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

Jack returned home from seeing his first hockey game last night to find me asleep in his bed.  His brother Luke, so used to having big bro in the room at bedtime, asked if I would stay as he tried to find sleep.  I am pretty sure I found it first.

“Hi, Mom.”

“Hi, buddy!   How was it?”

I scooted over and patted the bed.  Jack climbed in to share the single person space, our heads side by side on his Star Wars pillow.  He’s almost as big as I am now.  The aroma of the sports arena still lingered in his hair.

“It was awesome. Those guys can skate probably twice as fast as I can.”  (Jack has never ice-skated.  I love the confidence.)

Jack told me stories of fights, body checks, and getting tossed a puck as he and our dear friend, Manning, watched from the front row.  This was her birthday gift to Jack, and in the words of our boys, it was epic.

And then, as he often does, he checked in with me, “Mom, how’s your cancer?”

“Jack, I’ve waited all day to tell you some good news.  The doctors took special pictures of inside my body and the tumor is gone.  They can’t see the cancer anymore.”

Smiling, Jack slipped his arms around me and snuggled in close whispering, “This has been a really good day.  God is good.”

“God IS good.  Bad days or great days, God is always good,” I whispered back.  And once again, I think I found sleep first.

In the next few days we will tell the kids about my surgery.  Would you pray for wisdom as we tailor the conversation to each child?

And would you pray for the road ahead?  The two steps of treatment remaining – surgery and radiation – are the clean-up crew.  The ninja medicine certainly worked!  Hallelujah!  The tumor disintegrated, and the assumption is that the cancer cells anywhere else vaporized too.   As we all know, cancer is a war at the microscopic, cellular level.  Surgery will remove the areas where the cancer was visible, but it will also provide the tissue needed for the pathologist to determine if any cancer cells remain.  Radiation is the special-ops forces with gamma-ray laser guns to zap any lasting hold-out cells.  We’re gonna blast those suckers into smithereens.

While the war goes on, we are rejoicing that the hardest part is done and was so effective. Thank you for rejoicing with us!   Your messages and comments have been like throwing a party this weekend.  And thanks be to our good and mighty God, the Great Physician, who has tended to me so well, body and soul!

Pressing on with hope,

Anne

Mammogram, ultrasound and MRI show no visible signs of cancer in my body!  CLEAR! Tumor is GONE.

Happy, happy, happy tears.

Van and I met with my surgeon today who said it well, “It is great to know that all you have endured the last few months has been well worth it.”

Yes!  It certainly is!

Surgery is Tuesday at 10 am.

“Let your steadfast love be upon us, O Lord, as we hope in you.” Psalm 33:22.

When Van and I moved to Philadelphia in 2002, we decided that a proper initiation into the City of Brotherly Love meant reenacting the famous scene from Rocky in which Sylvester Stalone sprints up the steps of the Art Museum. I know what you are thinking: what a novel, unique idea, right?!

At the top of that grand stairway sat a bronze statue of Rocky with arms held high in victory. Once we caught our breath, we snapped a photo with the iconic figure, then spent the next several Friday nights watching all 17 Rocky films.

Cue the theme song to Rocky.

Today I’m stepping into the ring for my last chemo round. LAST round. My boxing gloves are laced. I’m punching the air with my opponent in sight. Dancing around the ring. Deep breath through my (pink) mouth guard. Pep talks from loved ones in my corner.

Did I mention it is the LAST round? (Music now changes to Handel’s Hallelujah Chorus.)

Rocky Balboa isn’t known for his eloquence, but he had a handful of memorable lines. One that particularly resonates: “The world ain’t all sunshine and rainbows.”

Looking back across the traveled terrain of the last four months, I see lots of rocky, dusty, difficult stretches. Dotting the landscape are piles of stones, visible reminders of how my Heavenly Father was with me. Every step. That gives me courage to endure what lies ahead.

Ahead…

Scans are Thursday, October 1st. How I long to hear the word “clear”! Bilateral mastectomy mid-October. Then daily radiation soon after, for 5-6 weeks. Followed by infusions of Herceptin, a hormonal therapy, which will continue until next June. Lastly, reconstruction surgery mid-summer. The hard-hitting treatments will be finished by this Christmas! Hair sprouting on my noggin will be a welcome Christmas gift. Sarah even said she would give me some new hair bows for my new hair. I’ll share the photos, don’t you worry.

As this last round of ninja medicine and body scans approach, fear is starting to pump up the volume in my heart. I needed C.S. Lewis’ encouragement yesterday…

“The great thing with unhappy times is to take them hit by hit, hour by hour, like an illness. It is seldom the present, the exact present, that is unbearable.”

Jesus taught us to pray for daily bread. Battling cancer is a grand lesson in this. If I get too far ahead on roads unknown, daily bread doesn’t seem to cut it. In those moments, I’m existing in an imagined life with a small God. Living in the exact present is hard work at times…

“He who did not spare us his own Son, but gave him up for us all–how will he not also, along with him, give us all things?…For I am sure that neither death nor life, nor angels nor rulers, nor things present nor things to come, nor powers, nor height nor depth, nor anything else in all creation, will be able to separate us from the love of God in Christ Jesus our Lord. (Romans 8:32, 35-39)

Past, present, and future grace summed up right there.  God has given his children a Kingdom that can never perish, spoil, or fade. He has given us Himself.  He is with us.  We know how this grand story ends…all sunshine, rainbows, and so much more.  Sooooo much more!  All because of the perfect sacrifice of Jesus.

