Friday, December 30, 2011

Day 9

Christmas Eve Dinner - That's Renee in the window :-)

Hello Friends, today is day 9, which has no particular significance....just time for an update.  There's not a lot to report - nothing moving on the blood count radar yet - I have essentially zero white cells, as my immune system has been effectively taken out by the chemo.  I am getting blood and platelets as needed, again very routine around here.  My low counts make me very tired, so I need extra sleep.  The chemo side effects have not been too bad, I have a couple of sores in my mouth and occasionally I feel a little queasy but we should be getting near the end of that shortly.  The main medical / comfort issue is my sinuses, which continue to be blocked, causing pain and trouble breathing (through my nose) at night......I had similar symptoms after hyper cvad treatments  but they were not as severe and I didn't get headaches.  So the docs are working that problem.  Well, my breakfast just arrived so I will leave it there for today.  We are starting to think that maybe my new stem cells will kick in within the next week or so......appreciate your prayers in that regard......Happy New Year to all.......Dan

Sunday, December 25, 2011

Day 4 Update

Today after the Transplant Floor "Pole Parade"
 Merry Christmas, everyone!  We have had a very good time here at MD Anderson - making the most out of this most unusual Yuletide season.  Last night, Renee organized a gathering in the lounge here complete with appetizers, wine (not for me!), gifts to open, and a dinner of chicken pot pie from Costco.  We took over a corner of the lounge and got on with it!  Renee's parents joined the four of us and made it a special occasion.  We even had cheesecake for dessert.  Yum!

Kenyon spent the night here with me last night and Renee and Rachel made a breakfast casserole and brought it over here this morning....we had another gift opening time after that and have been talking with family on the phone and watching Christmas movies since then.  Bob and Vaun returned to Raleigh today.
The sympathy card pays off big-time for Dan
 Medically, I have been stable - I have some minor issues but my doctor says I'm doing very well and to keep it up.  I'm on anti-nausea drugs and eating pretty well, walking 3 miles a day on the floor.  No intense workouts for the time being ;-).  I've gotten through one week of post-chemo side effects and will have at least one more week - if it's no worse than this week, I will be very fortunate.  Of course we are anticipating and praying for my new stem cells to wake up and start producing blood cells, but it's a little too early for that yet.  Renee and I wish you and yours joy and peace this blessed Christmas season.   

Dan's World - Party on, Dan!  Excellent!

Wednesday, December 21, 2011

Hello Friends, just a quick update on "Day Zero".....all went well, the transplant is very  much like a blood transfusion - it was done with two 'bags' of cells, one late morning and one around 2:30-4:00.  There were no side effects....but the side effects from the chemo continue and they could worsen - so far they have not been bad but I was very tired today and spent a lot of time in the bed.  I did manage to get out twice for laps around the floor.  The next milestone will be 'engraftment', which I think I have mentioned before - that could take anywhere from 7 days to 20+ days, so we have some time to wait on the Lord.  Merry Christmas to all....Christ is Born!!  Dan

PS there's a picture on my facebook page from today  :-) 

Monday, December 19, 2011

Crunch Time......

The Nurse Assignment board for floor 11, NE Pod.  I blocked the other patients' names.
Ho! Ho! Ho!  Merry Christmas to is my last day of chemo, which means I will start feeling very yukky very soon - I am already on anti-nausea meds 3 times a day - fortunately it is very effective, so I don't feel really sick, just what I call a little 'green'.  It will get worse over the next several days, my docs and nurses promise.

Our floor has a little exercise room that I am taking advantage of while I feel well enough.

Since we last "talked", Laure left to go back home on Friday and had a great reunion with her family on Long Island - bless her heart, even though she was so homesick, she felt badly for "leaving me" just as I start the long and difficult part of my trial. 

As for today's pictures, I thought I would show you a little bit of my hospital home away from home (apartment) from home (Raleigh) .  The nurse board shows the patients and nurse assignments for our pod, which is one of 4 pods on this all-SCT (stem cell transplant) floor - so there are 56 patients on the floor and it is pretty much always full.  There is also an overflow floor where there are usually another 10-30 SCT patients - so typically there are anywhere from 70 to 85 SCT patients here at MD Anderson, which makes it the largest SCT facility in the US....not sure about the world, but I believe it is.

On the last 3 mornings, I have bothered the nurses to open up the gym room at about 8 am - only security or a physical trainer can open it - and someone (a nurse or an assistant nurse) - has to be in there with me at all times, but they are  very supportive of maintaining physical fitness and activity levels - my nurse yesterday said that in a couple of days I will need to be coaxed out of bed to get walking laps around the floor because I will be sick and exhausted.

One corner of my room
   As you can see above, we've added some homey touches to the room - Renee got me the mini-Christmas tree and decorated it;  Laure gave me the 3 framed photos (from left to right), and Renee's parents brought the rightmost frame, my digital frame, along with them in Renee's car.  Bob and Vaun arrived here on Saturday after a 1200 mile drive in Renee's car - so now we have our own car and returned the rental.  Also, Rachel arrived yesterday and spent the evening here with was GREAT to see her again;  she will be here on her Christmas break until January 4.  Kenyon will arrive here on the 23rd, so while this will be a very unique Christmas, we will be together and that's what is important. 

Medically, this is my last day of chemo and I am starting to feel lousy.  I just got my blood counts and my white count crashed in the last 24 hours, from 2,000 to 400, and my neutrophils are zero - so now is the time to be hyper-vigilant about infection, as I am essentially defenseless.  This is all exactly as the procedure is designed.  Tomorrow is a "rest day", ie no chemo, and Wednesday the 21st is day zero, a.k.a. transplant day, a.k.a. infusion day.  What I can expect over the next three weeks is a week or so of harsh chemo side effects, including nausea and mouth sores, and a couple to three weeks of very low blood counts which will cause extreme fatigue.  Once I have Laure's stem cells infused, there is a waiting game for her cells to "ingraft", which will be indicated by the beginning of the recovery of my counts.  This is estimted to take 2 to 3 weeks from day zero.  The ingraftment is the #1 prayer request.  If the new cells do not ingraft by day 28, the transplant is considered to have failed and we will likely begin again with another attempt.  That is unlikely, but as you know, other unlikely things have happened:  i.e., most recently, Laure's collection process taking 10 days instead of 2. 

Second on the prayer request list is for little to no graft-versus-host-disease (GVHD), which is when the new immune system attacks healthy parts of the recipient's body that it shouldn't, like the skin or liver.  It can be mild or severe, even fatal in rare cases.  The third request is to remain infection-free, fourth is for side effects being minimal or at least better than advertised.  Please don't forget Renee and the rest of my family that is here in your prayers.

We continue to trust the Lord.  We had a heart to heart with Rachel yesterday evening that was one of those unforgettable discussions where Rachel declared her faith that everything was going to be OK, even though she knows that there is no guarantee of the success of the treatment.  I said that there is only one way that I will not make it through this process alive in body - ONE WAY - and that is if the Lord wants me in Glory with Him.  We all agreed again that I cannot lose this battle, and even that the phraseology 'so and so lost their battle with cancer' is inappropriate in light of the promise of eternal life, the victory over death that Christ won for us on the Cross and sealed with His resurrection on the third day.  Victory - is all that is in my future - victory over cancer or victory over death.  Halelujah!

