3/9/17 Urgent Prayer Needed

Dear Friends and Family,

This is just a quick, urgent request for your prayers.  In December, the company Tesaro, which makes cancer drugs, applied for fast track approval by the FDA of a new fully tested drug called Niraparib, which is designed to treat my exact type of cancer.

The FDA has agreed to fast track approval with a "target date" of June 30, 2017.

I am getting toward the end of my options at this point, and am praying so hard that my current therapy will be something my body can sustain, and that will hold the cancer in check, until Niraparib is approved.  

Niraparib could double to quadruple my current life expectancy.  I could see my son graduate from medical school.  I could perhaps see my daughter get married.  I could continue to love and nurture my beloved grandson, Jericho.  And of course, enjoy the blessing of more time with Steve, Renee, Daniel, and all of you--my dearest family and friends.

Will you pray with us for this drug to be approved on time and for God to give me strength to endure this current difficult therapy in the meantime?  

Thank you!!  

Love,
Gabrielle

Philippians 4:6-7 "Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus."

3/6/17 New plans

     Hi, family and friends.  Steve here with an update.  As some of you know, Gabrielle has been having worsening symptoms for the past month with more stomach pain, back pain, loss of appetite, and more.  It got even worse while we were on vacation on Maui last week.  So bad, in fact, that we tried to get an early flight out of there just to get back home, which is the only place you want to be when you don't feel good.  Gotta feel pretty lousy if you can't wait to leave paradise, don't you think?

Anyhow, while we languished in the Pacific, doing our best to make the most of our forced exile, Gabrielle was in contact with her doctors back home.  They arranged for her to have some tests the moment she got back.  We got in late last Thursday, rolling home after midnight.  Six hours later, it was time to get up and head down for an endoscopy (“upper GI” study) to be followed shortly afterwards by a CT scan to see what could be causing her symptoms. 

I spoke with the GI doctor just after the test and it was pretty good: no ulcers or significant findings.  We had a nervous time over the weekend, waiting for her appointment at 8:00 this morning to go over the CT scan results with her cancer doctor.  Unfortunately, the results were less than favorable.  In a nutshell, the cancer has spread to the liver with at least three new spots that were not there on the scan in late December.  Several lymph nodes in the abdomen have gotten larger as well and appear to be compressing some of the important structures in the area such as the main vein that enters the liver (portal vein).  Doctor said that this could also be causing “gastric outlet syndrome” in which she is hungry, but the food just doesn’t leave the stomach all that easily.  Can also account for all the horrible back and abdominal pain she has been having.

So, in clinical terms, the cancer is progressing and clearly the two medications she had been on since the first of the year weren’t doing a lick of good.  Treatment of cancer involves trial and error.  Some drugs are winners, and some are not.  New plan is to step things up to a much more aggressive approach with weekly chemotherapy which starts tomorrow.  Plan is to get two drugs: Taxol (the one which makes your hair fall out) and Avastin.  Had labs today to make sure that her blood counts are good enough to get Taxol, which we are hoping for, as this is the cancer fighting component of her new treatment.  Avastin is supposed to cut off the blood supply to the cancer cells, but doesn’t have any cancer killing properties of its own.  She has had both medications before.  We are a little nervous about the Avastin as that’s the one that has a potential side effect of bowel rupture, which is potentially life threatening, but we do not have a whole lot of other options at this point.   

Doctor said she had been in contact with our insurance company (Regence, not like I’m naming any names or anything) and they are being downright persnickety about approving the Avastin, unless it is combined with the Taxol.  So far, so good, since she is supposed to get the Taxol as well, but the concerning thing is that if she can’t get the Taxol due to low counts, they may not approve Avastin by itself.  When the doctor told us about this, she said it was infuriating that they would not approve it, and plans to go toe to toe with them soon.  She is, after all, the expert’s expert on ovarian cancer treatment, not the insurance companies.  We are confident that things will work out such that Gabrielle will get the drugs, but it is still very frustrating to deal with insurance issues in the midst of all this.  Having said that, am thankful for the insurance that we do have.

