by John Creasey
oLorazepam (Ativan) 5 mg – one or two tablets by mouth every 4 to 6 hours as needed for nausea, vomiting and anxiety
•Other prescribed medications
oCreon DR 24,000 units capsule – 2 capsules 3 times a day with meals. (pancreatic enzymes)
oZolpidem (Ambien) one tablet by mouth at bedtime as needed.
oAmox TR-K CLV875–125MG Tab – one tablet twice a day for 2 days (prior to dentist visit)
•OTC medications and vitamin supplements
oRanitidine Hcl 150 mg (Zantac) one tablet by mouth 2 times a day
oDocusate Sodium Stool Softener – one to two softgels daily until first bowel movement, 1 softgel daily thereafter.
oSenna – (Sennosides ) 8.6mg concentrate, natural vegetable laxative – two tablets once a day – maximum dosage 4 tablets twice a day.
oTylenol Extra Strength as needed
oB6 100 mg – one tablet daily
oD3 5000 – one softgel daily
It is a dizzying array of medicines to keep up with. It’s my job to administer these at home. There is no way for the patient to do this. Remembering with clarity is too much to expect. Different medicines at differing times of the day. Cancer treatments are hard stuff.
Wednesday. In the morning, my C3 Leaders Forum commences in our living room at 7:00. By 7:30, twelve men are present for a lively discussion that wraps up four months on pop-culture’s effect on our personal lives and on today’s society, led by retired history professor, Dr. LeRoy Johnson.
This evening, the dinner menu includes chicken soup, salad, and great chocolate chip cookies, left at our apartment door by a wonderful neighbor. We watch a pre-recorded program from the new television series, Madam Secretary.
Thursday. I teleconference with the CASA Network board this morning, while Dixie reads the Seattle Times. She then gives up more than an hour in conversation to a young, newly married woman who is searching and who has sought Dixie out for older adult connectivity. Most young people today seem to have an abundance of peer friends, but not enough seasoned adults who will take an interest in and reach out to them. Dixie is one of those seasoned adults who can’t resist reaching out. When the young woman is gone, she has obviously expended all her energy. I just smile. This is Dixie being Dixie.
Friday. Pastor Gary visits with us today, always a special time, concluding with prayer and assurances that he and Jorie will walk with us in the days ahead. Marie, a member of our former pastorate in California makes a surprise telephone call to tell us of her love and appreciation. Susan and George, also from our VCC family, write an e-letter giving much encouragement, even as Susan is undergoing chemotherapy treatment herself. It has been years since we’ve seen some of these who write notes, send cards, email, or text to share their love and concern. I read each one aloud to Dixie. The incredible gift of friendship!
Rejoice in the Lord always; again I will say, rejoice. ~ Philippians 4:4
34
Midcourse Check
The Winter View.
The skies are gray today and the bare limbs of the trees are stark against the gray. It’s a beautiful sight to see how carefully each branch is formed to hold the leaves of spring with all their beauty, while continuing to hold their own beauty now, stark as they are.
The “winter of life” can be and is beautiful, too. I am in my “winter” time and as stark as I feel at times, I know God is here. Life has slowed . . . and I am slower, but there is still life in my limbs.
Thank you, God, for your life in me. How very rich I am. ~ DLT diary, January 2008
Since the physical upset attached to Dixie’s earlier rounds of chemotherapy in May and June was severe, we did not know what to expect following her first infusion with the pairing of Gemcitabine and Cisplatin chemotherapy drugs.
Gemcitabine, a relatively recent advance in pancreatic cancer care, is not reputed to be as debilitating as some other forms of chemotherapy. But it resulted in a great deal of nausea, physical upset and fatigue when used alone during her first infusion series. We wonder what will be her body’s response when doubled down with powerful, platinum-containing Cisplatin?
During the days following, we find out.
