Build on Success

 "The LORD was ready to save me: therefore we will sing my songs to the stringed instruments all the days of our life in the house of the LORD." -Is 38:20

[Running with my brother Eric (I'm in the gray shirt). You can only see part of the full-length rainbow.]

High-Level Process Update

I started a chemo again on Jul 11. Surgery recovery was much longer than I expected it to be, but for all practical purposes I am fully recovered. My abdomen stopped shrinking a few weeks ago, which doesn't bother the surgeon or oncologist at all. I, on the other hand, don't appreciate having the "dad bod" back that I worked so hard to get rid of several years ago. And then stick a giant colostomy bag on the front of it - but not centered, just over to the left side. But if this is what I'm complaining about, life must be pretty good... 

Surgery Recap and Overall Status

You might remember back in May I had emergency surgery to remove the primary colon mass because it had caused a complete obstruction. So the tumor from which all other cancer spread, and the associated lymph nodes, have all been removed. I am left with 4 tumors on the liver and one small one on the left lung. There used to be another even smaller one on the left lung, but it became nonexistent or too small to measure while I was on chemo before.

I had a CT scan just before surgery, and another one approximately two months later before restarting chemo. You would think with no treatment of any kind during that time, it wouldn't be a pretty picture... What actually happened is that the largest tumors on the liver and the one on the lung stayed about the same, and the other two on the liver actually shrank. There was nothing new found anywhere else in the body. I praise God for His goodness on this point by itself, let alone the rest.

I still never had any infection or complications with anything during recovery. One place on my incision looked like it was going to open up and get infected, but I prayed about it, and it healed right back up again on its own.

The surgeon believes eventually I should have liver surgery, but others believe I shouldn't. So we're still putting that off indefinitely. As long as the tumors are shrinking and/or not growing, and my liver function is good, I would rather avoid surgery. I didn't enjoy it last time, and that was with basically zero complications.

In fact, to my own surprise, I'm not even that eager to get my colostomy reversed. Eventually yes, but I am in no hurry to get back into the OR.

Chemo Status

The regimen I was on before was known as FOLFIRINOX, which is florouracil (or 5FU, the main 60-year-old drug they give almost everyone with gastrointestinal cancer, which you take home in a pump for 2 days after every infusion), irinotecan (the one that comes from the tree in China), and oxaliplatin (the one that gives you neuropathy and sensitivity to touching anything cold).

This time I have irinotecan again, and a monoclonal antibody called panitumumab (the brand name is Vectibix, which is much easier to say). This one gives you a terrible skin rash - it's sort of like getting acne in every single skin pore, and then sunburning it. But I have to say it was better than nausea. I say "was", because after waiting 2 weeks (I guess to make sure I actually got the rash, or maybe to make sure I would be thankful for it), my oncology team prescribed an antibiotic - It works wonders. Not perfect, but very manageable.

In the past 7 weeks I've needed a total of four nausea pills. Energy level for the most part has been excellent (see picture above, and further explanation below). 

The only things I'm taking right now other than the nausea pills mentioned above are liposomal vitamin C (10 grams a day), vitamin D, and Ativan and melatonin for sleep (80 mg per night).

CEA (carcinoembryonic antigen) is a rough measure of tumor load in the body. This protein should only be present in cancer patients and if you are pregnant. Normal level is under 3. Dr. Yang said several months ago that he would be happy with single digits. It was 314 when I was diagnosed last year. 

The first chemo regimen brought it down to the 30-50 range from Dec 2021 to Mar 2022 as you can see in the chart below, and it stayed there for a few months until I started chemo again. The last measurement was 5.5.

To me this represents God's answer to many of your prayers. My dad prayed for more time. I survived and recovered from emergency surgery. The imminent threat of cancer is decreasing. Chemo is having a minimal impact on normal life right now. What else could I ask for??

My dad said on his way out the other day after my last infusion, when we got this last test result, that now is not the time to slack off - now is the time to double down and keep doing what I've been doing. Right on.

Fitness Status

This is another place where I have to say this is the work of God... I wasn't exactly running 8-minute miles or keeping up with Christina on 5-6 mile runs before, so why am I able to do that now? Everything in terms of physical strength is going in a good direction.

In terms of lifting I've stuck with low weight / high reps so I don't tear anything: 3x10 sets of squat @ 125 lb, overhead press @ 55 lb, bench press @ 95 lb, and deadlift @ 125 lb. It has taken a while to work up to this point. On the off days I do more bodyweight exercises like pullups, dips, and pushups, or running.

I have to make myself stick with it - I realize this isn't enough weight for most of my friends to even warm up with. Every single workout involves a mental battle. There is nothing in my body that wants to do it, or even wants to agree with it in principle. I do think chemo makes this worse, being mentally defeated and afraid to put effort into ANYTHING.

Build on Success

Maybe I should back up and explain again why I think my fitness work is important. For one thing, there is a small amount of research to say that high-intensity muscular exertion hastens cancer cell death. Next, all researchers of either persuasion (mainstream or anti-mainstream) all agree 100% that cancer patients to exercise regularly live many years longer than those who don't.

