Familia Hermosa: Two Great Weeks

Familia Hermosa: Two Great Weeks



https://youtu.be/yqpvquN9W4c

Two Great Weeks

It has been a wonderful 2 weeks for me.   Even though my mind keeps me from remembering all the details, I will try to remember a few.  The first week we were planning Agustin's 80th birthday party which our kids helped organize.   A complete success! Although it was not a surprise, he was thoroughly surprised when old friends from over 50 years ago, traveled down from northern VA just for the party and spent part of the next day with us.  He was good friends with Judy Stehling and Edgar Ariza...such a great surprise!   We also welcomed Juan Esteban back who had spent 4 months with us 2 years ago as well as Jessika, his girl friend who works as an au pair in Raleigh.  So grateful for all the folks that could wish him well on his 80th. birthday:)
 Such a busy week it was.   During the week, we visited  Veritas Vineyards and Agustin, Kathy, Ruthie and Juan enjoyed wine tasting. (I did not get into that:)
Deciding against surgery and having it confirmed by Dr. Oberholzer and the surgeons at UVA  has taken a load off of my mind and heart.  I looked over my early "blog" entries and realize how sick I was last year at this time, not yet knowing I had a mass of adenocarcinoma in my pancreas and minute spots on my liver.   It has been a tough year with chemo but God, in His time and in His will, has brought me to this day through the prayers of friends and relatives, the care of my devoted husband and family and the shrinking of the tumor with the chemo.  Of course, there is still the remains of a tumor and as I have been told, it never goes completely away, but for now, feeling healthy and energetic 2 weeks out of 3 is my gift of quality of life.  I will continue to have chemo as long as it works and as long as my body can tolerate the side effects, every 3 weeks.
This past week I joined the Y again and have gone swimming 3 times.  So far so good with not contracting any viruses:):) 
I felt well enough this week to take the big "plunge" tomorrow morning and sing a hymn-solo at our church.  The hymn I chose has lyrics with my journey.  The thought of singing over this past year has not been appealing with all the energy, drive, hydration and desire that it takes...I am depending on God's continuing inspiration to get me through this challenge of singing again. 
This is the song I will sing.

Day by day, and with each passing moment,

Strength I find to meet my trials here;

Trusting in my Father's wise bestowment,

I've no cause for worry or for fear.

He, whose heart is kind beyond all measure,

Gives unto each day what He deems best,

Lovingly its part of pain and pleasure,

Mingling toil with peace and rest.

Every day the Lord Himself is near me,

With a special mercy for each hour;

All my cares He fain would bear and cheer me,

He whose name is Counsellor and Pow'r.

The protection of His child and treasure

Is a charge that on Himself He laid;

As thy days, thy strength shall be in measure, 

This the pledge to me He made.

Help me then, in very tribulation,'

So to trust Thy promises, O Lord,

That I lose not faith's sweet consolation,

Offered me with Thy holy Word.

Help me, Lord, when toil and trouble meeting,

E'er to take, as from a father's hand,

One by one, the days, the moments fleeting,

Till we reach the promised land.

Finally a peaceful decision....

   Today we finally heard from the "tumor board" at UVA.  As I have written before, Johns Hopkins also presented my case in their tumor board meeting over 2 months ago and gave me their viewpoint on having a "trial distal pancreatectomy surgery" which would involve first radiation and then the "trial surgery" which would include taking out the spleen, the tail of the pancreas along with the tumor, and any spots on the liver if there were under 3 found.  They also said that they are the only hospital that would do this kind of "trial surgery".  
    Anyway,  Ruthie and I were on the conference call today with Dr.  Oberholzer from UVA and she took great notes over the phone....something I cannot do well.   
   We were told the  tumor board  discussed my case yesterday.  Dr. Adams, head of the cancer department, along with the board of other surgeons came to the conclusion that I was doing very well with my  current treatment.  (They actually said very few patients they have treated have done so well)   I have been told that right along by my oncologist and other oncology professionals and that is always reassuring to me:)   
    Since I have responded so well and they feel that if I were to have surgery, there would be little assurance that the surgery would even help.   The surgery is risky and may accelerate the cancer tumor to grow.   So, the board all agreed and recommended that I do not have surgery.   
    Dr. Oberholzer said no one knows the entire truth of what will happen, but their viewpoint is that I need to enjoy the time I  have and the good quality of life as long as the chemo is controlling the cancer.
    I do have a peace about this whole outcome since I am having very good quality of life at the moment.  Even though I have to endure 4-5 days of discomfort, 2 weeks of normal good quality of life are the gift I have right now.  How long that will go on is in God's hands and has been all along.
    Psalm 118:24  "This is the day the Lord has made, let us rejoice and be glad in it."
    
  
    
    

My personal 23rd. Psalm Prayer this Morning

You, Lord, are my Shepherd and my hope, I shall not want for anything.   You let me lie down in green pastures.  You  lead me beside still waters.  You give me hope and peace everyday. 

You restore my soul: you lead me in the paths of righteousness for your name's sake.

Even though I am walking through the valley of the shadow of death (in the future), I will not fear evil thoughts,  anxiety, sadness because you are always with me.

Your rod which helps me walk and your staff which helps me stay close, comfort me.