My present fear just got swallowed in love. Cue Amazing Grace.

Amazing grace! (how sweet the sound)
That sav’d a wretch like me!
I once was lost, but now am found,
Was blind, but now I see.

‘Twas grace that taught my heart to fear,
And grace my fears reliev’d;
How precious did that grace appear
The hour I first believ’d!

Thro’ many dangers, toils, and snares,
I have already come;
‘Tis grace hath brought me safe thus far,
And grace will lead me home.

The Lord has promis’d good to me,
His word my hope secures;
He will my shield and portion be
As long as life endures.

Yes, when this flesh and heart shall fail,
And mortal life shall cease;
I shall possess, within the veil,
A life of joy and peace

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

My first thought was, “You’ve got to be kidding me.”

I was standing at a store checkout counter when I got a phone call from the school nurse. Sarah had hurt her wrist at recess. 

Daddy to the rescue. 

The day had already been stressful, and it was only 1:45 pm.  Emotionally, I felt like I had been crawling through mud and barbed wire as sporadic enemy fire whizzed overhead.  I’m weary and don’t need this, I told myself. 

But. No matter how cruddy you feel, when your child is in pain, you pop it into a special gear reserved for such occasions. 

Beeline to Raleigh Orthopedic’s Urgent Care. May or may not have pushed the accelerator a little harder. 

Sarah and I show up to an almost vacant waiting room. Score. 

After a relatively uneventful x-ray (for which Sarah keeps her eyes closed the entire time), I’m relieved to hear it’s only a sprain. My baby girl and I immediately decide a milkshake run is called for. 

I’m polishing off a frosted lemonade from Chick-Fil-A as I drop off my brave little girl at home, where a joyous welcome party greets her at the door. 

Now, back to work for a bit. 

For the life of me I can’t remember what I was stressed about.

  

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I’m sitting here in the land of chemo side effects, feeling especially thankful for laughter. Can’t get enough of it these days. Web MD, my favorite online health resource, repeatedly lists laughter as a powerful agent in treating all sorts of illnesses. So then it’s official, right?!

The other morning I got a good dose of laughter.  Sarah, my kindergartner, who possesses a silly bone the size Texas, chimed in while eating cinnamon bread, “Mom, did you know that ‘booger’ and ‘booger’ rhyme?”

After further discussion, I figured out that she was trying to say “burger” and “booger”.  The fact they actually do not rhyme is beside the point…we’re working on that. My kids have each had homeschool speech therapy for pronouncing the word “burger.”  Burrrrr-Gurrrrr.  Ok, try again.  Burrr-gurrr, not boog-er.  Burrr-gur. These therapy sessions occur on hamburger nights and when we have drippy noses.  They all have their first cold of the school year, so boogers are on their minds and unfortunately, their sleeves.

But I digress…

During these harder, feeling-really-icky days of fighting the big, bad thief, laughter has truly been medicine for my body and soul. It both invigorates and flows from recognition of the good things in life. God is the giver of those good things. Funny things. Just look at a walrus or platypus; God certainly has a fantastic sense of humor. And as those created in our Heavenly Father’s image, we can laugh because He laughs.

Part of this cancer journey for me has involved growing in the skill of “good-things scavenging”, a.k.a. thanksgiving.  When laughter comes via my kids, Jim Gaffigan, Jen Hatmaker, and my husband Van, giving thanks comes more easily.

On that note, I am thankful for some biggies – the comforting presence of my Heavenly Father, the peace of my Savior that pervades my fearful heart, and the loving embrace of my church, friends, and family. I’m also thankful for little things that, from where I am sitting, make a big difference. They make me smile. Like my eyelashes.

At Van’s insistence, I would like to give my beloved lashes a Standing Ovation by sharing a poem I wrote the other day, entitled Ode to my Lashes. Hope you enjoy…

Ode to my Lashes

Your comrades adorning my head and the rest, abandoned their stations at the start of this test.

Determined you’re clinging with admirable might; Standing firm on my lids for this prolonged fight.

Heavy the pressure you endure from your peers. But you, oh lashes, are my faithful dears.

---

Beating the odds and proving your strength, your staying-power is rather impressive in length.

Even the micro-hairs deep in my ears have, along with the nose kind, surrendered, I fear.

Assessing each day what hair remains still, I admire, oh lashes, the strength of your will.

---

Applying mascara, I’m exceedingly proud; you’re strong little guys, standing out from the crowd!

Your presence provides a near-normal appearance; grateful am I for your dogged perseverance.

A small but significant help to my sanity. Thank you, oh lashes, for this one gift of vanity.

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Realizing, indeed, a rough road lies ahead, you may, at long last, be forced out and shed.

Even the mightiest can not forever stand, as winds and waves buffet your soft land.

Yet it seems through the tempest you’ll hold on ’til the end. For you, oh lashes, are my loyalest of friends.

“Blessed are you who hunger now, for you shall be satisfied.  Blessed are you who weep now, for you shall laugh.”  (Luke 6:21.)

I’m thankful for these heavenly doses of laughter.