Boy I love Thanksgiving. 

It’s escaped commercialization. It centers around gathering. Slowing down. Taking stock. Giving thanks.

This year, Thanksgiving had a different tenor. Having just had chemotherapy yesterday, Anne needed to lay low and rest. So we all did too. 

Game of Monopoly this morning. Then Honeybaked ham and Whole Foods sides, enjoyed around the table as we all voiced what we were grateful for. Naps and scooters and NFL football and pretend play followed. Now the kids are winding down in front of Ratatouille, preparing for bed even as Anne has found refuge in ours.

This year, thanksgiving – that is, giving thanks – has come more easily for the Fletchers. If that strikes you as an odd thing to say in light of our circumstances, I think this quick analogy will illuminate what I mean…

Which traveler is more thankful for the cold glass of water awaiting her: the one who traveled across a hot desert by high-speed train, or the one who walked?  

Listening to my children pray and express the things for which they were thankful, I was struck how our family’s hardship has made my kids better able to see and understand God’s provision and blessings. They called out specific names of friends and teachers who they felt had loved them well this year. Thankful for family, for mommy’s improving health, for the good food that people have brought, my children spouted. 

Then Anne had the wonderful idea of asking the kids what they knew about the Pilgrims and the history behind our Thanksgiving holiday. Admittedly, I had semi-forgotten the history until Jack told the story quite beautifully.

Having survived a harsh winter in which half of their brethren had died, the  Pilgrims celebrated a successful harvest season with a three day feast in the fall of 1621.  Partying alongside them were almost twice as many Native Americans, many from the Wampanoag tribe, to which the famous Squanto belonged. 

It was Squanto and the Wampanoag who had given the ill-equipped, weakened Pilgrims extra provisions to survive the harsh New England  winter. And, it was they who had helped the Pilgrims plant and grow their crops. The Pilgrims’ knew their survival as a colony was inextricably bound to the generosity of the local natives. Powerful. 

This Thanksgiving, the Fletchers are celebrating our harvest of blessings. And we are deeply thankful for you, our Wampanoag tribe.  

We’re wrapping up week two of the new Navelbine treatment for Anne.  She’s enduring with a tough-minded determination. 

The drugs’ side effects have manifested in fatigue, tingly hands, nausea and loss of appetite. Like how I felt immediately after riding the tilt-a-whirl twice with my boys at this year’s State Fair. Except worse. And hers doesn’t go away. So nevermind. 

For the first time since Anne’s treatment started in Early June, I’m under the weather. Don’t you worry – I’m seeking no pity.  Feeling bleh has given me a fresh glimpse into Anne’s daily fight. 

When I don’t feel good, everything feels harder. I “will” things a lot more.  Pouring a glass of water for a child. Taking out the trash. Making phone calls. Listening.  Being enthusiastic. 

I find it especially difficult not to let how I physically feel affect me emotionally. When I feel yucky, durn it if I don’t find myself fighting off feelings of hopelessness and despair, even though nothing externally has changed.  I feel like my sick body forms a dark cloud over my heart. 

Which brings me back to Anne. My little virus will run its course for a few days, and then I’ll be back in shape. Not Anne. Six months of feeling like crud, and many more ahead. It really hit me today: being sick has served as a fresh reminder that Anne’s cancer fight isn’t just physical. It’s mental. Emotional. Spiritual. 

Many of you reading this have endured suffering. Cancer. Loss of a loved one. Failure. Abuse. An ailment that persists. You can relate to the daily battle to “keep it together.”  It’s so stinking hard. 

So Annie – and fellow sufferers – here’s a tribute to you for ploughing ahead. Pushing through the tears. Clinging to hope. Asking for help. Embracing the reality of your hardship. Refusing to give up. Doing the next thing. Believing there’s divine purpose even though you can’t see it. Loving others in your weakness. And relying on God’s grace, daily. 

It’s a long road, Annie. I marvel at how well you are doing. Keep it up love. I’m with you. We’re with you. 

Hi friends. It’s late and I hear the bed a-callin’.

Anne starts a 12-week chemotherapy cycle tomorrow. Once a week, every Wednesday. 