You prepare a table before me in the presence of my enemies who are not people but thoughts that creep into  my mind to scare me and make me doubt your constant care for me.

You anoint my head with healing oil (figuratively:) and my feet with coconut oil which my loving and faithful husband gives me foot massages to relax and stimulate because of  the neuropathy in my feet:).

Thank you Lord for your goodness and mercy all the days of my life.

Thank you Lord for the hope I have in You and your saving promises which are always following in my life.

Thank you for my husband, extended family, sister's family and extended family, my wonderful children and grandchildren.  Thank you Lord for my supportive prayer warriors in many friendships who love and support me.

I thank you for the gift of music you blessed me with and helped me to sing for you all these many years.

I pray that surely goodness and mercy will follow me all the rest of my life here on earth and on to eternity with You dwelling in your house forever.   Amen

Adapted personally from Psalm 23 by Mimi

My 76th. Birthday Today

Today was a beautiful day and I was very blessed to be able to enjoy a birthday full of love, family and friendships.  So many facebook greetings, cards and good wishes plus we ate a delightful lunch at "Trios" with our long time close friends, Nathan and Brenda Brooks.  Tonight our family came over and we celebrated with cake and the usual noise and laughter.

Since I have not posted anything about the recent consultation at UVA, I would like to relay some notes our Ruthie took last Friday at UVA...Sept. 29.  She does such a fine job in taking notes, I would never be able to remember everything discussed.  So, here goes:)  In the room with the doctor and me were Kathy, Agustin and Ruthie.


We met with Dr. Jose Oberholzer who just moved to the UVA Hospital last March from Chicago.   He recently did an emergency liver transplant on a friend of ours and she asked him if he would talk to us about my situation.   I was very hopeful that I might be eligible for robot-assisted surgery, but alas, I am not.  This was a consultation only and he hadn't seen any of my scans or reports!

https://uvahealth.com/findadoctor/profile/jose-oberholzer

Our beginning discussion started out like this:   Dr. Obertholzer said we have to ask ourselves 2 questions!
1.   Will surgery help?
2.   If surgery will help, what kind?

Normally when disease (cancer) has spread, surgery is NOT a reasonable option.  Removal of the local tumor would be done in a radical way because it's a systemic disease meaning it's one that affects a number of organs and tissues, or affects the body as a whole.   It may not be simple because of the vessels by the tumor.  
The portal vein (blood vessel that carries blood from the gastrointestinal tract, gallbladder (don't have one:), pancreas and spleen to the liver) is in close proximity to the tumor.   The only way to truly see this is through surgery, so not necessarily a technical problem.

There are 2 main arteries that have to be pulled away from the tumor.  The Celiac Artery (trunk) provides oxygenated blood to the foregut.  IT supplies blood to the stomach, liver, spleen and part of the esophagus that reaches into the abdomen.  It also supplies the superior (or upper) half of the duodenum and the pancreas.  The celiac trunk is a critical blood source for the gut, since the other major arteries aren't connected in such a way that these organs can receive adequate blood from them.   Therefore, any obstruction of the celiac artery is extremely dangerous for the organs it supplies.

The Superior Mesenteric Artery (SMA) arises from the anterior surface of the abdominal aorta, just inferior to the origin of the celiac trunk, and supplies the intestine from the lower part of the duodenum through 2/3 of the transverse colon, as well as the pancreas.   When these  arteries get infiltrated by a tumor, you can remove the tumor but it won't guarantee to prolong your life. 
Because of the complexity of these  vessels, Dr. Oberholzer would not recommend robotic-assisted surgery!

I asked what the tumor marker means?  It tells how much cancer is in the body but that's only part of the story.  It is impossible to cure the tumor with just chemo because it is solid!

This surgery would be palliative, meaning it is designed to relieve symptoms, and improve quality of life but not a curative treatment.  The chance that this surgery would cure is very low.

At some point the tumor cells throughout my body will come back even with chemotherapy.   Surgery would give longer life but it also might weaken me.  It would temporarily reduce my immune response which would make the tumor come back quickly!!!

He told me "the time I have now, will not be taken away with the treatment I am doing currently".

Surgery would take 3 months recuperation.  Hospital stay would be 4-10 days with a  6 hour surgery!

I would continue with chemotherapy, however, the biology for the tumor after its removal would tell them which chemo to use.

I was told that I have achieved the most I can out of  the chemotherapy treatment and my WINDOW is NOW to do the surgery!   Once the chemo stops working, it is aggressive and I will not have this opportunity again.

My case is being presented to the chemo board at UVA his week.   

So, this is my situation and I keep weighing my options as to whether I can physically take a surgery of this magnitude considering it is not a "cure all", could take down my immune system or just wait it out and continue the chemo until it doesn't "work" anymore!  

I am praying that I will be convinced beyond a shadow of a doubt that I really want or don't want to go through this surgery.   I will wait until I hear what the UVA tumor board says.  I realize they will probably focus on the same things that JH tumor board  did.  

I have thought a lot about this the last few days.  In my limited way of dealing with the "facts", it would seem that getting rid of a tumor that is cancerous would be the way to go and trust God for the rest. (recuperation, no infection, no complications, no cancer left, etc, etc, etc:)