Sunday, June 26, 2022

Going Through the Storm

What do you do when the only option is to go through the storm? Have you ever been driving along and a storm pops up? You are stuck either on the side of the road or you choose to go through the storm. The dark black clouds loom low to the ground and the rain starts to fall obstructing your vision in front of you. You keep moving because you don't want a car from behind you to run into you, but you are cautious as you move forward not knowing what lies ahead. As you pass through the storm everything around you fades into shades of gray, a big blur, and loud pounding on the windshield and roof of your vehicle. Will it end soon? Thunderstorms typically don't last that long and are moving rapidly. Just like the storms of life that last mere moments or seasons. I'm learning that some storms in life you don't get to choose to go through, they choose you.

Photo By: Stacey Beam

Photo By: Stacey Beam

Have you ever been on a bear hunt? Maybe a deer or turkey hunt? Hunting is one of those tricky outdoor hobbies that require a bit of skill and luck to bring home the trophy prize. My experiences with hunting are somewhat limited.  I’m a beginner and have only lived here in Missouri for almost five years. I’m learning about how to hunt the wildlife in the Ozarks. I enjoy being out in the woods, breathing the forest air, and observing the flora, fauna, and wildlife around me.  It is a peaceful time of sitting in silence from human noise, absorbing the surroundings, and tuning into the sounds of nature.  It can be physically demanding to find the perfect location due to terrain and weather conditions.  The time of year typically is in the fall and sometimes it is warm or downright freezing cold.  The wind can be your friend or foe. There is great anticipation built up to the hunt itself.  So much preparation goes into sacking the big one.   


I’m reminded of a pre-school song “I’m Going on a Bear Hunt, Gonna Catch a Big One.” You may be familiar with the catchy tune. If not check out my link to the song.  


I’m going on a bear hunt of my own.  Well not for a real bear.  The bear of cancer. Defeating the big, scary bear.  I keep repeating the line from the song, "I’m not afraid!” Mentally repeating the phrase and replacing it with scripture.


Philippians 4:4-8 "Rejoice in the Lord always. I will say it again: Rejoice! Let your graciousness be known to everyone. The Lord is near. Don't worry about anything, but in everything, through prayer and petition with thanksgiving, present your requests to God. And the peace of God, which surpasses all understanding, will guard your hearts and minds in Christ Jesus. Finally, brothers and sisters, whatever is true, whatever is honorable, whatever is just, whatever is pure, whatever is lovely, whatever is commendable --if there is any moral excellence and if there is anything praiseworthy -- dwell on these things."


Romans 8:18 " For I consider that the sufferings of this present time are not worth comparing with the glory that is going to be revealed to us."


John 16:33 " I have told you these things so that in me you have peace. You will have suffering in this world. Be courageous! I have conquered the world."


2 Timothy 1:7 "For God has not given us a spirit of fear, but one of power, love, and sound mind."


Exodus 14:14 "The Lord will fight for you, and you shall hold your peace."


Isaiah 43:2 " I will be with you when you pass through the waters, and when you pass through the rivers, they will not overwhelm you. You will not be scorched when you walk through the fire, and the flame will not burn."


Philippians 4:13 "I can do all things through him who strengthens me."


In the song, "Going on a Bear Hunt" there are several obstacles encountered before arriving at the cave of the bear. For me, I feel like there have been many obstacles along this journey with breast cancer. Most of which are completely out of my control. The thing I keep repeating to myself is to keep perspective, keep calm, keep hoping, and keep fighting. I don't have understanding or answers, but I know the One who does.


