It's the Final Medical Update

Hey you! Yeah, you, one of my loyal dozens of readers of this blog, I thought it best to update you one last time on this medically-challenging chapter of my life. Let's pretend that you're not tired of reading about it.

A QUICK SUMMARY: 

In late July, my wife and father convinced me to go the hospital as I had been sick for awhile. A week prior to that, I visited a doctor who ran some tests and diagnosed me with pneumonia. They ran an Xray and found that, in addition to the pneumonia, I also have a mass in (or near) my lung. The hospital saw the Xray and omitted me to the hospital. They believed it was lymphoma. It wasn't. 

Eventually the diagnosis evolved to having a broncho-pulmonary sequestration (a section of my lung didn't form correctly in utero) and Graves' Disease (an autoimmune disorder). A month or so ago I was treated with radioactive iodine for the Graves' Disease. Two weeks ago I had video-assisted thoracic surgery (a thoracotomy) in Indianapolis to remove the 5x9cm sequestration and the lower lobe of my right lung. It was painful, but has healed really nicely in two weeks. If you look at an Xray, I have a very healthy left lung and a shortened right lung. He goes by the name "Captain Stubbin'". Please do not confuse it with a nubbin' though. 

Yesterday I returned to preaching. My lungs were a bit sore yesterday afternoon. They're still a bit sore today. But, it felt good to return to some normalcy. Over the next few weeks, I will slowly start assuming the roles that I have vacated while being ill. I've tried keeping up with most things, but there has been some stuff that suffered while I was away. 

Today I am going to start working out again. I'm on a 10-pound weight restriction for another couple of weeks, but I am allowed to do cardio exercises to help stretch the remaining parts of my right lung out. If all goes well, that remaining part of my right lung SHOULD fill the space that was left from taking the lower part out. The doctors believe that I should breathe better than I ever have in my life. Eventually. We'll see.  

In conclusion, I'm getting better. The sequestration is removed, my autoimmune disorder is being managed, and I feel pretty well.  

My wife has been a saint throughout all of these health issues. She's really the most caring person I know. For a few weeks, I was too sick to do much help around the house or with the kids. She managed to handle all of our dual-responsibilities mostly by herself, worked a part-time job, and looked great doing it. I'm blessed to be married to her. 

Finally, my wife took some videos of me when I was waking up from my surgery. Who knew that being on such a heavy sedative would turn me into such a whiny kid! [we all knew the potential was there] I also catch a serious case of being vain. Here's one of the videos. Enjoy! 

Medical Update: Version 4.5b

Last time we talked about my maladies, I told you the good news that they were not able to find any cancerous cells in the mass in my chest. My wife and I collectively Kip'd. 

Since then I've met with my family practitioner who, in cooperation with my endocrinologist, has tried to balance the thyroid medication. They cannot do the surgery I need until my thyroid issue is handled. Currently, my medications aren't balanced enough. How do we know? I still exhibit many of the symptoms of Graves' disease; sweating, shaking in the hands, and irritability to name a few. Part of the reason why I haven't been around many people is because I have become a cynical curmudgeon in my spare time. Perhaps I've always had this untapped potential, but it has really shown its face brightly over the last month or so. I'm living at the intersection of Walt Kowalski from Gran Torino [without the racial anger complexities] and Michael Bolton [with the great displeasure for office equipment] from Office Space. This is the look that my kids have gotten a bit too often over the last week or so:

But, there's hope for all of us in the Loucks house. My thyroid should be balanced soon and I'll be back to being a bit more like my usual self. Happy, jovial, and only ever-so-slightly cynical. 

Most people probably wouldn't think of me as any form of cynic, but I feel it and it needs to get better. If nothing else, post-surgery I won't have a scientific and medical explanation for my curmudgeon-like tendencies and cynicism outside of me just not being a very good man. I'm a work in progress.

We met with a surgical oncologist today to talk about my upcoming surgery for brochopulmonary sequestration. We've been on such a high from the news about the cancer that we had not thought much about the inevitable surgery. I knew it'd be an invasive operation, but I didn't think it'd necessarily be overly technical. As the doctor was telling us more about what will happen to make sure that my lung doesn't collapse and how the pain will be excruciating afterward and that I should expect a 7-day stay in the hospital and that they won't know how much of my lung they need to remove until they actually get in my chest, my disposition started to change. Excuse me, sir, can we go back to the part about me not having cancer? That's my favorite part. 