Forgive me for such a long post;  I hope you are still with me.  All the Rookers, Moores, DiCiccos, McKennas, and McElraths send you warm wishes for a blessed and joyous Christmas and Holiday season.  Please remember us in your prayers as you have been doing so faithfully and wonderfully.  Til next time - Dan and Family

Thursday, December 15, 2011

Phase II Underway

Laure and I with her 5th and Final Collection on Tuesday Afternoon

 Hello Friends, I was just poking around on the blog utility and for the first time saw some data on "page views"....kind of interesting - it said there were 171 page views yesterday.  I was impressed! 

Renee has divided our stay in Houston into 3 phases - Phase I was the time prior to my admission to the hospital, Phase II is the period when I am an inpatient, and Phase III is the time after my discharge from the hospital, while still here as an outpatient.

So using that nomenclature, we have entered Phase II !!  Laure was able to donate again on Tuesday and we learned early Wednesday that the count from that donation was 1.22 million cells (per kg), bringing the 5 session total to exactly 4.00 million cells.  Since my transplant coordinator had tentatively scheduled my hospital admission and associated activities for Wednesday, everything was set and I was admitted yesterday evening at about 6:30 pm. 

Laure is still here and will be flying home tomorrow morning.  She ended up being here in Houston for 17 days and travels home on her 18th day.  I cannot tell you how grateful I am, and Renee is, for her commitment and patience through this process - of course she says that's silly, she never even gave it a second thought.....but still, I am so grateful.  Laure observed yesterday that she and I have not spent this much time together in our adult lives - the closest thing we can remember to spending this much time together is one of those 2 week station-wagon vacations out west when we were in our early teens.  I believe that the Lord had a good reason for this week-long delay, and it could have been just that - it's been a blessing to have so much time together, and honestly, there have been no cross words, arguments, or any rancor at all - certainly some fatigue and anxiety during the early part of the collection process, but once her stem cells lost their shyness, the enthusiasm returned. 

This post is getting longer than I intended, so let me wrap it up - I'll say more about the hospital tomorrow or Saturday.  You can see a pic of me in my room below.  Today is "day minus 6", and also my first day of chemo as we count down to transplant day on December 21 ("day zero").  I still feel fine and remain remarkably busy.  We wish you and yours a blessed and joyous Holiday season - we will be worshiping our Heavenly Father for His amazing plan of redemption through His son Jesus - Emmanuel, God with Us.

Wishing you Peace, Hope, and Love - Dan, Renee, and Laure

Large man in a small but festive hat

Tuesday, December 13, 2011

A Good Day in the Apheresis Center

My Nephew John DiCicco (Jill's son) and Finn, Rice Lake, Wisconsin, August 2011

Greetings Friends!  Another quick update - Laure's collection yesterday (#4 for those of you keeping score at home) yielded 1.14 MILLION stem cells - yee haw!!  That brought the total to about 2.8 million, just a few hundred thousand short of the goal.  The other good news from yesterday was that her platelets had boomed over the weekend, to 104,000, which resulted in her being able to donate again today, rather than have a rest day(s)s in between.  So at the moment, we are in the apheresis room for what should be the last time.  Dr. Korbling was just here to see us and he is confident of that as well. 

That means that Laure should be able to fly home on Thursday after 17 days in Houston and 5 stem cell collection procedures BLESS HER HEART!!  For me, it means that I can be admitted to the hospital tomorrow afternoon and get down to business with a one week delay;  chemo would start on the 15th (thursday) and "day zero", transplant day, would be the 21st.

That's all for now, I will post again when all this is confirmed tomorrow.  All praise and honor and glory to our heavenly Father and our Lord Jesus Christ - He is more than able!  Dan, Renee, Laure :-)

Monday, December 12, 2011

Steady Progress

Descending from Mt. Clark, Yosemite, 2004
Hi friends, I know it's been 5 or 6 days since my last post, so a quick update....Laure had rest days on Wednesday and Thursday while her platelets recovered;  Friday she donated 700,000 stem cells, bringing our 3 session total to about 1.7 million.  We need a minimum of 3 million, so we are hopeful that she will hit the magic number in 2 more sessions.  There is a chance at any point that she will "pop" and go to 1, 2, or 3 million cells in a single session, or we could just keep seeing this slow, steady pace......we're in the hospital right now and just started session 4.  We are enjoying some of the interesting cuisine of Houston and we've had some great meals in the apartment as well.  Laure is getting nupagen shots twice a day, so each day starts with a blood draw (to check platelet count) and shots.....then we have to come back in the afternoon for shots again.  To say the least, Laure is a TROOPER.  While this phase has had its frustrations, we continue to wait on the Lord and seek His peace and His joy as Christmas approaches.  I will update the blog again when we have the results from today's collection.  Dan

Wednesday, December 7, 2011

Apheresis non Rapidium

Laure making a generous donation

Since Friday, our main focus has been the stem cell collection process, of which Laure is the star.  She has her "own" doc in the transplant clinic, a gentleman of German extraction named Dr. Korbling.  The process is called apheresis.  So my little joke in the title of today's post indicates that the process is not moving along at a rapid pace.  It normally takes 1-3 days to collect the needed stem cells, but it looks like we will be at it for several more days and likely into next week.

The process begins with Laure getting shots of a drug called Nupagen, which causes the bone marrow to push stem cells out into the bloodstream.  After 3 days of Nupagen shots, the first collection is done;  for us that was Monday.  The goal is 3 to 4 million stem cells per kg of bodyweight (of the recipient), and the first day produced only 300,000 cells per kg.  Laure was back in there on Tuesday afternoon and they got another 600,000 we still have at least 2 million cells to go - the docs remain confident that it's just a matter of time.  There is another regulating factor - each time they collect, platelets are also collected (the technology cannot remove all platelets from the collected stem cells) and therefore reduced - if the donor's platelet count goes below 70,000, we have to pause and let her counts come back up - so today is one of those days where we are waiting for Laure to gin up some more platelets.  The next several days will be a combination of more shots, more collections, and some resting/waiting for platelet counts to come back up......

My transplant therefore will not happen on the schedule I spoke of on Friday; as I may have said before, they will not admit me to the hospital (and therefore start chemo) until we get to 3 million stem cells per kg from Laure - our best guess is that we may move everything out a week, but it's impossible to know for sure. 

The apheresis process involves establishing a blood circuit where blood comes out on an IV in one arm, goes through a machine (centrifuge) that separates and stores the stem cells, then sends the blood back into the body via another IV in the opposite arm - during the course of a 4 hour procedure, all of Laure's blood goes through the machine 3 times.  At any given moment, there is about a cup of blood out of her body (tubes, machine, etc).

Obviously we are all a little frustrated and impatient, but trying to give this all to God and continue to trust Him, and look for the little blessings that He continues to shower us with.  And of course the BIG blessings,  like we had on Friday.  Another big blessing is that I continue to feel great and have been able to work out every day I've been here except one.

Prayer needs are for Laure's Nupagen shots to "kick in" and start cranking out stem cells- it's possible that we could get through this in one more collection, i.e., have a surge in production.  Also, that Laure's platelets would replenish rapidly.  Thanks everyone for your continued care, concern, love, and prayers.

Dan, Renee, and Laure

Friday, December 2, 2011

Great Ending to the Week

How cool is this?  Laure got to meet Dr. Keating with me today

2 Samuel 22:1-3
“The Lord is my rock, my fortress and my deliverer;
my God is my rock, in whom I take refuge,
my shield and the horn of my salvation."'s going to be hard to summarize the events of the past few days - I think I will make those of you who like detail happy - sorry to the rest of you :-)  When we met with Dr. Hosing on Wednesday, she was not nearly as sure that we would be going to transplant as we we led to believe on Tuesday.  She actually put the likelihood at 50/50, which was quite a shock - we got this news early in the day, so we were walking around in a bit of a fog for the rest of the day.....they promised to call us on Thursday morning after Dr. Hosing met with her colleagues and formed a consensus.  We got that call at about noon yesterday and the answer was that they were OK to proceed, but they wanted Dr. Keating's opinion as well - which is why I did not update the blog yesterday - as I said to Renee, Dr. Keating has surprised us a few times, so we didn't want to assume anything.