Obstacle one – the grass

Do you ever find yourself looking at what other people have that you don't have? Maybe it seems like the grass might be greener on the other side of the fence? I'm talking about playing that comparison game. You know the one where you scroll through social media, stopping at the pictures of friends on these vacations, or the perfectly posed family photos like Joanna & Chip Gaines? Yeah, I want to be like that, but deep down I'm not. This constant comparison is exhausting. It robs you of joy and replaces your feelings of security with doubts and what-if questions. It is dangerous. When you walk through tall grass or brush in the woods it is very important to watch your step. Hidden in the path may be snakes. Sounds a bit like how the devil wants to trip us up in our thinking--yep the grass sure is green over there. Don't fall for this lie. The devil is keen and cutting. He is crouched like a lion ready to pounce on the prey moving in the tall grass. If the devil can get to us by using mind games to get us thinking we don't compare and measure up against others he wins. We have to win the game in our minds and take control of the negative and degrading self-talk we often partake in. It tends to be in the realm of social media where it runs rampant. Check yourself -- make sure the grass is kept short around you. Remove those distractions, know your boundaries, and call out for help if you get lost in the tall grass. We may look at those pictures and think, wow they have it together. The real reality is those pictures don't say it all. True they may be on vacation once again this summer but you don't know the full story. You are assuming the information you don't have. It may look like life is going along just fine. But under the air-brushed photos and piles of unpaid bills and sleepless nights of loneliness are other Moms wishing their life was like yours. Really we don't want to trade places with anyone. But sometimes we want to because life just seems unfair. My summer certainly isn't going the way I had planned. I'm making the most of it, regardless of a cancer diagnosis and needing chemotherapy. I'm not hiding out in the tall grass wishing I was someone else. This is my path and the enemy better move along. SWISH. SWISH. SWISH.


Obstacle two – the river

Water can be very deceiving. The river may look calm and slow-moving on the surface, but underneath it is swiftly moving with currents. Sometimes in life, it seems like we are drowning in a river of regrets. We made bad choices or worse someone we love made a bad choice and now life is messed up. I see it over and over again. The brokenness of families ruins confidence and confuses young children as to what true love is. We end up drowning in a sea of broken promises, confusion, anger, depression, and bitterness. The river for me seems to be this constant battle with my health. Maybe for you, it is finances or relationship woes. It really doesn't matter what the issue is we can all relate to this feeling of water rising to the point of sucking us down. We are trapped and figuratively drowning. Feeling like you are in over your head? Join the club! Rest assured the Father knows what we need even before we ask. Call to the one who can speak a Word to calm the seas in an instant. You might get wet in the process of getting out of the boat. Be okay with that. Life is hard. The struggle is real. SPLASH. SPLASH. SPLASH.


Obstacle three – the mud

Mud is messy. Life can be a real mess. It's not always easy and it certainly doesn't go the way I want it to go every time. Maybe you have never thought of mud as a medium for transformation. Certain types of soil produce clay.  Wet clay is very sticky and rolls like plasticine.  It is easy to mold and shape into the desired object. When it dries it is able to keep the shape of the object. Usually, the clay is put in a kiln and heated to very hot temperatures around 1,800 to 2,400 degrees Fahrenheit.  Does anyone else feel like it is hot in the trial? Like you are going to burn up or out? This is part of the process. Clay has to be molded. Whose job is that? The Bible gives the analogy of the Father being the Potter and we are the clay. In Isiah 64:8 "But now O Lord, you are our Father; we are the clay, and You our potter; and we are the work of your hand." So all this mud and clay is the work of the Father. He is making us like Him as we go through the hardships in life. He is molding, shaping, breaking, creating, over and over again in each of us a perfectly unique you and me.  Just like Peter wrote, "Beloved, do not think it strange concerning the fiery trial which is to try to you, as though some strange thing happened to you;  but rejoice to the extent that you partake of Christ's sufferings, that when His glory is revealed, you may also be glad with exceeding joy." 1 Peter 4:12-13 The mud may be messy but God is making something beautiful out of it.  SQUISH. SQUISH. SQUISH.


We can't go over it
We can't go around it.
We can't go over it.
We must go through it.
That is what Jesus wants us to do -- go through the grass, river, and mud -- He is with us every step.