We have an appointment with the head of thoracic surgery at the Indiana University Medical Hospital in Indianapolis in early September.  If all goes as I have planned (which nothing has yet), I will be having surgery in Indianapolis in mid-September (so all my Indy friends get ready for the party in my hospital room that will surely take place while I'm on my epidural.) I'll be in the hospital for a week and can expect a 4-6 week recovery. If the surgery goes well, I should breathe better than I ever have in my life (this is a congenital issue that has been with me my whole life). But though it's been with me, mooching off my lung capacity for almost 32 years, it's time to evict this failure of lung tissue. You've been put on notice, Carl the Tissue-Failing-Failure-of-Tissue. 

So as not to confuse the dozens of readers of this blog, I am in a good place. I'm tremendously happy to have spent so much time with my family the last month. They may be ready for my return to work, but I'm not ready for a departure from them yet. Next week I will be preaching a message at State Street. The first message I've preached in over a month. I can't tell you how excited I am for that to take place. I'll be preaching about making a statement about love and stability in the future of our community.

Finally, speaking of love and stability, I feel the need to show some appreciation to one of my best friends, David Cramer. David has been a friend of mine for 10+ years. He's a doctoral student in moral theology at Baylor University. He's also my own personal favorite theologian. When Dave found out I was sick, he asked some of my favorite theologians to send me a note of encouragement. And, they did! Every time I go to the mail and see a letter from an astute theologian:

I've got really great friends, Dave being one of them. I'm also a part of a caring and tremendously gracious church community who has given me time to heal. They bless me beyond belief. And, to top it off, I've got the best family who doesn't stay angry at me even though I've been a bit too Clint Eastwood-y lately. Christ has been constantly reminding me that I am blessed. May I learn to be such a blessing to others in the future.

Biopsy: Nailed it!

When I entered the hospital earlier this month, we weren't sure what was wrong. We just knew that I had a large tumor in my chest, I lost 30+ pounds in two weeks, I couldn't breathe well, and I had night sweats like a boy who forget to do their science project the night before it was due. Added to that was a persistent cough that wouldn't go away. 

After a few days, the oncologist believed that my symptoms aligned well with Hodgkin's Lymphoma. But, none of that can be certain until various biopsies are done to detect the existence of cancer cells. You can only go on inclinations. I got checked out of the hospital and my wife and I started reading about lymphoma. We bought a book, read peer-reviewed articles, and prepared ourselves with what could be bad, but certainly not devastating news. As it goes, Hodgkin's Lymphoma isn't the worst cancer one can get. It's actually one of the most treatable cancers. It's as if we won the cancer lottery (with apologies to those who have pancreatic cancer, you are in my prayers.) So, we weren't worried too much, knowing that with chemotherapy, I would be back to normal within a matter of 6-8 months. It was a blip on the radar of a long life. 

After already getting a needle biopsy and having it come back inconclusive, I had another one done this week at another facility. Prior to this biopsy, we asked another oncologist if he thought that Hodgkin's Lymphoma was still probably the best guess of what could be wrong with me. He agreed. His exact words, "I see nothing here that goes against that inclination." So, we did another biopsy and hoped for the best. As the doctor told me, "We got quite a bit of tissue out your tumor. We should know for sure if it is or isn't lymphoma." 

Last night, they called.  There was no sign of cancer. 

It was quite a surreal call. We had prepared ourselves based on what we had been told and the inclination was wrong (a quick note: I don't blame the doctors for their inclinations. They have been great. They never promised me they knew for sure, this is why they run tests. Plus, my mass/symptoms look A LOT like lymphoma. It was a good, educated guess.)  

So, you may wonder, how does it feel to know that I likely do not have cancer? 

Being diligent and appropriately concerned, it would not surprise me if my oncologist still wants to do a surgical biopsy. Needle biopsies are fairly accurate, but the most accurate biopsy is still going in and looking at it through surgery. I'm waiting for a call today from my oncologist to see what our next step may be.  

The next question is; what can it be then? My symptoms are still with me. There is still a large mass in my chest. We still have the lost weight to deal with. 

A doctor suggested to me yesterday that my condition may be congenital. It's called Bronchopulmonary Sequestration. It's a very rare disorder that is often times caught in utero. It's even more rare for an adult to have it. But, my symptoms also align with this issue. Here's a definition of BPS for those curious:  

Bronchopulmonary sequestration (BPS), sometimes referred to simply as pulmonary sequestration, is a rare congenital malformation of the lower respiratory tract. It consists of a nonfunctioning mass of lung tissue that lacks normal communication with the tracheobronchial tree, and that receives its arterial blood supply from the systemic circulation.