So we met with Dr. Keating this morning, and he just has a way of making everyone feel great, and he did it again.  He had a few bits of new and very good news - the first thing he said was that he supported the transplant option, so we finally had the last piece of the answer we thought we would have on Tuesday.  But, he also told me that my PET scan - a test which identifies tumorous tissue based on glucose absorption - was clean.  Which meant that the tumor that we have been so focused on, while it's still there, it's inactive, or dormant, and could even be scar tissue at this point - so it's less of a concern than we thought earlier in the week.  Dr. Keating also said that the percent of leukemic cells in my bone marrow had decreased from 52% in late September to 31% this week - this was a fortunate by-product of the 2 rounds of hyper CVAD - Keating called this 'minimal disease', which is what you want going into a transplant (if you're not in a complete remission).

So all in all, it has been another roller coaster week, but we are ending on a mountaintop.  Dr. Hosing and Dr. Keating both put the finishing touches on it today by telling me that with these most recent test results, they both feel I still have a 50% shot at being cured by the transplant.  The schedule for the next couple weeks is that Laure will have her stem cells collected on the 5th and 6th;  I will be admitted to the hospital on the afternoon of the 7th;  my chemo regimen will run from the 8th through the 13th;  and the transplant will be on the 14th (henceforth referred to as "day zero").

And now, for those of you who are still with me, a real treat - my first guest blogger, my sister Laure: 

A word from the "donor"- It has been a whirlwind week here with Dan and Renee. But, what a great hospital, and what great doctors!  We are so blessed to have the best care in the world.  Dr. Keating lived up to all expectations.  He is so warm, and funny.  Dan said, something that included, "if you cure me...." and Dr. Keating immediately interrupted and said "WHEN I cure you!!....."  and this not in any way and egocentric remark- he is just incredible. So,  I am thankful to be here and share this with them, and to play the part that God has given me to play- with Joy! 

Thanks Laure!  Apart from all the medical stuff, it's just been a blessing to 'hang out' together this week.

As always, we are borne along in this journey by your prayers, texts, phone calls, cards, love....please keep them coming.....Dan, Renee, and Laure  :-)

Tuesday, November 29, 2011

Lymphoma Update

Laure and I on our little balcony

GOOD NEWS TODAY!  My lymphoma has responded to the chemotherapy and the transplant doctor is planning to proceed.  I don't want to diminish the great news, but just to share all the facts, the tumor in my lung has shrunk, but is not gone - so I am not entirely sure how that will affect the likelihood of a complete cure of the cancer, but I will have a chance to ask Dr.Hosing tomorrow about that, and of course pass it along right here.  One other slight caveat is that Dr. Hosing meets with her peers every Thursday to discuss cases and she will get their input on my case - but that is not expected to change the direction - once again I will update you with any news from that.

We picked up Laure at the airport this afternoon and for the next 9 days Renee, Laure and I will be sharing this one bedroom apartment as we do all the preparatory tests over at the clinic.  The address here is

3 Hermann Museum Circle Dr.
Apartment 5319
Houston, TX 77004 

We are very relieved and full of thanksgiving and praise for this great news today.  God is faithful! 


Thursday, November 24, 2011

Gobble Gobble!!!!

This was taken in 1983 just before Renee met my parents

Happy Thanksgiving everyone - I wasn't going to post this weekend but I've been thinking since my visit with Dr. Kritz yesterday and I feel moved to take a moment and praise God for what has occurred over the last 2 months.  2 months ago, I had just been released from Rex Hospital with the new knowledge that I had 2 kinds of cancer - having added 'large cell lymphoma' to 'chronic lymphocytic leukemia'.  I was facing 2 rounds of what was described as a fairly harsh chemotherapy regimen (hyper-CVAD), with the added complication of pneumonia and associated symptoms.  I was told that my counts would esssentially zero out, that I would be sick, that I had a 50% chance of getting an infection and ending up in the hospital, plus a high likelihood of having to have transfusions to support my blood supply.  Additionally, there was a chance of having to delay the transplant while my counts recovered from the chemo.

Yesterday, Dr. Kritz pronounced me fit to travel on Monday - he was going to have me get my counts checked again on Friday and possibly respond with a shot or a transfusion to support my flight to Houston, but my counts were so strong that he said 'not necessary - you're good to go'.  In my mind, this marks a transition into 'transplant mode' from 'chemo mode'.  As such, I wanted to take a moment and thank God for how well these two months have gone - the blessings are many - the chemo had an immediately positive effect on my breathing, my lungs cleared, the side effects were not as bad as advertised, I did not get an infection, my counts recovered strong and soon, and I have been able to maintain my weight, just to name a few.  So - thanks be to God our heavenly Father and the Father of our Lord Jesus Christ, who is more than able to do more than we can ask or imagine!

There is one more hurdle before we officially enter transplant mode, and that is that when I get to Houston, I will get a cat-scan to determine the state of my lymphoma - what kind of remission, if any, full, partial, etc.  That test will be on Monday and I will get the results on Tuesday afternoon - if the lymphoma is not in a satisfactory remission, they will postpone the transplant and give me more chemo.  At this point our fervent prayer is (and has been) for a complete remission and full speed ahead with the transplant.  Please join us in this prayer request.

I mentioned our prayer meeting Sunday evening - if you want to joins hands with us in spirit from where you are, between 7 pm and 8pm eastern time will be the right time.  If you do, I would appreciate you letting me know that you prayed with will be a very special time and I would love to hear that you were with us in spirit.

Some of you have asked questions about the details and mechanics of the transplant process - I found a link at the University of Maryland medical website that is pretty comprehensive if you are interested - feel free to check it out - I did not find an equivalent resource at the MD Anderson site.  God's blessings, peace, and contentment to you on this Thanksgiving Day.  Dan

Tuesday, November 22, 2011

Jill's Visit

Jill with a dwarf donkey we met on our walk
Hello Friends, it's been 6 days since my last post and I guess you could say they have been far, the best part is that my sister Jill flew down on Friday and spent the weekend with us - we had a wonderful time, and Jill, Rooker that she is, cooked up a STORM for, we had homemade biscuits, homemade chicken soup, homemade mashed potatoes, homemade butternut squash soup, homemade cinnamon rolls, etc etc - with Jill, you can drop the "homemade" and just assume it - she doesn't cook any other way :-)  YUM!!

It was beautiful weather and we walked 3+ miles each day on Saturday and Sunday.  I was in low-low blood count mode so we had to be very careful about hugs, doorknobs, etc.

Without going into a lot of unnecessary detail, there were two hospital stays interspersed over the last 4 days - on Friday, Dr. Kritz sent me over to the hospital to get 2 units of blood - my hemoglobin was down to 8.0 - so that interfered a bit with Jill's visit - she arrived at noon, I checked in to the hospital at 3, and I got discharged at 1 am.  No complications, just a comedy of errors at the hospital that dragged the process out.....