HEALTH UPDATE

Monday, June, 27 I will be having outpatient surgery to place the power port for chemotherapy.  This will be done in West Plains. On Tuesday I have a planned visit up in St. Louis along with a bone density scan.  On Wednesday I begin my treatments for chemotherapy. We are coordinating the chemotherapy with my oncologist here in West plains to make travel trips less.  I am very thankful we have that option. All of my 4 chemotherapy treatments will be done locally here in West Plains. I am very eager to get this going.  The quicker we can start the quicker I can be done! Please pray that my labs are all "normal" and comply with the protocols for receiving chemotherapy.  I will try to update as I can.  I know that while receiving chemotherapy you feel rather groggy due to all of the medications you are receiving. Praying no major side effects and allergic reactions occur. 

I have had several reach out and want to know how they can help my family.  If you can get ahold of anyone at New Hope Baptist Church that would be a great place to start.  You can always message me and I can relay the message. Thank you again for text messages, calls, Facebook messages, and cards.  You are all so amazing and I'm blessed to have a wonderful support family.









Tuesday, June 14, 2022

Facing the Tough Decisions

Indecision. Feeling stuck. Fork in the road. Right or left.  Up or down. Choosing to not make a decision is paralyzing, agonizing, and plain exhausting. I have spent some time in this camp lately. Gathering all my information to build a case for or against chemotherapy has been the hardest decision I have had to make.  Ultimately it comes down to faith.  Do I trust in the God of the universe who created the heavens and earth and holds my life in His hands, or do I trust in myself to pick what is best? I have been wrestling this out between the voices in my head and the dozens of pieces of papers from the doctor's office, google search tabs of breast cancer articles, notecards filled with scripture verses, and an abundance of cards/notes from friends and family. I've heard from many of you offering prayers and words of encouragement. I can't tell you how important each one of you is to me. 


I have prayed for clarity, wisdom, and direction. My prayers were confirmed Wednesday evening. I was tying to justly a 2-3% in my favor or against my favor. On Wednesday night I went to bed with my decision made: No chemotherapy.  I had weighed my options. Reasoned the pros and cons of partaking in the poison cocktail club and firmly announced to myself, nope not going to happen this time.  I was ok with this. I honestly thought the side effects and potential risks involved outweighed the benefits of doing the treatments. But God had other plans...

On Friday afternoon my oncologist doctor called.  There was a clerical error in the final pathology report she wanted to clarify and have corrected.  I agreed.  It was regarding how many lymph nodes were taken and tested.  There were 3, and all 3 tested negative for cancer.  This is good news and didn't change anything we knew.  She wanted to repeat a previously completed study using a piece of tissue that had not been used for another testing.  She was wanting to confirm the hormone status of my type of cancer as well and just ordered a repeat on that.  It is not as common to have lobular carcinoma in situ with only estrogen positive.  Typically you would see both estrogen and progesterone positive and she wanted to confirm my data.  She also wanted run the Ki-67 test once again.  This test is commonly used to measure the cellular proliferation (how fast cells are dividing) of the breast cancer tissue.

SCIENCE CONTENT WARNING (I know I love this stuff, maybe you do too!)

Ki-67 assessment is probably the best known.  A monoclonal antibody is used for IHC (immunohistological) staining of the proliferation-association nuclear protein Ki-67 in tumor cells to determine the percentage of Ki-67 positive cells among the total population of tumor cells in formalin-fixed paraffin-embedded sections contained from a core-cut biopsy sample, this is the Ki-67 index.

Tumors are classified as having a high or low Ki-67 index based on a prespecified cutoff.  Tumors with a high Ki-67 index have a larger number of proliferating cells and are therefore likely to grow more quickly. A score of greater than 30% of tumor cells showing staining compared to malignant cells is considered high. Breast cancers that are ER-positive (estrogen receptor) can be classified into two molecular subtype groups: Luminal A and Luminal B. Typically Luminal A tumors have a lower rate of proliferation than Luminal B tumors. This means Luminal B tumors are more aggressive types of cancer. About 85 percent of breast cancers are ductal carcinomas, while 11.4 percent are lobular carcinomas, according to a study published in the Annals of Medicine and Surgery. More than three-quarters of lobular carcinomas fall into the luminal A and triple-negative tumor category.

