that he will continue to come out of the coma. He is progressing and is able to give hand signals to answer questions and communicate. He’s even able to focus his eyes for short periods of time.

Pray that his kidneys will begin to function. He is still on dialysis every other day.

Pray for the family as they look for a place to move Erik to—after the hospital discharges him. Right now the only place they can find is rather far away.

Pray that Erik will be able to be removed from the ventilator in the next day or so.

Erik is uncomfortable—with all of the tubes and machines attached to him. Pray that he will recover enough that these can all be removed.

Wednesday, March 07, 2007

I Feel Good

The great thing about AJ and Gracie is that they don't really know or care that I'm battling cancer. That helps me feel normal when I'm around them.

I'm feeling a lot better now that I can eat. For the past 5 days I've been eating anything I can get my hands on to try to gain some weight before radiation starts. The thing is that I still have to eat slowly and carefully lest I bite the sore parts of my tongue. My neck is still sore, but it isn't really uncomfortable unless little Gracie punches me in the neck when I'm cuddling her.

Being off work has been a blessing because I've been able to spend a lot of time with my wife. The only exercise that I've been able to do is take brisk walks with Grace around the neighborhood or up the hill to the supermarket. Those are my most enjoyable parts of the day.

I remember the first night in the hospital the nurse asked me to try to walk to help my circulation. I walked about 5 steps and then had to go back and get in bed. Now, other than being a little tired, I feel good. Praise God!

Sunday, March 04, 2007

My Wife

She’s so beautiful.

In 2002 I ended up moving across the street from Grace's apartment in Los Angeles and that's when we became good friends. We always had so much to talk about and we shared so much in common. We became good friends, fell in love and got engaged there on Kelton Avenue in Los Angeles. We then got married in New Jersey on January 10th, 2004 and moved to Seattle.

Grace has been my best friend ever since. When she hears the garage door open when I arrive home from work Grace and the kids all hurry to the top of the stairs and wait there. When I come around the corner I see her smiling radiantly with Gracie on her hip saying, "Welcome home!", while AJ stands at her feet saying, "Pops, home. Pops, home!" I love my job, but I really really love coming home.

Grace is not only my best friend, she's also my biggest fan and she supports me no matter what. She sacrificially gives of herself to her family every day. The way in which she has supported me through this trial has given me great hope, and it has taught me how I ought to support others. If not for her I would probably still be slumped over in my bed depressed and wasting away.

When I was first diagnosed with cancer I was so fearful of the future. Grace came to me and said, "No matter how bad it is, we're going to fight this. Even if its all over your body we're going to fight this cancer together." These past six weeks I've watched Grace boldy step up to all of our challenges. She's more amazing than I could have imagined.

Grace continually teaches me how to sacrifice for, encourage and strengthen others. She loves the Lord so much, and helps me to love Him more each day. If anything good ever comes out of me these days it is because of the encouragement and support of my wife. She is so strong, so bold, and so bright, yet so gentle and so caring. There isn’t another woman on this earth like her. She is so precious, and yet I don’t show enough gratitude to her for all that she has done for me and our kids. I love her so much, but I don’t deserve her. I don’t deserve half the woman that she is. Thank you, Lord, for giving me such a precious, undeserved gift.

Friday, March 02, 2007

The Pathology results

Dr. Futran called last night and confirmed what we were all expecting. Thankfully they were able to get the whole tumor out with clear margins. There was no cancer in the lymph nodes on the left side, but there was cancer on the right side. That means I will need to have radiation treatment to the right side of my face and neck area.

Grace and I were pretty much prepared for the news, so it didn't sadden us too much. We've spent the past week thinking about radiation and mentally preparing for it. Praise the Lord for providing Dr. Futran and his team who were able to get the entire tumor out through the mouth, even though Dr. Moore (the doctor from Swedish) didn't think it could be done without cutting the jaw. We really like Dr. Futran because he's not only a skilled doctor, but he's a really nice guy. His confident, yet kind, personality takes the edge off the pain and fear that comes with cancer treatment.

Anyhow, today was a pretty good day. It snowed about 6-8 inches yesterday and so I got to wake up to the sun glistening over the snow-covered ground. That was a real treat considering the typical rainy cloudy weather we've been getting for the last month. I also got to take a nice long walk with Grace through a trail in our development. One of the cool things about being home these past couple weeks is being able to spend lots of time with my wife.

This may sound funny, but the best part of the day was actually eating a pork chop. I've been starving for real food for 2 weeks now. When we sat down at dinner I initially wasn't planning on even trying to eat it. But then after everybody started digging in, my famished stomach took control of me and cut a piece off the pork chop. I carefully chewed it and savored the flavor and quickly took another bite, and another. It hurt to eat it, in fact I even bit myself trying to eat it. But it tasted so good that I was willing to endure the pain. I'll probably do it again too.