Then, yesterday morning, I was getting platelets at the REX Hospital cancer infusion suite (good outfit and process) and began to have severe pains in my lower back, legs, and groin.....I got myself over to Dr. Kritz' office (barely) and they gave me some morphine....they also thought I needed more blood so they checked me back into the hospital at about 2 pm yesterday - they did a few diagnostics, checked my counts again, decided that I didn't need blood after all, and kept me for observation overnight.  I've been discharged now and am waiting for Renee to pick me up.  Dr. Kritz is pretty sure the pain was from a shot I got a week ago - the Neulasta shot sometimes causes significant bone pain as the patient's white counts recover.  I had not experienced it before (and I don't care to again!).  You know the pain is bad when you start making involuntary noises.....the good news is that my counts this morning showed good progress in all areas, so Dr. Kritz pronounced me "recovering".

Time is getting short now as we prepare for our trip to Houston.  We will be having a small gathering at our house with a few close friends on Sunday evening for a time of prayer, healing, and fellowship.  Renee and I really appreciate your prayers for what is to come - we pray for healing, but above that we pray for God's will to be done in our lives, so that we might bring honor and glory to Him in all things. 

Oh, and Happy Thanksgiving!!  We all have so much to be thankful for!   Dan

Wednesday, November 16, 2011

Schedule Taking Shape

Laure and I, Rockford, Illinois, circa 1968

 That's me and my big sister, Laure Rooker McKenna, in front of our house in Rockford, Illinois, about 43 years ago.  In about 3 weeks, she will donate her stem cells to me in a life-saving, potentially cancer-curing procedure at MD Anderson in Houston, Texas - now known as a stem cell transplant (was formerly known as bone marrow transplant).  I would be remiss if I didn't mention my kid sister, Jill DiCicco, who by genetic happenstance was not a match - all I can tell you is that she wishes she had been a match but rejoiced just as much for Laure being one.  Both my sisters would lay down their lives for me, and I for them.  "Greater love hath no man than this - that he lay down his life for his friends".....*snif* !!

The main thing today is to share with you the latest schedule for our temporary move to Houston.  

I spent some time on the phone yesterday with my MD Anderson transplant coordinator and we have a plan that goes as follows - 

-  Renee and I fly to Houston early on November 28th.  The first order of business will be to do CAT scans to determine if my lymphoma is in remission.  This is a "go / no go" decision on the transplant that I assume Dr. Hosing and Dr. Keating will confer on.  That afternoon Renee and I will "move" in to our temporary apartment near the medical center.  We are optimistic about the lymphoma but we need prayer for this - we are praying for "no sign of lymphoma" - i.e., a complete remission.

-  On Tuesday afternoon, November 29th, Laure will fly from NYC to Houston.  She will get pre-testing starting Wednesday - the main test will be blood labs, the results of which will be available Friday - this is a "go / no go" decision on her being a donor - it is routine and as long as her blood counts are within normal ranges, there's no issue.  

-  Chill over the weekend
Left to right - Jill, Matt (deceased 1993), Laure, circa 1992. 

-  Laure will start the stem cell donation/collection process on Monday, Dec 5 and continue Tuesday the 6th if necessary.  Both of us continue as out-patients during this time.

-  When they have a successful collection from Laure, probably sometime Tuesday afternoon, they will freeze it and begin the process of checking me in (probably Wednesday the 7th) and getting me ready for the conditioning chemotherapy, which might start late Wednesday or Thursday - that lasts approximately a week but I will not know that schedule until after the CAT scans and bone marrow biopsies are done.  The conditioning chemotherapy is designed to suppress my immune system so that it will not interfere with Laure's stem cells when they are infused.  

-  In broad strokes, I should be in the hospital for about a month, then move out into the apartment sometime between January 5 and 15, and continue with outpatient visits, side effect management, etc for another 2 to 3 months - Renee will be with me for the duration, splitting time between the hospital and the apartment, though we are planning at least one "home leave" for her in late January for a week.

The side effects from hyper-CVAD 2 have been very manageable so far;  this is "day 10" and I have a week of very low counts and mouth/stomach sores coming- so we're in germ-o-phobe mode now.  Let me know if you have any questions - more soon......God Bless....

Dan and Renee

Sunday, November 13, 2011

Rex Redux

Greetings everyone, my 2nd stay at Rex was much less eventful than the first, back in September.  No complications, no operations, no infections, etc.....lots of chemo, however.  They really took care of business, getting my 5 day treatment done in more like 4 days - I was in at 4 pm Monday and out at 5 pm Friday.  Since this is the 2nd treatment, I have a good idea of what to expect over the next couple of weeks;  so far I have felt OK, with some mild side effects - as before, the main thing is to try to avoid infection.  Your prayers are appreciated in that regard!

I've been on the phone with MD Anderson this week - transplant department - and I'll have a pretty firm date early next week of when they want me down there to get started on the transplant - still looks like somewhere between the 5th and 12th of December. 

Well. I'm just hanging out watching football, wanted to let you all know I was home and doing OK.  I'll keep you posted.  God bless..........Dan

Encore photo of "The Pizza from Chicago"

Wednesday, November 9, 2011

Weekend Wrap and Hyper CVAD Round 2

Wow, a lot has happened since my post on Friday, all of it good.  Friday night, Renee and Lisa Wetzel surprised me with a combination birthday party/sunday school class reunion at the Wetzels house - this is a dear group of close friends from our old church, the North Raleigh Church of the Nazarene.  We had a class called People Inc. that we were a part of for something like 12 years, and it was just wonderful to see everyone.  Thanks a million to Lisa for doing the heavy lifting in getting everyone there.

Good lung function, but only tested on 2 "representative" candles :-)

Saturday was our family birthday gathering, with Rachel home, my parents still here, Renee's parents, and Renee's sister Karen and her husband Scott, one of my best buddies - my brother-from-another-mother.  We also had a surprise special guest, another best friend, Jeff Williams, who has also graced the pages of this blog, most recently when he and I went fishing in California (Jeff's adopted home state) in June.  We grilled a whole tenderloin, for which my dad made a killer sauce out of shallots, red wine, and shitake mushrooms....oh baby....

Jeff crashes the party, bearing champagne - GREAT blessing / surprise.

Noshing, sipping, fellow-shipping

 We wrapped up the weekend with a great dinner over and Bob and Vaun's house - the weather was just spectacular Saturday and Sunday.  All these wonderful occasions, put into context - 3 weeks ago the doctor said that there was a 50% chance that I would end up in the hospital sometime this cycle with an infection - so we could not really plan on anything, which is why we kept everything small and modest.  I love how God's plan unfolded - the events were just perfect, and my health was as good as could be.  "And now to him who is able to do far more abundantly than all that we ask or think, according to the power at work within us, to him be the glory in the church and in Christ Jesus, throughout all generations, forever and ever.  Amen."  Ephesians 3:20-21, ESV.

At Bob and Vaun's Sunday evening
 So you facebookers know that I am in the hospital, but to update you blog followers, on Monday, Dr. Kritz was satisfied with my counts, though my neutrophils were only 1100 - up from 1000 on the previous Wednesday.  We decided to move ahead with Round 2 of the hyper CVAD, so I checked in to the hospital at about 4 pm Monday.  The treatment should take 5 days and I am hoping, best case, to be discharged Friday around dinner time.  So far everythig is going well, in fact my white cell and neutrophil count popped up this morning to almost 3000 - Dr Kritz says that's due to the prednizone I am getting with the chemo - in any case it's a very good thing.  I still feel OK and I am a lot stronger going into this treatment than I was my last, with pneumonia and all the weakness, breathing issues, fever, am am praying this cycle will be as uneventful as the first.

Preparations are underway for our long trip to Houston - it seems everyone is eager to keep treatments going without any unnecessary delay - now they are talking about getting me to Houston for Dec 5....we'll see....