The results came back confirming what we previously knew -- ER-positive only.  But the Ki-67 test confirmed again with a high index value greater than 30% of cells stained were present.  She also mentioned that the subtypes were present and that indication "heightens" the aggressiveness of my lobular carcinoma breast cancer.  She went on to say that she is changing her suggestion of adjuvant chemotherapy to recommending I really need to do this. Big sigh. Deep breathe. You got this! Ok, so what you are saying is even though...

  • 3 out of 3 lymph nodes negative
  • Stage 1
  • Clear Margins from DBMX
  • Grade 3
  • ER + / PR -
  • Oncotype score 18
  • Ki-67 <30%
  • Lobular carcinoma in situ (LCIS)

So we need to partake in chemotherapy? Yes, I'm so sorry. So my decision became clear. I am to do chemotherapy. The data doesn't lie. 

The plan now is to coordinate doing chemotherapy here in West Plains for the sanity of myself and my husband.  Driving to St. Louis is a long drive and the price of fuel is not helping! I am so glad that Siteman will work with my local oncology doctor here in West Plains. I will have more information soon as to when all of this will begin.  I will do 4 treatments, 3 weeks apart. We will be placing a power port to receive chemotherapy IV directly. When this begins will depend on scheduling and getting insurance lined out.  I have every intention to continue working each day for as long as possible. I know that some days that just may not happen. I am so grateful for wonderful teacher friends and administration who are willing to support me and give me time to take care of myself.  



On Saturday my church family rallied together to support me with a benefit event.  Everyone went all out. I am so grateful for the kindness and generosity of my friends at New Hope Baptist Church and the many local businesses that donated items to help raise money.  You all know who you are and I love you!

Now I will begin to prepare myself for the battle ahead. So how do you tackle the monster you are dreading? Put one foot in front of the other — and walk toward the impossible water. Drench yourself in Hope. Get out of the boat and walk on the water.   The only way forward is to step into your sea — because you’ll drown in despair if you don’t follow Hope Himself forward.  The road may look uncertain. I know who goes with me. I will be brave. 

You Make Me Brave

I stand before You now
The greatness of your renown
I have heard of the majesty and wonder of you
King of Heaven, in humility, I bow
As Your love, in wave after wave
Crashes over me, crashes over me
For You are for us
You are not against us
Champion of Heaven
You made a way for all to enter in
I have heard You calling my name
I have heard the song of love that You sing
So I will let You draw me out beyond the shore
Into Your grace
Your grace
As Your love, in wave after wave
Crashes over me, crashes over me
For You are for us
You are not against us
Champion of Heaven
You made a way for all to enter into
Your love, in wave after wave
Crashes over me, crashes over me
For You are for us
You are not against us
Champion of Heaven
You made a way for all to enter in
'Cause you make me brave
You make me brave
You call me out beyond the shore into the waves
You make me brave
You make me brave
No fear can hinder now the love that made a way
You make me brave
You make me brave
You call me out beyond the shore into the waves
You make me brave
You make me brave
No fear can hinder now the promises you made
You make me brave
You make me brave
You call me out beyond the shore into the waves
You make me brave
You make me brave
No fear can hinder now the promises you made
You make me brave
You make me brave
You call me out beyond the shore into the waves
You make me brave
You make me brave
No fear can hinder now the promises you made
As Your love, in wave after wave
Crashes over me, crashes over me
For You are for us
You are not against us
Champion of Heaven
You made a way for all to enter in
As Your love, in wave after wave
Crashes over me, crashes over me
For You are for us
You are not against us
Champion of Heaven
You made a way for all to enter in
Source: LyricFind
Songwriters: Amanda Cook
You Make Me Brave lyrics © Bethel Music Publishing

