If there were a competition for...

If there were a competition for finding cancer lumps, Pam might just be in the running for world champion because she keeps finding them. It was probably Sunday when Pam started probing areas on her chest. Three spots didn't feel quite right to her. With chemo (Taxol/Avastin) scheduled to begin Monday Feb. 2nd, Pam really wanted her doctor to have a look. She saw him this morning (here she is at the cancer center on the phone). He stopped short of proclaiming anything official. Unofficially, one was explained away, kind of what Pam thought. Another, the one that was not round in shape, rather tubular (yes, even someone "shapeblind" like me can tell round from long & ropelike...shapeblind is a term assigned to me by our nearly 9 yr. old daughter at dinner two nights ago as I mistakenly saw a trianglular object as round) is on the not-too-worried-but-watch list. It was just that little hard round one that drew the most attention by the doctor and his nurse. While it was reassuring to have actual medical people give opinions, it is a bit disappointing to have anything show up so soon after the surgery removing the last three tumors.


The plan is to proceed as scheduled with chemotherapy beginning on Monday. The lump(s) will be watched very closely for any increase or decrease in size and shape. I believe that either of those actions (growing or shrinking) will say a lot. Sadly, either probably means they are cancer. The silver lining...shrinking will be a great indicator of the effectiveness of the treatment. Growth, don't want to see that. So here, you know how to pray in a specific way. We are praying for complete destruction of any and all cancer cells/tumors through this chemo and the following treatments. What chemo only shrinks or stops from growing, let the radiation that is coming finish the job and destroy completely.


As I have said before, our faith is the most important thing in our lives. We are serious about prayer. We also don't treat prayer like a genie's lamp. We ask, knowing that the answer might come in an entirely different way than we expect. Believe me, Pam has been through a lot. We have seen answered prayers and those answers aren't always shaped the way we expected. Evens the field for the shapesighted vs. shapeblind.

The pink bracelets are coming back out. Haven't worn them for a long time. This time it is going to serve as a reminder to pray. It will start on the left wrist with the first treatment and switch to the right for the second, then back to the left (odd treatment left, even right). Hopefully, Pam will be able to complete the 12 cycles and the bracelet will end up on the right, away from her cancer plagued left side.


Expect another post Monday.

Signs, signs, everywhere are signs

The non-hug warm greeting for Pam, as demonstrated by serious hugger Susan Rychener Saturday night.

Pam, Pam, Pam, Pam, Pam..........

You can click this little picture to make it bigger. What you'll see is a compilation of Pam photos. Each and every one of these photos were taken within the past 5 years, the oldest at the 12 o'clock position and the newest at about the 11 o'clock spot. And in every photo Pam was carrying cancer tumors within her, recovering from surgery, experiencing chemotherapy, or struggling through the last couple of years with chronic pain and fatigue. It is so hard to know what a person is going through by looking at them (the exception being the picks around 6 o'clock).

Cancer is a long haul. There is the shock and awe of finding it (both within the victim, Pam, and her family & friends). The pain and scars of surgery (so difficult for a woman). The physical destruction brought by chemotherapy. The longterm and debilitating effects of the treatment. It is a physical and emtional roller coaster. Tough to do it once, looking tougher to do it again. This time the book is being thrown at Pam. No break after chemo this year as she'll jump right into radiation. That will be followed by hormone therapy that promises even more side effects.

Pam's faith is stronger than these drugs, but there will be days of weakness. There will also be days of extreme lonliness, pain, fatigue and dread. It doesn't go away just because her hair grows back or when she throws on her fashionable clothes or does her makeup. 3.5 years from her last round of chemo and each day was a struggle with this disease, you just can't see it by looking at her exterior.

More views from the "caregiver" will be coming. In the meantime, Pam wouldn't mind if you read this post regarding hugging, written by our friend Randy. It kind of applies to her right now. Click here for "arm rest."

Side effects showed up today

The good side effects showed up today as Pam spent the middle of it in the hospital getting her PowerPort. What are some of the good side effects of cancer? Stronger and deeper relationships. Stephanie Elder and Pam shared the chair (and she blew our minds). Lisa Benson made sure to have Pam again, giving her the attention only a close friend can. "Kitten," stage name for Kathy since she didn't want me using her real name, came in to check on us. She has been checking on us since she began in the Ambulatory Surgical Unit 12 years ago. Jeannine Vote and Rachel White made it just in the knick of time to hang and encourage. Rachel then slowed everything down as she covered Pam with the most incredible prayer.