It is more of the same, but different, too. Tuesday through the following Tuesday are hard days. There is an inability to summon the drive and energy for even normal day-to-day activities. Hard for one used to being so active and energetic. Her digestive system regresses into similar patterns of upset and physical discomfort. The anti-nausea drug administered this time, together with chemotherapy makes a difference. There is nausea still, but this time there is no vomiting in response to the nausea.
After a week of days have come and gone, Wednesday is a turning point as the light in her eyes flickers and slowly returns.
Dixie, ever the consummate teacher/mentor, volunteering from the very beginning in Fred Hutch and UWMC cancer research projects, understands carcinoma of the ampulla of vater is rare, with comparatively little research being available. I mention at the time of diagnosis, “Wouldn’t you know, you’d have your own designer illness?”
Early on, we discussed how to approach this with family and friends as well as those who look to us for spiritual guidance. As mentioned before, we are private people who have lived a very public life. It is not always easy. The first reaction to Dixie’s diagnosis is to withdraw and become invisible. Let’s just be sick now and tell people later after its all over. Ultimately, however, we agree we will not waste our cancer. This terrible illness is also part of our sacred journey. Others need to know. Is there a difference in the way followers of Jesus face suffering and death? If so, what is it? Or are we all the same?
We have no illusions. This terrible illness will eventually take Dixie’s life. Then why go through the battle if there is no hope of winning? Why not just surrender?
We anticipate some will criticize her acceptance of medical treatment because of her age and the low chance of success. Still others may see it as a lack of faith and trust in the healing power of Jesus. Second-guessing another’s actions is human nature. It is what we do. But after discussing it with family, Dixie makes her own conscious and prayerful decision on two levels.
One, her initial cancer diagnosis is Stage II, and doctors believe there is a reasonable chance it can be treated and stopped at its initial source without metastasis. If successful it will offer precious additional time, perhaps years to enjoy our two great-grandsons. And, of course, the rest of the family will enjoy her, too. This is of high value to her.
Secondly, if left untreated and short of a divine miracle, the median survival duration from the time of diagnosis until death is arguably the worst of any of the major cancers, about 3 1/2 months. American Cancer Society prognosis figures estimate the twelve-month all-stage survival for pancreatic cancer to be 20%, and the five-year rate at about 4%. Those who received the Whipple surgical procedure in one study (from an experienced Johns Hopkins team) were reported as having a 21% five-year survival rate, with a median survival of 15.5 months.
Once she qualifies for the Whipple and subsequent treatments, it appears to be the right choice. It promises the possibility of more time with those whom she dearly loves and who love her. Her willingness to help protect future generations from this disease that will inevitably take her life is in keeping with her character; as important to her as her own short-term comfort and wellbeing. Of course it is her choice. She must bear much of this alone; but in a very real way it is our family’s choice as well. Once she says, yes, we are all in!
And so there follows:
Days as a teaching hospital patient, filled with waves of
Uncertainty
Anxiety
Fear
Loneliness
Emotional overload
Weeks filled with
Schedules
Pharmacies
Blood draws
Scans
MRIs
Biopsies
Chemotherap
y treatments
Radiation treatments
Infections
Antibiotics
Months filled with
Hospitals
Medical centers
Surgeries
Pain
Nausea
Weight loss
Sickness
Fatigue
No appetite
Scores of doctors, resident physicians, interns, nurses, technicians, administrative staff, attendants
And yet:
There are things I’ve experienced more deeply than I would have, were it not for my Enemy Cancer. This is a different, perhaps even a more important victory.
A Trust more total than I’ve ever known.
Psalm 32:10 . . . the Lord’s faithfulness overwhelms the one who trusts in him (NET).
A Joy more full and all consuming.
Psalm 16:11 You lead me in the path of life; I experience absolute joy in your presence; you always give me sheer delight.
A Peace that brings such physical and emotional rest.
Psalm 4:8 I will lie down and sleep peacefully, for you, Lord, make me safe and secure.