Thanks as always for your prayers and support.  Let me and Renee know how we can pray for you.  Dan 

Friday, November 4, 2011

Half Century Mark

Pizza in it's last moments
Greetings friends, thought I would put up a quick post with some photo highlights of the last few days - On the day my folks arrived, my Mom had hand-carried a frozen, stuffed Giordano's pizza - a longtime favorite of mine - to Raleigh.....bless her heart!!  And we ate it!  Photo above.  I saw Dr. Kritz on Wednesday and my counts are mostly improving - the only ones that have to get better before treatment are my platelets, which were up to 75,000, but they want above 90,000, and my neutrophils, which dropped from 1500 to 1000 - they want the neuts to be closer to 1500.  I see them again Monday and if the counts are where they need to be, I'll go straight to the hospital for round 2 (Rex Hospital).  If not, I'll go back on Thursday and try again.

The pic below was taken at Margaux's on my birthday - we were going to go to a Japanese restaurant but Dr. Kritz said no raw fish! - and what's the point of going Japanese with no raw fish?!  Margaux's is a wonderful place.  Sushi can wait.

Champagne Toast
the photo below was taken yesterday as my dad and I went out for a half day on Harris lake with a guide, looking for Mr. Bass - as you can see from the pic, it was a gorgeous fall day.

Fish on!
Fisherman's secret - stretch out arms to enhance apparent size of 1.7 lb bass :-)

We've had a wonderful few days with Mom and Dad, and they will be here for a few more days.  Thanks everyone for the birthday wishes on facebook, the cards, prayers and well wishes - I get to feel really good for a few more days but I am eager to get on with the treatment on Monday.  We believe the lymphoma is down, and we want to get in that knockout punch before it gets up.  God's blessings, grace, and peace to you all....Dan

Friday, October 28, 2011

"Feelin' Stronger Every Day"

Casting for spooky Yosemite trout in the Lyell Fork of the Tuolomne River

On Saturday I was walking through one of those spectacular fall days we are blessed with in North Carolina, and listening to Rich Mullins sing "The Color Green", the chorus of which goes:

"Be praised for all your tenderness by these works of Your hand
Suns that rise and rains that fall to bless and bring to life Your land
Look down upon this winter wheat and be glad that You have made
Blue for the sky and the color green - that fills these fields with praise!"

It was just perfect - here is a link to the Youtube video -

I am pretty much through all the side effects of the chemo (except my hair is nearly gone :-)  ) and feeling very good these days.  I have been walking 4 miles a day for the last 3 days - continuing to regain strength and weight.  I have a few cold symptoms; runny nose, sinus congestion, a minor cough - so Dr. Kritz put me on (yet) another antibiotic to help make sure it does not turn into an infection.  On Wednesday my counts were good: whites stable, platelets rising into the 60,000+ range, hemoglobin stabilizing around 8.1, so Dr. Kritz said we did not have to do a transfusion this week - next week is still a possibility if the hemo does not start climbing.  Dr. Kritz surprised both Renee and I by telling us to come back and see him in a week - - I have been in the clinic every other day since returning from Houston - so that was a great signal that I am in good shape.  My parents are arriving for a week's visit on the 1st of November, I turn 50 on the second, Dad and I are going fishing on the 3rd, and we'll have a small gathering for my birthday on the 5th.  So there is a lot coming up, including a Hurricanes game (with mask on!) tonight with Kenyon.  All this is subject to my continued good health, for which I look to the Lord for His sustaining grace and mercy.

I continue to be amazed, comforted, and encouraged by the prayer support that so many are providing - I have gotten cards from people I have never met - friends of friends who are praying for Renee and I - it means more than we can say.  Please know that it is deeply appreciated.

Round 2 of HyperCVAD looks like it will be the week of November 7th, of course depending on my counts getting to where they need to be.  More on that soon.  God's Grace and Peace - Dan and Renee

Saturday, October 22, 2011

Surprisingly Strong Counts!!

What can I say?
Hello friends, it's always a joy to bring good news - and on a glorious Saturday that is just stunning here....about 65 degrees, bluebird sky and light breezes....I walked for about 70 minutes this morning - feelin' stronger every day...praise God.  The big news is that my counts were up substantially yesterday, particularly my whites - they were 3,000, up from about 500 on Wednesday - the neutrophils were up to 2.4, up from .3 on Wednesday.  That means that I'm no longer neutropenic, and I have a reasonable infection defense now - which is great!  My physician's assistant (PA), Jessica, said the neutrophil pop could have been in part due to a Neulasta shot I had on the 12th (but that was quite a while ago)...she and Dr. Kritz are very encouraged about the counts - my platelets came up a bit, too.  The weekend and coming week should be about as close to being normal as I have been since early September - of course we are taking everything a day at a time and assuming nothing.  Still, we are very thankful and blessed at this latest turn.  Who knows, maybe a little fall fishing this week!  hyper CVAD round 2 is still open but it looks like maybe sometime between Nov 2 and Nov 9....we should be a little more certain next week.

Rom 11:36: "For from him and through him and to him are all things. To him be the glory forever! Amen."

Thursday, October 20, 2011

Hair is Over-rated!

This is not photo-shopped - that is a Bull Trout dad caught in Missoula in '09

Well, the hair is finally letting go....hung in there for a good while.  That's neither here nor there though, the main thing is that my blood counts showed a little spark yesterday - the white count poked up from "zero" to about 500, including neutrophils from zero to 300.  Dr. Kritz was pleased.  I feel pretty good, still weak from the low counts, mouth  and digestive tract still a little raw but all things considered, very thankful to be where I am.  If my counts continue to recover, I suspect we're looking at round 2 of the chemo (hyper-CVAD) in early November, and the transplant in early-to-mid-December (assuming - praying - that the chemo hammers the lymphoma!).  Your prayers continue to be a great blessing to Renee and I - our best to you.  More soon.....Dan

Saturday, October 15, 2011

Prayer for Today

Morning has Broken
Dear Lord,

Thank you for this beautiful morning, the quiet and peaceful sunrise through the trees, the sounds of birds starting their day...thank you for the ministry of your Spirit in early prayer.  Thank you for my dear wife, who is steadfastly honoring her vows before you to care for me in my sickness; what a blessing she is to me!

Thank you for the teaching of John Piper on the sovereignty of God in suffering - thank you for the profound truths concerning our trials, that they are of great importance in Your work in the world and in my life.  Thank you for the spiritual knowledge that all suffering will be redeemed for your Glory and the promise that we will fully understand all your plans and purposes one day.

Thank you for the Bible, your inspired Word, which documents events such as the life of Job - which has spoken directly to a suffering world, words of Life, words of purpose, words of hope for centuries upon centuries - and how it ministers powerfully to me today.  Thank you for stories such as Peter's denials of the Lord Jesus, which were preceded by Jesus saying to Peter, "Simon, Simon, behold, Satan demanded to have you, that he might sift you like wheat - but I have prayed for you, that your faith may not fail.  And when you have turned again, strengthen your brothers".  Thank you Lord for the way these stories strengthen me today.  How awesome is it to know that Jesus Himself is praying for my faith to be strong!

Lord please protect me today from disease and infection.  Please reveal more of yourself to me, Renee, my family, and all who yearn for you.  Thank you Lord for the outpouring of love, affection, care, prayer, and service of all who have reached out to me in this trial - words cannot express our emotions, how deeply we have been touched by so many people, some of whom we do not even know directly.  Thank you for the fierce love and support of my family who is not here in Raleigh - Mom, Dad, Laure, Jill - but who are praying without ceasing for me and Renee.