            This is all quite an adjustment for us, to see such rapid change in the CT scan and see such worsening symptoms in such a short period of time.  We are all nervous about what lies ahead, but are confident that with God’s strength we will weather the storms.  His grace is indeed sufficient.  We appreciate your kind thoughts, prayers, and support.  It looks like we are in for a bumpy ride ahead.

            I will end by saying that this sad news comes as a shock to all of us.  It also seems a tad incongruent in light of how good she looks.  Time and again, people have commented on the fact that she appears so healthy.  This is a testimony to her iron resolve and determination not to let the cancer define her or bog her down.  Being around her a fair bit, I have been so impressed with how she has faced this cancer from the very beginning with an attitude of strength, determination, and sheer guts.  She has never let the setbacks get to her.  She always has kind words and smiles for the medical staff attending her, and thanks them for their service.  She faces pain with a fortitude that I cannot even begin to fathom.  Her faith in God and His providence and goodness is unwavering and an inspiration to us all.  In short, she is my hero.  As she goes into this next battle, I have no doubt that she will continue with the same bravery and courage that she has demonstrated all along.

            Even now, as I am finishing this little note, she is sitting across from me, reading passages to me from C.S. Lewis’ Mere Christianity (phenomenal book by the way).  She just hit on a passage about the contrast between this life and the next being similar to the difference between cold stone statues and the real living, breathing organisms that we all are.  There is a hush about the sculptor’s studio as there is a rumor that some of us statues are going to come to life some day.  That will indeed be a glorious day.

Maui, last week.  People always say "You look so good!" which, of course, is nice to hear.  But just like in much of life, what you see on the outside is not always reflective of what's going on on the inside of a person.  Best to get beyond the surface if you really want to know what a person is going through and if you want to learn how best you can come alongside them in the journey.   

2/16/17 Thoughts on Cancer and Churchill

Dear Family and Friends,

At the Dudley home, we have an elliptical machine in our basement that faces the TV.  This makes it immeasurably more fun to work out!  Recently while sweating away, I watched an outstanding documentary about Winston Churchill’s wartime years called “Appointment with Destiny.”  I had always admired Churchill before, but after watching this portrayal, he rose to the auspicious rank as one of my top five favorite famous humans (apologies for the “f-words alliteration). 

Five of his quotes have particularly stuck with me, as I am in a life and death battle with cancer, obviously on a much smaller scale than Churchill’s (hereafter WC) battle with Hitler.

1)  Since Steve last reported to you after my 12/29 scan, a few things have happened.  I began a new daily oral chemo drug called Cytoxan on January 10^th, and two weeks later, had to go to the ER due to intense pain from my chest down to my lower abdomen that would not go away.  The ER doc was to rule out things like heart attack or a blood clot in my lungs.  Thankfully, I was cleared of both worries, so I soldiered on with the Cytoxan.  “If you’re going through hell, keep going.”--WC  The hourly, daily suffering continued—indigestion, gas, bloating, heartburn, and a general unwell feeling.  After a month, I couldn’t take it any more and the doc told me to stop the Cytoxan immediately, as it was doing more harm than good.  

2)  Next, the doctor told me tests had revealed an infection, so she started me on antibiotics, and to heal my stomach and intestines from the toxicity of the Cytoxan, she put me on a “low residue diet.”  Basically I get to eat things that are low fiber, low fat, and super easy to digest until I heal.  I am normally a high fiber eater, so it is just mildly irritating to have to eat canned peaches and green beans and unbuttered peeled potatoes for dinner while Steve and Daniel are having roast chicken, lobster bisque, and broccoli!  Every day I anxiously wonder whether or not my guts will heal before my trip to Maui, for we have reservations at a top-rated sushi restaurant there that is exceedingly difficult to get into!  But I must quit worrying, for “It is a mistake to try to look too far ahead.  The chain of destiny can only be grasped one link at a time.”--WC

3)  I know that pride is a sin…but I am no saint, and I guess I have prided myself on being able to handle all the chemos the oncologists have thrown at me.  I’ve had chemos make me nauseous, ones that make me so tired and out of breath I can barely walk up our stairs, and had one that leaked out my surgery stitches in copious amounts such that I had to keep putting clean towels on top of my bandages on top of my stitches, and the towels would soak through every hour all day long!  And (with God’s help, of course) I handled it!  But this Cytoxan beat me to a pulp.  I couldn’t cope with 10-12 hours a day of pain that didn’t go away with medicine, despite the admonition to “Never, never, never give up.”--WC  I still agree with Churchill’s famous phrase in theory, but sometimes, you just have to admit your latest chemo drug has defeated you and yes, give up. 