More importantly, if I can be disciplined in physical fitness I can more easily be disciplined in more important areas of life. I can be more disciplined in my thoughts (I think I had a blog post about that). I can more easily believe that I will be successful in other parts of my life if I am successful in this one part of my life. This helps me conquer fear and mental defeat, which is important when dealing with cancer. Success builds on success.

Even more importantly, doing everything I can for myself shows sincerity in prayer. If I'm asking the Lord to work miracles, I want Him to see me putting some skin in the game.

"Know ye not that they which run in a race run all, but one receiveth the prize? So run, that ye may obtain.

"And every man that striveth for the mastery is temperate in all things. Now they do it to obtain a corruptible crown; but we an incorruptible. 

"I therefore so run, not as uncertainly; so fight I, not as one that beateth the air: But I keep under my body, and bring it into subjection: lest that by any means, when I have preached to others, I myself should be a castaway." -1 Cor 9:24-27

Have you ever run a couple of miles one day, then run a couple of miles again after a couple of weeks? How much benefit was there to your fitness? Zero. How much did it help you the second time that you had already run a couple of weeks before? Zero. 

You have to keep doing it. It only helps if you do it every day, or at least every other day. You only win if you make consistent efforts - day in, day out, over and over, building on success.

This is also and more importantly true of the Christian life. Please note in the 1 Cor 9 passage above, Paul is not making an argument for better physical fitness. He is using physical fitness as an illustration of how we should live to please God - like there is only one winner and we will do anything to be that winner.

You will not become a spiritual giant in a day. The way I've been taught, David's regular spiritual exercises were confession, meditation, prayer, and self-examination (David is worth studying, by the way, here or even more here).

The Crook in the Lot

This is a great little book to read if you ever have a prolonged circumstance in your life that bothers you and is out of your control. The title is based on Ecc 7:13 - "Consider the work of God: for who can make that straight, which he hath made crooked?" The "crook" is the particular circumstance that bothers you, and your "lot" is your overall hand of cards dealt to you in life by God.

The first point made in the book is this: "Whatsoever crook there is in one's lot, it is of God's making." This was also point #1 in the sermon series Understanding Affliction that I referred to in an earlier post. And if you think about it, this is the only point we REALLY need. Afflictions are from God. And knowing Him, we should be able to conclude that He means to accomplish some good for Himself and for us in it. This should be good enough reason for us to bear it cheerfully.

In explaining several ways a Christian should respond to a crook in the lot, one of them is "Profitably" (pg 68). Meaning, "that we may gain some advantage thereby (citing Ps 119:71, Rom 5:3-5, Heb 12:11). More: "And it is certainly an ill-managed crook in our lot, when we get not some spiritual good of it. The crook is a kind of spiritual medicine; and as it is lost physic that purges away no ill humours, in vain are its unpleasantness to the taste and its gripings endured; so it is a lost crook, and ill is the bitterness of it borne if we are not bettered by it." 

In other words, don't let a good trial go to waste. As my brother Eric said once, God gives us easy lives so much of the time that we don't get many chances to experience a significant trial. So we should get as much benefit as possible out of the ones He sends our way, and by all means handle them correctly.

And what would be "correctly"? From one angle, "Better it is to be of an humble spirit with the lowly, than to divide the spoil with the proud (Prov 16:9)". Starting on page 81 there is a long discourse explaining the difference between the lowly and the proud in dealing with crooks in their lots, which are experienced by both types of people.

What is a lowly person: "They think soberly and meanly of themselves; what they are; what they can do; what they are worth; and what they deserve. Viewing themselves in the glass of the divine law and perfection, they see themselves as a mass of imperfection and sinfulness." "They think highly and honourably of God." "They think favourably of others." "They are apt to magnify mercies bestowed on them." And so a lowly person in affliction justifies God rather than themselves (see prior referenced sermons from Job). "They see it is of the Lord's mercies that it is not worse; they take up the naked cross, as God lays it down... and so it becomes really more easy than they thought it could have been, like a burden fitted on the back" (Lam 3:26-29, Hab 3:17-18, 1 Sam 30:6).

And what about the proud when they encounter a crook in the lot (or a "cross" or a "yoke" as it is referred to in this passage)? "Their spirits were never subdued by a work of thorough humiliation, they remain at the height in which the corruption of nature placed them: hence they can by no means bear the yoke God lays on them. The neck is swollen with the ill humours of pride and passion; hence, when the yoke once begins to touch it, they cannot have any more easy." "They have an over-value for themselves; and so will not stoop to the yoke; it is below them." "They have an unmortified self-will, arising from that over-value for themselves, and they will not stoop. The question between heaven and us is, whether God's will or our own must prevail? Our will is corrupt, God's will is holy; they cannot agree in one."