This new drug (Navelbine) will fatigue Anne for several more months. Not as hard-hitting as the first round, but still no cakewalk. 

And boy. You continue to care for our family so well.  Cancer is heavy, but you guys lighten the load. 

Thank, thank, thank you. 

 

There’s something invigorating about a crisp, cool Friday night that seeps into your skin and makes you temporarily forget the long week. 

At least tonight it did.  

Guess what guys?  The pathology results from Anne’s second surgery showed that only three of the 20 lymph nodes removed were infected.  Woohoo!  

Two positive implications: All infected tissue is now gone. Buh bye. More importantly, it’s unlikely that the cancer spread beyond the breast area because so few lymph nodes were actually infected (they are the body’s special filters for collecting diseases).

Thank you Lord, for your mercy to Anne. 

Once Anne heals up from surgery, she’ll begin a new course of chemotherapy for 12 weeks with a different drug that promises less severe side effects. In fact, her hair should continue to grow back. Can’t wait to see those brown curly locks again. (Though I think Anne could totally rock the buzz-cut look she has going right now.)

Switching topics to “our sweet bears,” as Anne often refers to our kiddos, I love how so many of you ask how they’re doing. If there is one place where God’s grace and kindness is evident in the midst of our hardship – I’m talking tangible.real.miraculous.unmistakable evident – it’s in our children. They are doing remarkably well. 

Just before bed tonight, I gathered our bears on the boys’ bedroom floor for a little daddy powwow.  I told them how much I appreciated the ways in which they were caring for mommy. Thinking for her. Serving her.  Their sleepy eyes brightened when I told them that mommy was beating the cancer because she was doing everything the doctors were telling her to do, even though it hurt, made her tired, and changed the way she looked for a little while. 

As we sat in a little circle, Luke gently asked, “Dad, do you think mom will perish?” Then with his hand cupped over his mouth, Luke whispered, “I said ‘perish’ because I figured Sarah wouldn’t know that word. I didn’t want her to worry.”  Oh no, I thought. How’s my astute 5 yr-old  going to react to Luke’s question?

I quickly tried to answer Luke’s earnest question with a confident no, but not before I was interrupted by Sarah, who chimed in, “Daddy, she’s not going to die right now, but probably a long time from now.”  As the words flowed out, her face was smiling, not the slightest hint of fear or sadness. 

“Well love, that’s right. So why doesn’t that make you scared?”

As her brothers moved to reassure her by holding each of her hands, Sarah answered, “Because Daddy, Mommy is gonna go to heaven where Jesus lives.  So when she does have to die, we can see her again. But that’s a looooong time from now Daddy!”

Amen, sweetheart.  Amen. 

Here we are, camped out in our little curtained recovery area at the Blue Ridge Surgery Center.  Anne’s resting beside me, hovering in a semi-conscious state induced by the lingering effects of anesthesia, pain medication, and exhaustion.

I’m relieved to report that Anne’s radical lymphadenectomy was successful. All the thief’s little node-accomplices were yanked out of hiding and thrown in the slammer for good. If any of those suckers escaped Dr. Canale’s surgical extraction, they’ll be wiped out by radiation.

Deep sigh.

In her more vulnerable moments over the past two weeks, Anne has whispered, “This feels like a bad dream. I just want to wake up and have it all be over.”

Me too sweetheart. Me too.

“I will rejoice and be glad in your steadfast love, because you have seen my affliction; you have known the distress of my soul, and you have not delivered me into the hand of the enemy; you have set my feet in a broad place.”  ~ Psalm 31:7-8

“The thief comes only to steal and kill and destroy I came that [you] may have life and have it abundantly. I am the good shepherd. The good shepherd lays down his life for the sheep.” ~ John 10:10-11

Boy this particular post has been a challenge. I’ve started and stopped it at least half a dozen times. So much I want to convey.

So let me get this out before I get bogged down again: Things are looking up for Anne. Much more than we originally believed.

See, that wasn’t so hard, Van! Sheesh.