Tuesday, June 7, 2022

When All You Want in Life is the Easy Button

It has been a while since I last posted. This journey has been rough, to say the least. The waiting is long and even when a test result comes back, it is not definitive. It just seems like the information keeps coming. It's a case of probabilities that may or may not be in my favor. It is hard. All my heart wants is to press the big fat red easy button and for it to all be over with. Get my life back to "normal." The problem is there is no such thing. There is no such button you or I can push to alleviate the hard in life. We all have hard. It just might come in different packages for each of us. I want to be in control. It is a reminder that I am not, and frankly, I really don't want to be. I just don't want the hard stuff. There is a purpose in the hard. Without the hard in life, we would have no need for faith, no need for a savior. Jesus said, "In this world, you will have tribulation; but be of good cheer, I have overcome the world." John 16:33 We are given a promise from the very lips of Jesus: you will have hard things in life (trials). Did you catch that? Not if you have trials, but you will have trials. Notice the preposition: BUT. The good news is followed right after that little word: but. It's a direct order, a command to "be" meaning to take action (verb) with something we can control within each of us. It is your attitude. Be of good cheer means having a good attitude, having self-control, choose joy in the midst of a hard circumstance or situation. Then we get the reminder that Jesus has a plan and in the end, He wins. I have a poster in my classroom I made. It reads, "Two things you can control, 1) attitude, 2) effort." I am constantly telling my students in the classroom that they are responsible in life for their attitudes about someone or something. They are also responsible for how much effort they want to apply themselves to complete tasks. This covers literally all issues we teachers face in the classroom today. I personally like to reward students who demonstrate excellent attitudes and give measurable effort despite a poor grade. I have found that an optimistic/positive attitude is directly related to the effort level. Guess what, it works every time. If attitude can be "coached" and a student is willing to make some mental changes and try harder to apply himself or herself the sky is the limit. I have witnessed some students do amazing things they didn't think were possible of achieving. I'm trying to listen to my own words and give myself a pep talk.

I am pondering some hard decisions regarding my future treatments. I haven't reported much lately because I really don't know what to say. At first, I thought with the stage of 1 Breast cancer and clear margins and no lymph nodes positive meant I was in the clear -- no chemotherapy necessary. More test results have shown strong indications that chemotherapy would be advantageous for my type of cancer. I have a very aggressive form of breast cancer (LCIS with ICS). They did catch it in its early stage. When you combine all laboratory pathology, genetic testing, and future predicting breast cancer testing all the numbers point to adjuvant chemotherapy along with hormone therapy for lower reoccurrence rates. When combined together the numbers significantly go down as far as the likelihood of reoccurrence over the next 9 years. The hardest part is the doctor is just giving me all this information and wants me to decide what I would like to do. I can just do the hormone therapy alone, or I can do both chemotherapy and hormone therapy. The easiest way to explain it is like this: Based on a huge study (TailorX) the data can be applied to my situation like this, out of 100 women 12 are more likely to have a reoccurrence. So 88% chance it is not coming back. If I add in the hormone therapy it increases that percentage to about 94%. If I add in the chemotherapy regiment, it adds another 2-3%, at about 96%. This is a prediction. Not a guarantee.  I could do nothing more and take my chances that I am not one of the twelve. I could do all of the above and still have something come back in the next few years.  The choice is mine. No pressure. Now you see why I want an easy button. I've been here before. Having to face chemotherapy before is not something anyone wants to undergo. I have had conversations with God about this all ready being on the "not to do ever again bucket list," and here we are again on the doorstep of staring at the beast of chemotherapy. This is not on my bucket list, again! So the decision has to be made on what direction to go for treatment. I choose to seek medical treatment at the Siteman Cancer Center because it is one of the best cancer treatment facilities in the US and maybe the world. I wanted expert minds to review and advise what is best in my situation. I have prayed. I have waited and waited. I am wrestling with my scientific self who says, yeah do the chemotherapy for that extra 2-3% decrease in reoccurrence over the next 9 years. But my heart is just not in it. Is it worth the stress my body will have to endure? Is it worth the rearrangement of my schedule? My husband's schedule? My kid's schedule? What about the side effects both short-term and long-term? It is well known that some chemotherapy drugs do in fact cause or lead to other types of cancer. We all know that the purpose of undergoing chemotherapy is to kill cancer cells. The problem is the chemo drugs can't distinguish which cells are possibly cancerous and which ones are healthy.