This wasn't brain surgery today. It was just a little plumbing job that will make administering chemotherapy a whole lot easier. And it stings a little, and it will leave a mark, but ya gotta do what ya gotta do. You can see it, sort of, in the last pic with Lisa, right before we left the hospital. Pam actually does amaze me. I have officially lost track of how many procedures/surgeries she has gone through. I used to be able to count the scars, but anymore the surgeons try to go in through old scars for new procedures, so I can't keep track that way. In the past four years I would guess Pam has had 9 or 10 procedures/surgeries (THIS JUST IN...the number is actually 12). Turn the clock back to before cancer and you can add in another dozen (or two) or so. I could never count how many IV sticks she has had. Blood transfusions...she has been there, done that. Office visits, easily in the 400-500 range (she has had 20 since mid Nov. 08, 4 appearances since Monday this week alone). We have friends who are doctors and doctors who see her so much they are now friends. Same with nurses obviously.

The bad side effects are horrible memories and fear of them lurk on the horizon. But God is so good and He has done an amazing job of balancing those bad ones with equal and/or better good ones. We can be thankful. Pam is thankful through all of this.

Today's kidwatchers Amy Crose and Stephanie Farris.

Eight Words

January 2nd was the day Pam met with her oncologist to discuss her treatment plans. She left the cancer center really thinking that she would pass on chemo. It seemed that although there would be some benefit from chemotherapy, that it would be too hard to do again. Pam was charged with considering that decision carefully for a few days. That was on a Friday. By Sunday the thoughts of passing on the treatment began to subside along with any ability to sleep. For the next seven days Pam was awake. Unable to rest, unable to decide, unable to move forward. Too many times I received emails from her, sent at 2, 3 or 4 in the morning, linking me to breast cancer issues. She was researching on the internet...argh... By the end of last week though, through much prayer and some interesting and slightly mysterious connections, Pam was very close to consent.

Being Pam, she drafted a beautiful 3 page, 12 question document and put a call into Dr. Veeder. Without hesitation he asked her to come in and discuss her concerns. We sat and talked for nearly an hour after his office was closed on Monday the 12th. He was in no rush and did his best to explain things and answer questions. He confirmed most of what Pam's research yielded. Breast cancer is very common and commonly cured. About 10 percent will have a recurrence. Once you are in the 10 percent the information becomes sketchier. Studies are fewer as the variables are wide. Pam tried in a variety of ways to pin him down regarding the staging of her cancer, to compare to the results of her research. He didn't totally disagree or agree with her findings. That's OK. Of the thousands of words that were spoken that evening it was all summed up with a simple eight word sentence he produced when Pam kind of backed him against a wall so to speak. "This is your last chance for a cure."

Pam's research from the previous week had told her this, she just needed to hear it. She is in the running for a cure still and she officially decided to do everything available. If the cancer isn't stopped this time, a third recurrence will be treated entirely different (more along the lines of "making you comfortable," "prolonging," etc.). Pam actually walked out as though a weight had been lifted from her.

The fears of the effects of chemotherapy are diminished when compared to the effects of cancer cells left untouched. So she consented to have them touched, hopefully in the most destructive and violent sense. Next Wednesday the medi-port will go in. Chemo begins on Feb. 2nd (one day after Erin's birthday, that's good). One treatment per week of Taxol for 12 weeks. 4 doses of Avastin on the 1st, 6th, 9th and 12th weeks. Then radiation, then anti-estrogen treatmet. Thats the plan.

The kids have been briefed, and they aren't thrilled, but they understand their mom has to do everything she can. Their memories of chemo the first time are fading, but they are fresh enough to strike some fear. Our plans for 09 are kind of taking shape. Thanks for praying Pam/us through.

Oh, the photo. I missed my brown haired wife. She surprised me by actually changing it back last week. Last night I took a photo of her that I thought would be great, but my camera was having problems and the pic wasn't on the card. So today at lunch, desperate for a photo for this update, I asked her to step outside, into the bright sunshine, beautiful white snow and crisp 4 degrees for a photo. The sun was just in the right (wrong) spot to totally overexpose the picture. But I think it turned out better than I could have ever planned or hoped. I have to tell you, I am pretty happy about the way she looks after her first bout with cancer. Kind of makes me anxious to see how much better she'll look after the second. Hubba, hubba.

Still Living the Dream

Nightmares are dreams too.