A Hope making real all I have believed since becoming a follower of Jesus.
Psalm 119:74 Your loyal followers will be glad when they see me, for I find hope in your word. ~ DLT diary, 2015
There are Good Days—with short walks on a sunny, tree-lined street.
There are Bad Days—ending as they begin, physically spent, emotionally drained.
We’ve stood through the years with hundreds of others in the Valley of Shadows. Laid to rest family members. Made our way back from two near-death experiences of my own. We are meant to live with a divine sense of trust, joy, peace and purpose. Yet these are not won easily. Jesus teaches us this by his own example. Yes, this is a special time . . . a sacred journey through the shadows.
O Son of Mary,
how wonderful
Your friendliness to me!
How deep! How unchanging!
Help me pass it on.
Help me to find my happiness
in my acceptance
of what is Your purpose for me:
in friendly eyes; in work well done;
in quietness born of trust;
and, most of all,
in the awareness
of Your presence in my spirit.
Come, Lord Jesus, come as King.
Rule in our minds: come as peace.
Rule in our actions: come as power.
Rule in our days: come as joy.
Thy Kingdom come among us. Amen.
~ Unknown
35
My Journey Through the Valley of Shadows
(Dixie shares the power of Scripture on her sacred journey. This chapter includes some things already mentioned, and some new as well. In her own words, in a e-letter to her prayer partners, she opens her heart to God and to us in life’s most difficult time):
Being a private person who lives a very public life is never easy. Acceptance of public visibility into all areas of my life as a minister’s wife has been a great challenge for me, as it is for many pastor’s wives. It is hard work to stretch and grow to meet the challenge. Ward has always been the consummate cheerleader for my every endeavor. For this I am so very grateful. He knows me well enough to understand I will come around. Eventually.
My “coming around” in this difficult season has brought me your messages of love and encouragement. These have been life-giving to me. They come in forms of cards, letters, flowers, phone calls, email and visits. Most of all, your prayers sustain me through the grim and difficult moments. Thank you for loving me so tenderly. I am blessed! Now, let me share a little of my journey and trust it will remind you of God’s faithfulness.
I memorize Psalm 23 when I am nine years old. The world is at war, and since America is being drawn into it, every home is touched by its horrors. All the while, another war is being lived out, in many ways even more frightening to this young girl and much more personal, as it is being fought inside the walls of our home.
Life for this nine-year-old is scary; I am a target for the physical and emotional upheaval of angry parents. I feel lonely and unloved. Unwanted. While I don’t fully understand the content of Psalm 23, I like it. Its words feel comfortable to me. They promise security to an otherwise insecure little girl. Now, looking back from the distance of seventy years, I realize it is a metaphor for my life.
18 Dixie finds still waters.
“The LORD is my shepherd, I shall not want. He makes me lie down in green pastures. He leads me beside still waters. He restores my soul.” I didn’t know much about sheep, and still don’t. I’m a city girl. I do know this much. They have no natural defenses and are prone to wandering off from the flock, unaware that danger can be lurking close by. Obviously, sheep need a shepherd, someone who cares enough to lead them to safe places for nourishment and rest.
In the Psalm, sheep are made to lie down in green pastures for their safety, comfort and nourishment, and for rest that restores their energy for the next stretch of territory they must cover to get to more green pasture. Sheep are afraid of running water. Their wool is heavy when it is wet and can easily pull them into the water, causing them to drown. Quiet water is safe for stepping into and drinking fully. I guess if I can trust the Shepherd to restore my soul in “green pastures and still waters,” I can also trust him to “guide me in paths of righteousness for his name’s sake.”
I am a Christ-follower. I am His namesake—Christian. He guides me for the sake of his own name.
I often pray the verse in Psalm 25:4,5. “Make me to know your ways, O LORD, teach me your paths. Lead me in your truth and teach me.”