Because of Anne’s specific type of breast cancer, she required what’s called neoadjuvant therapy, a fancy term for “chemo before surgery.”  One of the benefits of this therapy approach is that doctors are actually able to see how the cancer responds to chemotherapy prior to surgery.

Despite learning that the ninja medicine didn’t completely kick cancer’s arse, Anne’s chemotherapy was still very effective. As I mentioned in an earlier post, the tumor all but vanished. The pathology report also showed that the infected ducts, lymph nodes, and surrounding tissue all had good therapeutic responses to the ninja medicine.

To put this in context, around 80% of breast cancer patients undergoing neoadjuvant therapy display remaining tumor cells in tissue sampled prior to surgery. What we initially considered disappointing news has become a normal, to-be-expected outcome.

Yet, the objective remains clear as day for Anne: K.C.A.

She’s young, healthy, and can handle more treatment, so now that the tumor and infected breast tissue are gone, Anne has green-lighted additional treatment at the recommendation of her physicians.

On Friday Anne has surgery to remove remaining infected lymph nodes.  Those lymph nodes sit under her left armpit, so the surgeon will simply reopen the incision from her last lymphadenectomy (performed at same time as mastectomy) and go to work.

Following her surgery, Anne will begin another course of chemotherapy for 12 weeks with a drug called Navelbine (Nav-ul-bean). Fewer side effects, which is welcome news. I chuckled when I heard the name of the drug, telling Anne that I’d mix her a glass Ovaltine to go along with her Navelbine. As a side note, Navelbine is partially derived from the vinca vine, commonly known as periwinkle. Little did I know we are growing Anne’s cancer drug in our front yard.

After chemotherapy ends, Anne will undergo radiation five days a week for seven weeks, which should clean up any trace of the cancer in the previously infected lymphatic area.

In the time between my last post and this one, Anne and I have learned a great deal more about the nature of her cancer, the trajectory and specifics of her treatment, and most importantly, reasons to be hopeful.

As you all continue to love and reach out to our family, two questions come up the most often: How can you help? And how are we doing?

Regarding help, a couple of things come to mind my friends.

1. Dinners. Guys I can’t express what a huge ministry this has been to our family. With surgery on Friday and another course of chemotherapy through January, we would still love your help with family meals. Here is the sign-up link, which I believe Manning has updated in light of our extended road: Fletcher Meal Sign-up.
2. You know what else blesses our socks off? Taking our kids for fun outings. They LOVE it.  Anne and I feel so encouraged when we know our children are being cared for and loved by our village of friends and family. It’s the best feeling.

As to how are we doing? I’ll give it to you straight: weary. I chuckle as I type that because if I weren’t so doggone tired I would elaborate.

Yesterday afternoon was our follow-up visit with Anne’s breast surgeon.

When he walked in the door, I could tell something was up, I told Anne afterwards.

The mastectomy was successful.  Tumor and infected breast tissue, gone.  Also, Anne’s decision to remove her right breast prophylactically was smart, said Dr. Canale. Essentially, her right-breast tissue was just the kind of soil in which breast cancer loves to grow.

Now for the not-so-great news.

The pathology analysis of her left-breast tissue (location of the tumor) and surrounding lymph-nodes revealed that while the chemotherapy was effective, it did not completely wipe out the cancer. Some of it didn’t respond to the ninja medicine.

Yeah. Sucker punch. A few friends and family we’ve told may have blurted curse words. Permission universally granted.

Before you go there: this ain’t a death sentence. She hasn’t been told that she has some rare breed of incurable cancer that resists all forms of treatment. The ninja medicine did work: shrinking her tumor dramatically, diminishing its presence in her lymph nodes, and largely wiping out those nasty cells. There are certain cells that resisted the chemotherapy treatment she was given. So we go after ’em with other weapons.

As far as what’s next, here’s what we know today:

All of her lymph nodes surrounding her left breast need to come out.  So, surgery next week.  Bummer.

Radiation is still on the docket after Anne’s lymphadenectomy (say that ten times).  We have to napalm her left side to make sure we incinerate every last one of those S.O.B.s.