Lord there are many who have it tougher than I do - like the little girl we met in the waiting room at the radiology clinic, Sanaya.  Lord we lift up these little ones who have diseases - we pray for their comfort and healing - we pray that they all, like Sanaya, would have special knowledge of You and a special closeness to You - the blessed assurance that You love them and hold them in the palm of Your hand.

Lord we acknowledge Your supremacy in all things, that you are the ultimate end and desire of our hearts.  We worship You today and lift Your name in praise!  Amen.

Wednesday, October 12, 2011

Hey, It's Good to be Back Home Again.........

Rachel and I diving on Bloody Bay Wall at Little Cayman Island, 2010
Some of you may recognize that as a John Denver lyric...highly appropriate today.  Yesterday Renee and I traveled back from Houston and arrived home at about 1:30 pm.  Renee's parents plus Rachel and Kenyon were here to welcome us home to a spotless and highly disinfected house - carpets, upholstery, dog beds, everything....Rachel and Kenyon made an Italian vegetable/noodle/chick pea soup last night for dinner that was just the ticket for me.  I am truly blessed, and yesterday in particular by seeing R&K work together touchingly on a service project for their ol' dad.

The chemo effects have been manageable so far;  I have been taking anti-nausea medication every 8 hours and so far have not been ill.  Weak, yes.  I saw Dr. Kritz today and he seemed to think that I was out of the worst part of the nausea, which would be great.  I've eaten well today, including two additional helpings of Rachel's and Kenyon's hearty soup.  Just wanted to do a quick post to let you know that I am home and under the best care in the world (Renee).  It will be several weeks before we have a definitive answer on how the lymphoma is responding, but as I think I mentioned before, the respiratory symptoms having improved is a good early indication.  I will be vulnerable to infection as my blood counts drop over the next many days - if you would join us in praying that I stay infection-free (and therefore out of the hospital), we would be grateful.  

More His love - Dan

Saturday, October 8, 2011

Positive Signs!!

Getting Rigged up for a Day on the River - 9-07-11

Dear friends and family, today is Saturday and I have a very good report for you.  First, the chemotherapy is going well; I have not had much discomfort so far, no nausea (though they tell me that's coming :-(    I've had  no complications to this point and the docs, apparently optimistic that I will skate through the rest of this, have already processed my discharge papers for Monday morning.  The nurses joke with me as I walk laps on the floor - 'who you here to see?', i.e., I look more like a visitor than a patient - praise God.

Even better though, all the symptoms of my pneumonia - fever, cough, restricted deep breathing, sore throat - have all dramatically improved in the last 48 hours.  Because of the interplay between my lymphoma - the main tumor is blocking the bronchial tube that leads to the lobe of my lung where the pneumonia is - the docs said that the first signs that the chemo is working on the lymphoma might be exactly this improvement - so the current view is that the chemo is indeed shrinking the tumor, beginning to allow air into that blocked lobe, and doing it's job.  The rounds doc this morning said that's what he thought, and he said the real question is will it "stay shrinking/shrunk", which we won't know for 3 to 4 more weeks....but we couldn't have asked for more in these 3.5 days.

Renee is doing well, thanks for remembering her in your prayers.  I wanted to share a song by Rich Mullins with you - it's a little melancholy, but it expresses a deep longing that I am sure many people feel when they are in a scary spot - it has ministered to me for many years......and has been particularly meaningful during these most recent times.  Rich Mullins has been a cornerstone of Renee's and my spiritual music collection for 18 years.  I hope you enjoy it.

God's grace and peace to you.  Dan and Renee

Wednesday, October 5, 2011

hyperCVAD Begins

Folks, after Dr. Keating and Dr. Hosing (transplant doctor) conferred today, they decided that the best course is to proceed with hyperCVAD, thus hitting the lymphoma head-on and going for full or partial remission within 2 treatments.  There is EBV present in my blood, as there is in most people's blood, and they may yet pursue a post-transplant procedure that will kill the EBV, which would enhance my recovery and reduce/eliminate the potential for EBV to cause mischief in the future.

So, the plan is back to what it was over the weekend, ie, 2 rounds of chemo and then transplant.  If the treatments go as planned, the transplant would take place in December.  There are a few dependencies, including but not limited to:

-  lymphoma responds to hyperCVAD treatment (tumor shrinks or disappears)
-  pneumonia/fevers are cleared up
-  chemo side effects, including low blood counts, are managed

If the above dependencies are met, we can proceed to transplant with 50% confidence in being cured - woo-hoo!!  We thank the Lord for His provision, His loving care, His plan for our salvation and His plan for our eternal life with Him.  We declare our complete trust in Him to oversee every detail of this process, to guide the minds and hands of the doctors, to walk with me, Renee, Rachel and Kenyon every step of the way, to carry me when I cannot walk, and to comfort and strengthen us through the coming challenges.  Each of you has a part to play in God's plan - your prayers and encouragement are more precious than gold to us...please keep them coming. This is all for His glory.

I'm reading the bible daily using a reading plan called "M'Cheyne" part of my assignment was this passage from 2nd Corinthians chapter 3 (verses 16-18):  "Therefore we do not lose heart.  Though outwardly we are wasting away, yet inwardly we are being renewed day by day.  For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all.  So we fix our eyes not on what is seen, but what is unseen.  For what is seen is temporary, but what is unseen is eternal."

This present treatment will run through Sunday and our plan is to return to Raleigh on Monday.  With much love - Dan and Renee

Monday, October 3, 2011

Keating calls an Audible

OK so for you non-football fans, an "audible" is when the quarterback changes the play that was called in the huddle at the line of scrimmage - he shouts out code words left and right to his lined-up teammates to take advantage of something he sees in the defensive alignment or to counteract a defensive play such as a blitz. 

When we spoke with Alice this morning, she was prepping us for hyperCVAD - when we would start, when we would finish, when my hair would fall out, etc........and Dr. Keating came in and sat down in front of me and said "I lie awake at night thinking about how to cure people like you - people your age - because I have children your age - and I think to myself, 'if this was my son, how would I treat him?' "...... with that touching preamble, Dr. Keating said that he wanted to find out if I am carrying the Epstein-Barr virus (EBV) because recent research has shown that this virus shows up a lot in "Richter's" patients;  they think that it's the virus that is often driving the lymphoma - If I have it and if it is driving the lymphoma, then curing the EBV may be all the treatment that is required for the lymphoma......

So basically, Dr. Keating asked us to "chill" for two days while he runs this to ground.  If I don't have EBV, I think we're back to hyperCVAD, starting Wednesday.  If I do have it, the treatment will be very different and much less (if at all) toxic to my immune system, and in fact, directed at the virus, not the lymphoma.

So - hyperCVAD is on hold for at least 48 hours while Dr. Keating investigates this thread.  Chill we will, trusting the Lord in everything.

Thanks as always for your faithful friendship and prayer support.......Dan and Renee

Saturday, October 1, 2011

Back to Houston

Renee and sister Karen with Renee's 50th birthday present (the waterfall)Sept 28
It's Saturday morning.  Yesterday we learned that the mystery lung mass is indeed a lymphoma, confirmed by MD Anderson's pathology lab.  Right away, I will say that we have been battling a little "Israelite syndrome" this week, where a week ago we were rejoicing and praising God in the highest because He delivered me from lung cancer - lymphoma was a blessing - think of the Israelites being delivered from Pharaoh when He parted the Red Sea - and within a few days, we were praying fervently that the mass would NOT be lymphoma - think of the Israelites saying to God "have you delivered us from Pharoah's armies only to have us starve in this desert?"