"It is better to yield to Providence than to fight it out, though we should win." "It is of so much greater concern for us to get our spirits brought down than our outward condition raised." "Think with yourselves how dangerous and hopeless a case it is to have the cross removed before the spirit is humbled. That is, to have the means of cure pulled away and blocked up from us, while the power of the disease is yet uncured. To be taken off trials ere we have given any good proof of ourselves, and so to be given over of our physician as hopeless.

"This is the time of humiliation, even the time of this life... As He has a special aversion to pride of heart, He has a special liking of humility... It is no easy thing to humble men's spirits; it is not a little that will do it... The whole time of this life is appointed for humiliation." "There is no humbling after this. If the pride of the heart is not brought down in this life, it never will be..."

"Wherefore, beware lest you sit out your time of humiliation. Humbled we must be, or we are gone forever. And this is the time, the only time of it; therefore, make your hay while the sun shines; strike in with humbling Providence, and fight not against them while you have them. The season of grace will not last; if you sleep in seed time, you will beg in harvest."

Perhaps the most meaningful and personal part of the book for me was the end of chapter 1, where the question is asked "why God makes a crook in one's lot?" The number one reason: To prove if I am in a state of grace or not, whether I am a true saint or a hypocrite.

Three examples of this are given:

1. Job: "The question was, whether Job was an upright and sincere servant of God, as God himself testified of him; or but a mercenary one, a hypocrite, as Satan alleged against him? And the trial hereof was put upon the crook to be made in his lot (Job 1:8-12; 2:3-6). Accordingly, that which all his friends, save Elihu, the last speaker, did, in their reasoning with him under his trial, aim at, was to prove him a hypocrite; Satan thus making use of these good men for gaining his point."

2. Israel in the Wilderness: "As God made trial of Israel in the wilderness, for the land of Canaan, by a train of afflicting dispensations, which Caleb and Joshua bearing strenuously, were declared meet to enter the promised land, as having followed the Lord fully; while others being tired out with them, their carcasses fell in the wilderness; so he makes trial of men for heaven, by the crook in their lot."

3. Rich young ruler: "Our Saviour, to discover the man to himself, makes a crook in his lot, where all along before it had stood even, obliging him, by a probatory command, to sell and give away all that he had, and follow him, 'Sell whatsoever thou has and give to the poor, and come take up the cross and follow me'. Hereby he was, that moment, in the court of conscience, stripped of his great possessions; so that thenceforth he could no longer keep them, with a good conscience, as he might have done before. The man instantly felt the smart of this crook made in his lot: 'he was sad at that saying', that is, immediately upon hearing of it, being struck with pain, disorder, and confusion of mind, his countenance changed, became cloudy and lowering... He could not stand the test of that crook; he could by no means submit his lot to God in that point, but behoved to have it, at any rate, according to his own mind. So he 'went away grieved, for he had great possessions'. He went away from Christ back to his plentiful estate, and though with a pained and sorrowful heart, sat him down again on it a violent possessor before the Lord, thwarting the divine order."

What about me? Will I humble myself under the mighty hand of God and submit to His will in my health and the length of life? Or am I faithful and thankful only when things are going my way, as Satan accused Job? Am I a true saint or a hypocrite?

What about you - what would you do?

Back to Normal Life

It took me a long time to get back around to writing because normal life has been busy (besides the fact that I don't find health matters like this to be very interesting). We took a family vacation to Hilton Head in June, and I've been back to work at the plant for several weeks. Work for me, by the way, is busier than usual with the latest X7 launch, because the smart people are busy with the next launch after that - the very interesting [redacted by BMW corporate communications]. Homeschool started back last week. For the past couple of weeks we've been wrapped up in a minor construction project in our back yard. Another daughter turned 13. So really everything in life is going fine and completely normal.

A couple of people I work with have commented that they wouldn't be at work if they were in my shoes. But the way I look at it, my best chance at survival is continuing to be faithful in every duty I've been given, to the best of my ability, even if the duty itself doesn't seem important in light of my present circumstances.

The Passage at the Top

My brother Chris shared this passage with me sometime after my diagnosis when we had an ongoing discussion about the role of faith in results. Those words were said by king Hezekiah after he was told he would get 15 more years of life, after initially being told by the prophet Isaiah that he was about to die at 39. Those words, "The LORD was ready to save me," have become very meaningful to me. What else is He "ready" to do if we just ask?

I just never want to fall into the next pitfall Hezekiah fell into after he was delivered: "But Hezekiah rendered not again according to the benefit done unto him; for his heart was lifted up: therefore there was wrath upon him, and upon Judah and Jerusalem." -2 Chron 32:25

Unless the Lord returns first, one day sooner or later I will decline and get weaker, and my organs will begin to fail one by one. But until then I have to stay the course in faithfulness with every duty... "While I live will I praise the LORD: I will sing praises unto my God while I have any being." -Ps 146:2

[Incredible photography of a recent thunderstorm in Greenville. I love thunderstorms. Taken by my colleague Andy from his apartment balcony downtown. Used without permission but probable forgiveness. Maybe a coffee would be enough?]