To fix this issue, they will need to go in and remove the excess lung tissue, cauterize the blood supply, and [likely] remove part of my functioning lung. It would leave me with 1.5 lungs, which if you think about it, is better than 1 lung or 1.25 lungs. Here's a nice video of the surgery if you're interested.  

On top of the BPS surgery, I'd also ask to have them remove my thyroid since they'll already be in my innards. I wonder if they can also take out any excessive fat in my belly or give me a bionic arm or James Woods' brilliant brain whilst doing the procedure. I'll ask. They'll oblige. This is how the medical profession works.

As a caution, nothing is confirmed. Like I said earlier, we may still do another biopsy and then find cancerous cells. Or, the inclination of BPS may totally be off. There's so much that the doctors don't know. But, they told me yesterday on the phone that no cancer was witnessed on the biopsy results. I'm the winner. So, as of now I:

Thank you to everyone who has prayed for my family and I. We feel tremendously blessed to know so many great people. Through this time, we've never lost site of the hope of the Resurrection. Even in more uncertainty, the hope of the Resurrection always stays with us. 

ps. the winner of the 'make-Nate-laugh' award goes to Alyssa Secor with this gem, "This issue [BPS] seems to mainly be in children, wow, now Nate has a little kid lung issue and an old ladies disease." I respond with a Walt Whitman quote, “Do I contradict myself? Very well, then I contradict myself, I am large, I contain multitudes.”

The God Who Risks

Last year at State Street we did a series on theodicy called, "[Skubala] Happens." In that series, we discovered that because of conflicting wills in this world (the divine will, your will, my will, the wills of the past, etc.) bad things can just happen. Without reason or explanation, they just do. Not everything happens for a reason, though it is much easier to believe in such a world. The biblical witness doesn't give us much reason as to why bad things happen nor did the Christian community really try to answer 'why' for many years. The hope of the Church has always been that resurrection happens in the midst of the chaos, darkness, and sin of this world. Bad things are a part of this world. Christ has made a way that the bad things of this world do not have the final word. That though we can choose sin, and at times darkness may happen to us (by a biological cancer that we cannot control), our unique Christian hope is for resurrection; in this life or the next. I no more believe that God has given (and by implication caused) me an illness to battle than I do that my mother died when I was young so that I would have a powerful testimony when I became a pastor (as was once suggested to me). What a moral monster God would be if He was sovereignly picking winners and losers in life so that a sermon would preach well on Sunday morning. God has brought redemption and resurrection out of darkness, a business that He works miracles. However, to implicate God of the darkness of this world would be to suggest that He is not who He claims to be as the arbiter of love and life. 

I was re-reading a great book by Dr. John Sanders called the God Who Risks: A Theology of Divine Providence. It has meant a great deal to me over the years. Since I will be in a biopsy and drugged this morning, I'll leave you with some quality reading. I hope you enjoy it as much as I have. 

"According to the fellowship model of sovereignty God does not have a blueprint that we are to follow. God has a goal for our lives, but there are numerous open routes to its achievement. This is not to say, however, that God never desires a specific individual to do some particular act. After all, God requested certain people in the Bible to perform specific acts (for example, God asked Gideon to tear down the alter of Baal, Judg 6: 25). Yet for most of us there is no such specific guidance. The will of God for our lives is not a list of activities regarding vocation, marriage and the like. Rather, it is God’s desire that we become a lover of God and others as was exemplified in God’s way in Jesus. “When people talk about God’s leading,” says van de Beek, “it is usually not rooted in the way of Christ, but in a general concept of omnipotence and protection.” The way of Jesus is a way of life not concerned about blueprints but about being the kind of person God desires. God’s major goal is to renew us in the likeness of Jesus (with all the attending individual and social implications). [emphasis added by Nate] In this sense it could be said that God has a specific will for each and every situation: to live as Jesus would. This is not, however, what people usually have in mind when they seek specific divine guidance.