In light of the pathology findings, Anne’s oncologist is advising we move more aggressively with hormone-therapy, especially estrogen-blocking drugs. Because Anne’s cancer thrives on estrogen (aka “estrogen-positive”), the basic science goes like this: block the estrogen, and the cancer cells won’t/can’t grow and spread.  She’ll start on Tamoxifen right away, as well as start receiving a monthly shot that essentially shuts down those estrogen factories: her ovaries. We’re hopeful. Hormone therapy is quite effective, we are learning.

After that, we know the doctors will continue to provide guidance as to what’s best.

Lord, you are the Fletchers’ portion. Help us to know, to experience Your all-sufficient, never-failing love.

With hope,
Van

 

So Anne came home the same day of her surgery (Tues).  If you think that seems awfully quick,  so did I!  But seeing as how her sleeping arrangements would be much better at home (staying overnight in a surgery center is something like trying to sleep in an airport), she welcomed the chance to begin recuperating in her own bed. 

Understandably, she’s sore and uncomfortable, which my tough cookie of a wife has to be reminded is normal after something as major as a bilateral mastectomy. (Side note: why does the third day always seem to be the hardest?!)

Her surgery went smoothly, I’m happy to report. As you may remember, there were a couple or more cancerous lymph nodes needing surgical removal, the sum and scope of which only being determined  during the actual surgery. Thankfully, her surgeon only had to remove three, which is a wonderfully low number. We rejoiced. 

What we are still waiting for is the pathology report. Microscopic examination of her breast tissue will tell us if there are any cancerous cells lurking. Boy do we pray not. THAT comes back clear and you are going to this guy doing high kicks, cartwheels, and street dancing. 

Flowers, notes, and food have shown up this week, soul-giving tangible reminders that we have the bestest friends in the world. Thank you guys. Tearing up as I type. 

Pray for us. The road is long, dusty, and hard. There’s still radiation. Eventual reconstruction. And recovery. 

Anne is so eager to start feeling better. I love her spirit. But I told her this week, “Don’t forget you were given poison all summer long, love. And now you just had major surgery. You should feel like sh#%.”

Yes, I did say that. 

I hate cancer. 

I’m up late trying to resolve technology issues, frustrated.

But I’m thinking about Anne.

Today was my sweet bride’s birthday.

Tomorrow she goes in for surgery to remove both breasts. Every time I think about it I well up with tears. Hard.

As I’ve been waiting for my callback from the Microsoft tech guy, I thought of the word…

Courage.

That’s what Anne has displayed. Every step. Like today, when she finished having some sort of radioactive dye shot into her left side to make it easier for the surgeon to see stuff tomorrow. Burned, she said. Yet the radiologist kept asking in perplexed manner, “you’re okay?” As if he expected her to hit him, wail in pain, or curse like a sailor.

I’ve heard Anne mention “war” the past few days in processing what’s ahead. Her metaphor has really stuck with me.

In war, you march on. Towards the enemy. To the battle front.  No matter how dog-tired, discouraged, scared, or famished you are.

That’s courage. And I like the Oxford dictionary’s nuanced definitions…

“The ability to do something that frightens one.”  

and…

“Strength in the face of pain or grief.”

That’s Anne.

Happy birthday to my courageous wife. You’re taking no captives in this fight with cancer.

We’re marching with you. I’m marching with you, sweetheart.

With love,

Hubby

Anne heads in for her final round of ninja medicine tomorrow morning.  Six of six. Celebrating a little bit over here. 

“Can you believe you’re almost done?!” I asked, as if time really had flown by for Anne. (I really knocked that question out of the park, eh?). 

“Yessssssss,” she responded succinctly, and appropriately.  

She knows what’s ahead. Couple of weeks of feeling shellacked by the drugs. Then surgery.  And radiation. Boooo. 

So we ain’t through this thing yet. Still in the jungle. Or desert. Or whatever purgatory-flavored setting you can think of. 

But. 

Our spirits are buoyed. Our hearts are strengthened. Our hope is real. And that is a testimony to God’s grace and mercy, not our faith. We feel weak and  helpless, the very place where our Heavenly Father sweetly meets us. 

Ninja time. Anne or I will be back to you in a few days. 

With joy and perseverance,

Van