I love my Shepherd for who he is! I love what he does for his flock. For all the unnamed fears and insecurities of this child-now-become-woman, the images of not being in want, of lying down in green pastures, of being refreshed by quiet waters all restoring to the soul, of being guided in righteous, though not always along easy paths for his name’s sake; all these over my lifetime have become enriching and enlarging descriptors for my view of God.
In these recent months on my journey, as with David, the Psalmist of old, I am being led into the Valley of Shadows, where the pronoun for God is changing from “He” to “You.”
For me, the Lord as Shepherd is a personal pronoun in this Valley. David could look to physical things like a rod and staff to comfort him. These were the things he knew. He drew from his own experiences with his sheep. A rod to kill any predators that might harm an innocent lamb. A staff with which he could rescue a sheep wandering from the fold.
Shadowy places can be scary and dark. This part of my life journey is all of that. Dark and scary. And lonely, too. Yet here in my Valley of Shadows, I have discovered what should have been obvious going in. Without light, there can be no shadows. Looking to the Light of my life has been my rod and staff that brings me comfort. The shadows are a reminder that my Light is always with me.
When we first heard the diagnosis “cancer,” it was a surreal moment. I was numb. I had no other immediate emotion or reaction. I even asked the doctor how I should feel about this diagnosis. His response was a one-word question. “Nervous?”
I do not feel nervous. Instead, I seem to be wrapped in a cocoon of peace. That peace remains with me most days as I move along the pathway through shadows of surgery and chemotherapy and biopsies and scans. Jesus’ words, “Peace I leave with you; my peace I give to you” take on new meaning for me. All the peace Jesus exhibited while here on earth, he gives to me now. His peace feels as warm and comforting as the blankets caring nurses wrap around me to keep me warm and comfortable.
But when the shadow of radiation looms over my pathway, it is not a shadow I merely bump into. It looms large and engulfs me. My radiation experience is a solitary, everyday procedure lasting six weeks. Technicians set me exactly in place. They place huge machines around and over me and then leave me
alone in the room. They can see me on their screens, but I cannot see them. I am alone and terribly afraid. I can’t move. The machines seem huge to me and make weird noises. It is cold. I am cold. I am wrapped with warm blankets, but much of me remains exposed for the radiation to do its work.
Then I remember the words of David in Psalm 56, “When I am afraid, I put my trust in you. In God, whose word I praise, in God I trust; I shall not be afraid.” I begin to praise God for all the attributes that come to mind: his love, kindness, strength, his knowledge of suffering, his ability to heal, his comfort. Before long an unexplainable, sustained joy explodes in my inner being. Radiation’s fearful shadow melts away in the pure Light of Jesus. Radiation is never scary for me after that day.
August is to be a month of respite from radiation and chemotherapy. We look forward to a trip to Victoria, a walk through the beautiful Butchart Gardens, and a regaining of normalcy. Sadly, it is not to be. My recovery is slow. Ward’s sister, Nadeen, a special mentor in my life as a young bride, has struggled with health issues for a number of years and now, in August, she dies. I want to use every ounce of stamina for several trips to Wenatchee. We are able to say our “goodbyes” the day before her passing. The following trips for her memorial service, then again for her interment, take what remaining energy I have to expend.
Chemo infusions scheduled for the end of August are delayed because tests intimate the possibility that the original carcinoma ampulla of vater has metastasized to the liver. CT Scans, MRI and a liver biopsy further delay the resumption of infusions until the end of September.
I experience feelings of discouragement and disappointment at the slow pace of my healing, and over Nadeen’s death. Depression shows its ugliness at times and I wonder, “What is the use?” Still another shadow in my valley. Then one morning during our devotional time, Ward reads from Revelation 21:23 “The City has no need of sun or moon to shine on it, for the glory of God gives it light.” It is amazing how quickly my shadow of depression turns into hope! Hope for the place where Light casts no shadows. Just the anticipation of this City as my future dwelling continues to give me hope in this, my Valley of Shadows.