It is God’s desire that we enter into a give-and-take relationship of love, and this is not accomplished by God’s forcing his blueprint on us. Rather, God wants us to go through life together with him, making decisions together. Together we decide the actual course of my life. God’s will for my life does not reside in a list of specific activities but in a personal relationship. As lover and friend, God works with us wherever we go and whatever we do. To a large extent our future is open and we are to determine what it will be in dialogue with God. God does not simply turn us loose to do whatever we please. Rather, we are to seek God’s wisdom for our lives ( Jas 1: 5). For example, there may be a variety of vocations available to me with which God is pleased, not just one that is “best” or “perfect” in comparison to the others. I am free to make my choice in consultation with God and others in whom I detect godly wisdom. In my opinion, God is concerned about which vocation I select but is much more concerned about how I live my life in that vocation. Whatever vocation I choose God wants me to do it Christianly. [emphasis added]

Furthermore, according to the relational model explored in this book there are “chance” happenings and genuine accidents that God did not specifically intend. God has granted humans significant freedom such that we may do things to others that God does not intend us to do. An employer, for instance, may harass and fire Jane without good reason. Jane should not view this circumstance as a “sign” that God’s will for her life has changed. She may, however, be confident that no matter what others do to her God is working in her life to redeem the situation. Since the broad range of circumstances that we experience in life, from being in a train accident to meeting an old friend on the street comer, are brought about by human freedom, we should not typically think of them as divine pointers for guidance. God resourcefully works with us in any and every situation, but God is not causing all our circumstances because this would imply a great deal of manipulation of humans. God has sovereignly chosen not to practice that sort of providence as his normal way of dealing with us. Though God can (even unilaterally) bring certain circumstances about, God normally works with us in whatever circumstances we experience. Hence, according to the risk model of providence Christians should not attempt to read all circumstances as signs of God’s will for their lives. [emphasis added]

King Saul, for example, made this mistake when he had David trapped, exclaiming that “God has given him into my hand” (1 Sam 23: 7). Of course, God had done no such thing. When those who murdered Saul’s son told David that God had avenged David of Saul, David rejected their interpretation of providence and had them killed (2 Sam 4: 8-12). In the risk model it is possible to mistake a divine action and misconstrue guidance."

- John Sanders, from the God Who Risks

A Tale of a Few Gifs [An Update]

Gather around everyone. Go ahead, grab yourself a chair and ol' Uncle Nate's going to let you know what's happening next in Tumor Gate '13. But, because I can't bedazzle a blog, I'll make it a bit more exciting with the proper use of .gif's.  

Since I was released from the hospital on August 3rd, we've been waiting by the phone for various doctors to call. We've been waiting for our next step from our oncologist and endocrinologist namely. Ema would call them and they'd say, "We'll call you back when we know something." Then, we'd get nothing. Just more waiting. We've figured out your little games, oh smart doctors. I like the cut of your jib. But, you won't get the best of my wife.  

Then we finally heard the news. On August 12 (today if a calendar isn't handy) we'd be meeting with a cardio-thoracic surgeon for a consultation. Because the appointment was early in the week, it would be likely to get a surgical biopsy that week. Needless to say, we were pretty excited. 

Then this morning I got a call from the cardio-thoracic surgeon's office. It's never good when you get a call from the doctor just hours before the scheduled appointment. 

As it goes, he had been called into surgery. Someone needed him more than me, which is understandable. It happens. Though my tumor consumes every thought of every day for my wife and I, the sun still rises. People have it worse than us. People are dying. He's a busy guy. But, then we heard the bad news. He probably won't be able to get us in for an appointment for another week or so. Surgery would need to be another 10-14 days. 
  

My oncologist, being the military colonel and touted oncologist that he is, went into action. As he said, "It's nuts to think you can wait that long for a biopsy." He called a cancer treatment center in Goshen, IN. They were able to get me in today for a consult. Dr. Abad (pronounced "A-bad-mamajama" sans the mamajama) met with us and set up an appointment for the biopsy for tomorrow. Here's to you, Dr. Abad.

There was a bit of a glitch, though. Dr. Abad wants to do another needle biopsy. But, this time, he wants to have a pathologist (and microscope) in the room as they do the biopsy. He doesn't want to do a surgical biopsy unless they absolutely need. So, here's the plans for now: if they find the cancer tomorrow during the biopsy, I will start treatment for whatever cancer it may be. If they don't find the cancer, they will do a surgical biopsy and look harder for it.  

That's all I got for now, fellas. You have a good day. Thanks to everyone coming along for this journey. Even you who I haven't met, but know you're out there. I see you and I appreciate you.