 My oncologist doctor is recommending Cylcophoshamide, trade name Cytoxan, and Docetaxel, trade name Taxotere. This would require 4 treatments over a 12-week period. It is an aggressive dose in a short amount of time. 
Technical Information (From Chemocare.com): 
Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division). The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in the division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis). Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, the rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles. Unfortunately, chemotherapy does not know the difference between cancerous cells and normal cells. Chemotherapy will kill all cells that are rapidly dividing. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, are the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body. Cyclophosphamide is classified as an alkylating agent. Alkylating agents are most active in the resting phase of the cell. These drugs are cell-cycle non-specific. There are several types of alkylating agents. Docetaxel belongs to a class of chemotherapy drugs called plant alkaloids. Plant alkaloids are made from plants. The vinca alkaloids are made from the periwinkle plant (catharanthus rosea). The taxanes are made from the bark of the Pacific Yew tree (taxus). The vinca alkaloids and taxanes are also known as antimicrotubule agents. The podophyllotoxins are derived from the May apple plant. Camptothecan analogs are derived from the Asian "Happy Tree" (Camptotheca acuminata). Podophyllotoxins and camptothecan analogs are also known as topoisomerase inhibitors. The plant alkaloids are cell-cycle specific. This means they attack the cells during various phases of division. Antimicrotubule agents (such as docetaxel), inhibit the microtubule structures within the cell. Microtubules are part of the cell's apparatus for dividing and replicating itself. Inhibition of these structures ultimately results in cell death. During chemotherapy, the idea is to rid the body of the cancer cells and try to keep you going. It is horrible. The chemotherapy cocktail is specific for each cancer patient. There are medications given to help alleviate and make unpleasant symptoms milder and easier to manage. I remember it like yesterday. Every time I brush my teeth it reminds me of chemotherapy. I had a big issue personally with how my mouth tasted during chemo last time. I wanted to brush my teeth all the time. The only problem was it made me gag. I know maybe that is TMI! But seriously the struggle was real, daily. 
I'm going for a walk again. Time to get to the bottom of this and make a decision. I appreciate your prayers and words of encouragement. I know this was a lot of information. It is for my brain and my heart. I have cried a lot. I am so torn. I do not have peace in my heart. I am asking God to give me clarity, wisdom, and the courage to walk boldly in the direction I am to go. I will continue to wrestle this out like Jacob. All through the night, Jacob wrestled a man. He wouldn't let the man go. He wanted a blessing. He wanted to know His name. He knew enough to give the man a name himself after not being able to win the battle all night long. Peniel-meaning I have seen God face to face. And the man touched Jacob's hip socket.  This took Jacob's ability to run away, physically and literally.  No more running. He changed Jacob's name to Israel. Meaning he contended with God.  He went from Jacob, meaning laughter to fighter or contender. I want in on what Jacob learned that night. God is in the business of not letting go. He wants to bless us. I'm a fighter a contender.  What about you? Nothing easy about it.







Kari Jobe  with Elevation Worship -- The Blessing

If you are local here in Missouri there will be a benefit event on my behalf on Saturday, June 11th at New Hope Baptist Church in Peace Valley (7908 CR 1790 WP 65775). It is from 3 pm to 7 pm.  There will be food and a silent auction. If you are unable to attend and want to help out privately message me and I'll get you the information.

It's About Time

Christmas 2022 Luehrs Family This past year has been filled with many planned activities and some of them were a surprise. Once again our fa...