It has been a week since Pam was given the treatment options. She has diligently spent this week praying about and considering what she should do. And she still is not sure. The first time through cancer was really hard and yet easier than this time. Emotions are a much bigger factor and experience is causing Pam to contemplate her next move very carefully. She made a couple of doctor changes this week in preparation for the potential chemotherapy that is looming. So without making the final decision, she is still moving forward toward chemotherapy.

I am not sure when Pam will make the final decsion. She meets with a couple key doctors early next week, so that might help. She will also be rescheduling the surgery to put the mediport into her chest (that was originally to have been done two days ago, but was cancelled). Thanks for praying for her at this very trying time.

The Simply Women magazine shown here is from Jan. 05. The photo of Pam and her mom Flo was taken just a couple days before Pam's hair fled the scene. It was also just short of two weeks into her first chemotherapy. I wrote a little about that (click) here. Some of you may recall that Pam had long brown hair originally. After chemo it came back very dark, but then magically got lighter and lighter as it grew longer. This week I put in a request for her hair to be returned to something closer to her original manufacturers specs. And much to my surprise it happened. A photo is coming soon.

Pam's Room

Every visit to the oncologist, regardless of the time or day, is in the same room at the cancer center. Odd. Her doctor is juggling a bunch of patients in many rooms, but Pam has always ended up in the same room. It is the room where she has received bad news, good news and all the stuff in between. It is where we sit quietly in anticipation and where we ponder complicated information.

A genetic test was done in the past couple of weeks called oncotype DX. It is a new test (2.5 yrs.) and helps in the decision making process of which treatments have the most benefit. In Pam's situation, the toxicities of chemotherapy are a huge negative. Her doctor implied that for most people in Pam's situation, recurrent breast cancer, node positive, chemo should be a given, but maybe not for Pam. She has a track record with chemo that is neatly documented in her 3 inch thick file. The high dose chemo nearly killed her last time. And even though she went through chemo, her cancer recurred. Thus, there is some thinking, and the oncotype DX agreed, chemo may not provide enough benefit and comes with huge negatives. That is decision #1, one which Pam has a few days to pray about and consider. She is scheduled to have a mediport put into her chest next Wednesday in case she decides to proceed with chemo.

Radiation is back on the table. Pam's surgeon, the radiological oncologist, and now her oncologist feel a 6 week daily application could be more beneficial than chemo. But again, it is Pam's choice to undergo this therapy as well. The greatest risk here is lymphadema, as well as fatigue and some added pain.

The treatment that is not really up for discussion is anti-estrogen therapy. That will provide the greatest benefit as far as reducing the short-term chance of recurrance.

None of the three treatments will be easy, but of the three Pam has bad memories and current struggles (chronic fatigue, chronic pain, physical damage) from chemotherapy. But, in the battle with cancer, every option must be considered. You hate to think in hindsight that you skipped something that might have been the difference. It is a tough decision to pass on any treatment. A lack of experience will help when saying yes to radiation. Pam has never had radiation and would choose it far quicker than the known chemo. Anti-estrogen...she HAS to do it, side effects and all.

So, prayer is requested as decisions have to be made.

(PS - no treatment comes with any guarantee and everything is subject to change from appointment to appointment...that's just cancer as we know it.)

Pam has spent the past month recovering from her surgery. She is trying to recover some strength and mobility in her left arm. She still battles the pain issues and sleep comes irregularly if at all. She managed to get composed enough to participate in Northwoods Christmas program. There were 9 services from Friday the 19th to Wed. the 24th, and Pam didn't miss one. Her role wasn't a stretch and she had the costumes already (thanks Ann Taylor and White Black). This photo is from right before one of the services. The kids (pictured in their program clothes) and I also participated, making it yet again another wonderful December experience for our family. I really didn't think she was going to be able to do it. Pam also managed to make the trip with me to Michigan to Randy's funeral. I never thought she could do it for many reasons, but she did and we are both glad she was able to. I also didn't think we would be doing anything on New Year's Eve. While we didn't make it to church or to the Kastelein's as we had so hoped, Pam was willing to venture a couple miles from home for a little while to ring in the new year at the Farris house.

How are our kids? Doing pretty well. It is amazing what they know that you don't realize. As we drove home from the party Thursday AM, Pam was recounting how many good things happened in 08 for us and mentioned that just the last couple months have been tough. 8 year old Erin spoke up and said something to the effect that Nov. 18th was bad. Josh asked why. Erin said that was the date mom found out her cancer was back. She remembered the date. That's tough.