So what we are focusing on is that lymphoma is still better than lung cancer, remembering that God showed Himself loving and powerful and He remains in control of my life and all these medical twists and turns.  The medical details are that my CLL has undergone a "Richter's transformation", i.e. some CLL cells mutated into a B-cell lymphoma.  It is a well documented complication of CLL and it is aggressive but treatable - mine does not appear to have spread much at this point.  Dr.s Kritz and Keating conferred yesterday and the "win strategy" (to borrow a term from IBM sales) is to give me two rounds of a chemo treatment called hyperCVAD, and if that is effective on the lymphoma, move to transplant and go for the cure.  The hyperCVAD is a fairly harsh treatment - I will lose my hair and feel pretty ill for a week to 10 days.  I believe they will know during or soon after the 1st treatment if the lymphoma is responding.

Dr. Keating wants me in Houston for the 1st round of treatment so Renee and I will fly tomorrow to Houston and hopefully the treatment will start Monday.  The tentative plan is to try to get home next Saturday and hunker down here for the worst of the side effects.  Because of the potential side effects of the treatment, hospitalization is required so I will be checking into the MD Anderson hospital on Monday.  If the 1st round goes well I may get the 2nd round here locally (still would have to be hospitalized).

The outpouring of love, care, prayers, cards, and concerns have touched Renee and I in ways you cannot imagine.  Please feel free to share my blog with your circle of friends - I want to share the message of God's ministry in my life with as many people as possible.  My daughter, a talented writer and artist, did a beautiful pastel of an eagle for me for one of my birthdays - it hangs in my office with the caption:

"And in the shelter of Thy wings I will take refuge, until destruction passes by." - Psalm 57:1

God is our refuge, our strong tower - He will give us the strength and grace we need to see this through.  In Him we have supreme and ultimate confidence.  May He bless you this week.

Wednesday, September 28, 2011

Update on the Update

Friends, Dr. Kritz was not too alarmed or concerned by the levels of fever/symptoms I am experiencing, so he sent me home - that's a praise - and counseled finishing the antibiotics and coming back to see him Friday.  No word yet from MD Anderson on the pathology report from the biopsy.  I will post when I hear something on that.  Last Thursday, Dr. Chang came into my hospital room and said "Rex pathology was wrong about the lung cancer".  We rejoiced to see God move and answer prayer.  We rejoiced that they now thought it was lymphoma.  It may yet be lymphoma, and we need to be submissive to God's will as always.  But - we do ask with full confidence in His healing power and His power over the entirety of the physical universe - to make it something other than cancer - and either way we will give Him praise and glory.  Please continue to pray with us.....thanks so much.....Dan

Quick Update

Folks, I've been home now since Friday noon and unfortunately my symptoms are not improving, so Dr. Kritz has asked me to come in to the clinic to see him in about an hour.  He may put me on outpatient IV antibiotics (given at the cancer center) or he may put me back in the hospital.  He may also have info from MD Anderson on my biopsy, not sure about that.  This is difficult - please pray for me that I would have courage and patience as we wait on the Lord - pray that I would trust Him completely and that He would heal me.  Thanks - Dan

Friday, September 23, 2011

No Place Like Home

Self-portrait of me and my two brothers-from-another-Mother, Keith and Scott McElrath

Friends, I'm writing this from the back porch at home.  I've been away from home on many a business trip but the homecomings were never this sweet.  I have to say that the nurses at Rex Hospital and especially on "5 East" are a wonderful group of people.  What a profession, certainly one of the most noble I can think of.  Many of them combined prayer and encouragement with their medical duties - one in particular, Deborah, took my and Renee's hands and prayed earnestly with us on our darkest day.  My hat is off to these angels.

As you saw in my last post, we received remarkable news on Friday, while my pastor was with us (I want to have him at all my doctor meetings now), that they no longer think I have lung cancer, but rather lymphoma.  Honestly I am reserving any conclusions until I hear from the MD Anderson pathology lab, which should be early to mid-next week.  Another interesting data point came in today - My nurse at MD Anderson told me that the slides from the first bronchoscopy, the ones originally diagnosed as squamous cell carcinoma by the Rex Path Lab, were deemed 'no definitive evidence on malignancy' by the MD Anderson lab.  So the plot continues to thicken and God continues to be at work in this situation.  The slides from my operation, both lymph nodes and a 'tumor' biopsy, are enroute to MDA now.

Well I just wanted to let you all know that I'm out of the hospital, still working on the pneumonia symptoms, and praying that I will continue to improve while taking it easy here.  My parents will be here through tomorrow, then Renee's sister will come for a few days, and then Renee's parents will be back.  Of course with me back home, the burdens are mostly lifted.  I also want to thank the many people who came to visit me in the hospital.  Yesterday was particularly busy with visitors, up until 9 pm. 

Please pray for my pneumonia to clear up, my immune system to start firing on all cylinders, and for MD Anderson to say, early next week, "no malignancy".  With God, all things are possible.  Keep the faith!  Dan

Thursday, September 22, 2011

A Miraculous Turn of Events

I lift up my eyes to the hills—
where does my help come from? 

My help comes from the Lord,
the Maker of heaven and earth.  Psalm 121, v1-2

Friends, a short while ago Renee and I were sitting here in my room with our pastor, Dr. Mike Garrett.  Dr. Chang came in and asked if we had heard the news from pathology - we said no, and Renee said "it's good news, isn't it?"  She could read his face.  We were waiting to hear whether I had stage 3a or stage 3b lung cancer, the difference being whether the lymph nodes on the opposite side of the tumor had been infected.  Dr. Chang said that the lab, based on the surgical lymph node biopsy and the 2nd bronchoscopy, was now of the opinion that the cancer is a lymphoma, not lung cancer.  Dr. Chang said that lymphoma is a lot better than lung cancer, but it will be a few days before Dr. Krtiz gets back from his vacation and we can discuss how to treat it.

Medically, it is yet to be determined how good this news is - the more important aspect is the spiritual.  So many of you prayed for the lung cancer diagnosis to be wrong, and with little medical reason - but God, being rich in mercy and loving kindness, has heard our prayer and shown us that as He promises, He is here, He is powerful, He is real, and He loves us.  Good news, difficult news - in all things and on all days, no matter how dark, He is here, He cares for us.  Rachel and Kenyon are here so I need to go - more soon.  Praise Him!  And thanks to all the praying saints!!  Dan

Wednesday, September 21, 2011

41 He withdrew about a stone’s throw beyond them, knelt down and prayed, 42 “Father, if you are willing, take this cup from me; yet not my will, but yours be done.” 43 An angel from heaven appeared to him and strengthened him. 44 And being in anguish, he prayed more earnestly, and his sweat was like drops of blood falling to the ground.[c]

Friends, the outcome of the surgery was not what we were hoping and praying for.  One of the lymph nodes in the center of my chest showed cancer despite the negative PET scan.  The doc estimated this as a 5% possibility before surgery.  Having found this, they stopped the surgery and I will be treated for this cancer by radiation and chemotherapy.  Given the very unlikely odds of everything that has happened this week, I am more convinced than ever that this is a custom-made trial authored by my Father in heaven.  I believe this with all my heart - there are people who will be touched, reached, and yes, saved because of this trial, provided I submit, honor and praise the Lord no matter what.  

I know He can heal me with a thought, and yet I know that is not always His plan.  I submit to His will for my life, as does Renee, while we pray for healing and mercy.  And really - what do I have to be bitter about?  There are hospitals throughout the world built for children with cancer.  Child or adult, we all need to understand that God will redeem ALL of the suffering of His people, as He said He would - His plan is an eternal plan, not a plan of years on this fallen earth.  If I may modify the great hymn, "When we've been there ten thousand years, bright shining as the sun - it won't matter whether we lived 30, 50, 70, or 100 years on earth.  We might not even remember.

You won't be surprised to hear that I am very anxious to get out of CLL docs will decide when they are satisfied with the progress of my pneumonia and hopefully let me go in a day or two.  Please pray for us in this regard as well as for special closeness to God, comfort, peace, and blessed assurance.  Thank you all.....Dan and Renee


Tuesday, September 20, 2011

Surgery Day

Hello friends, in about an hour they will come to start prepping me for surgery.  My last surgery was in 1967 when, as a 6 year old, I had my appendix removed.  The goal of the surgery today is to remove the upper-right lobe of my lung, which contains the mass that looks suspiciously like lung cancer.  The diagnostic process continues as the first step of the operation, with a biopsy of the lymph nodes in the center of my chest.  If they are clear of cancer, they will proceed to remove the lobe.  They tell me that this is the lobe that I can most easily do without and in fact, I should be back to full lung function within a few months after surgery.  If they remove the lobe, they will send it to pathology and a confirmation of the diagnosis will be made , and if it is confirmed, they will determine stage 1 vs. stage 2 (stage 2 is when cancer has infected some non-central lymph nodes).

Today, once again, I meditate on Romans 8;  please read carefully with me:

More Than Conquerors
28And we know that in all things God works for the good of those who love him,j whok have been called according to his purpose. 29For those God foreknew he also predestined to be conformed to the likeness of his Son, that he might be the firstborn among many brothers. 30And those he predestined, he also called; those he called, he also justified; those he justified, he also glorified. 

31What, then, shall we say in response to this? If God is for us, who can be against us? 32He who did not spare his own Son, but gave him up for us all—how will he not also, along with him, graciously give us all things? 33Who will bring any charge against those whom God has chosen? It is God who justifies. 34Who is he that condemns? Christ Jesus, who died—more than that, who was raised to life—is at the right hand of God and is also interceding for us. 35Who shall separate us from the love of Christ? Shall trouble or hardship or persecution or famine or nakedness or danger or sword? 36As it is written:

“For your sake we face death all day long;
we are considered as sheep to be slaughtered.”l
37No, in all these things we are more than conquerors through him who loved us. 38For I am convinced that neither death nor life, neither angels nor demons,m neither the present nor the future, nor any powers, 39neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord.

All of us can be counted among this family of God if we believe and answer His knock at our door.  Again, I am blessed by your support and prayers.  Back soon.  Dan

Thursday, September 15, 2011

Calling all Prayer Warriors

Friday, September 9, North Park, Colorado

Hello Friends.....apparently between work and recreation travel over the past two months, I've overdone it - or maybe it's just a random weakness in my immune system - but I have contracted pneumonia and I am in Rex hospital.  The short story is that I was feeling feverish and having some discomfort with deep breaths before I left for a long-anticipated fishing trip over Labor Day weekend.  After consulting with my medical team in both Houston and Raleigh, I was given the green light to go on the fishing trip after receiving a Neulasta shot on Sunday night, Sept 4.  The trip went well (see above!) and I felt good....however after returning home, seeing my doctor on Monday, and getting a chest x-ray, I began to feel badly Monday evening - and worse Tuesday morning.  The x-ray revealed an infection in my lung and Dr. Kritz checked me into the hospital Tuesday afternoon at about 5 pm.  I'm getting powerful IV antibiotics now that will hopefully knock out the infection.  There is another concern that was revealed by a CT scan that I received here at the hospital - a smaller, tighter concentration of opacity (spot) that is near my upper bronchial tube - this could anything from a related but different infection, to a tumor....I had a bronchoscopy yesterday and we are awaiting the results sometime in the next 24 hours. 

I am feeling better than I did Tuesday morning so we are thankful that the antibiotics appear to be working and we're praying that they will not only knock out the general infection but (please God) the spot near my bronchus.  If you would please pray that this entire event would be dealt with by these antibiotics, Renee and I and my entire family will be very grateful.  I had a beloved friend visit me just a while ago and during the course of our conversation he mentioned the story of Jesus and His disciples walking by a man blind from birth - the disciples asked Jesus, "tell us Master, who sinned, this man or his parents, that he was born blind?  Neither this man nor his parents sinned, said Jesus, but that this happened so that the work of God might be displayed in his life."  This verse and many others have shaped my thinking and renewed my mind and allowed me to see this trial for what it really is - a mission, an assignment.  Whatever comes, I know the Lord will give me the strength and grace to overcome.  Thanks for all your care and concern.  Dan

Sunday, September 4, 2011

Renee's Birthday and Visit with Dr. Keating

Hello friends and family, it has been an extremely busy time these last 3 weeks or so.  I've been on a business trip to New York, threw a surprise party for Renee (August 13th), spent a week in Europe and the UK, and this past week spent 2 days in Houston.  Tomorrow I leave on a week-long fishing trip with my Dad, father-in-law, brother-in-law Scott McElrath, and his brother Keith.  Today I want to show you some pictures and a video from Renee's 50th birthday party - it was a very special evening - we had about 40 guests, some of whom traveled from Florida, Georgia, Illinois, and New York to celebrate with Renee.  Here's the key video clip and a few pics:

Renee and college BFF Heather Holley

Renee's sister Karen with husband Scott, and Keith McElrath with the Birthday Girl

With sis Karen and childhood BFF Cindy

Renee with Sandra, high school BFF and dear friend of the family
 It was a really wonderful evening - Renee said she was taken completely by surprise, which I think the video bears out.  It was also an occasion worth celebrating - Renee has been a blessing to many, most of all me, for many years - as I said in my toast, she is by far the greatest blessing in my life :-)

So, the news from Houston and Doc Keating was that I had a partial response to the FCR, so I am in a partial remission - meaning that I have some residual cancer in my bone marrow.  This is actually the result that we were expecting based on the results that we had at the midway point.  So there's good news and not as good news in there.  The upshot of that is that Dr. Keating wants me back in Houston in January, at which time we will make a decision on the next course of action.  There are several possibilities, some that are standard treatments, some that are in clinical trials, and of course the stem cell transplant is also an option.  Dr. Keating and Dr. Hosing - the transplant specialist - say that I am an excellent candidate for a transplant given my minimal evidence of disease, age, overall health, and having a related matching donor (sister Laure).  Based on my conversation with Dr. Keating, he expects that we will need to take further action early next year, though it is hard to know what the residual cancer will do and when.  Based on my cancer type, I don't think they are inclined to wait around to see what it will do, but rather, treat it aggressively.

As ever, my faith is in the God of heaven and earth, and in His Son Jesus Christ, who loves me more than I can ever understand.  I trust him with every hour of my life, and with my eternal future.  He has asked many of us to trust Him through unimaginable difficulty, and it gives me great comfort to know that He is able to redeem  all our suffering for our good and His glory.  I fully believe the truth of Romans 8:28, even in difficult circumstances - "And we know that in all things, God works for the good of those who love Him, who are called according to His purpose".

If anyone you know is struggling with illness or other difficulty, and you think I might be able to encourage them, please have them reach out - or reach out yourself.  It is a great blessing to me when I can encourage a fellow traveler to find hope in the Lord.

I'll leave you with this - the last thing Dr. Keating said to me was "come on back in January and we'll decide how we're going to cure you.  He's optimistic, so I am optimistic :-)

Much love - Dan and Family