4)  The last news I received this week is that despite that horrific month of daily chemo, my CA-125 ovarian cancer tumor marker took quite a jump up, from 33 (normal is 0 to 35) to 57.  L  I had to cry most of yesterday over this news.  Renee is living in her own home now and Daniel and Steve were at work.  So I sat at home in mismatched jammies (navy with cherries on top and turquoise and white polar bears on bottom) and cried ‘til my eyes were pretty much puffed shut.  Then mid-afternoon, six hours before his work shift was to end, Steve’s Honda turned into our driveway.  “I thought you might need me today, so I found someone to come in and finish my shift for me.”--SD  There are moments when you are so filled with love for your spouse that you think you will burst.  This was one of those moments!  My spirits renewed, we played Scrabble, I enjoyed my tasteless, easy to digest dinner, and we held hands while watching our favorite shows.  

I am done crying for now, and though I will not soon forget the Cytoxan disaster, or the fact that four different chemo regimens have not cured me, I am moving forward.  Today I enjoyed a long walk with Steve in the spring-like weather and we worked on our conversion of Renee’s old bedroom to a “grandkids room” for Jericho and future grandkids, complete with “Welcome to the Jungle” themed bedding and large, framed prints of six different types of baby animals.  What fun!  And when we return from Maui, I will begin a fifth chemo regimen, ever prayerful and hopeful that the new approach will cause the enemy to retreat.  “Success is the ability to go from one failure to another with no loss of enthusiasm.”--WC

Lastly, I could not imagine having to face this powerful foe without my deep faith in God, built through years of experiencing His love, strength, and peace, while watching Him supply all my needs.  Thanks be to God! “I felt as if I were walking with destiny, and that all my past life had been but a preparation for this hour and for this trial.”--WC

Love,

Gabrielle

P.S.  See aforementioned jammie combo below.  Maybe on my 57^th birthday, which is this Saturday, I will make an effort and wear a matched set!  J

1/19/17 Today's meeting with doctor

Hi friends and family,

Steve here.  

It was four years ago today that we got the word that Gabrielle was facing ovarian cancer.  Since then, we have all been on a roller coaster of emotions, treatments, experiences and such.  And today has been another ride on that same roller coaster with some not so great news.  It started out with the disappointing news that Gabrielle wasn't going to meet with her doctor as she had hoped, but one of her colleagues (highly experienced, quite good and all that, but still it was someone she had not met before).  Her doctor apparently had some medical issues of her own and couldn't be there.  

Today, we reviewed the results of the scan which was done on Dec. 29.  Cutting to the chase: "nothing is getting bigger, but equally nothing has gotten smaller either".  But the more concerning part of the report is that there is one area near the stomach and small intestines which has seen an uptick in the level of "activity" of the radioactive tracer.  In other words, her current medicines aren't doing much good and the cancer's heating up, or as the medical people like to call it "progressing", which is a term I'm not too fond of because I like to think of progress as something good, not of something getting worse.  You remodel a house and you make progress.  You order the extra large pizza and you make progress as you nosh your way through the whole thing.  I would like to think we're making progress against cancer, but sadly that's not the case.

Doctor said that the chemo is hitting Gabrielle pretty hard, with each successive treatment causing more problems to her health with more fatigue, suppressed bone marrow, bone pain, and nausea just to name a few.  We were given some options ranging from no meds at all, to a weekly double drug regimen (combo of drugs she has had before), but which came at the risk of bowel perforation (25% mortality rate if that occurred), to a daily pill (Cytoxan) for a couple of months.  After carefully weighing the options, and with good input from the doctor and her nurse, Gabrielle chose the daily pill.  We are also shifting gears a little.  Whereas before, the treatment plan was to kill the cancer (or a least try really, really hard), the new regimen is going to focus simply on keeping the cancer from getting worse, buying some time and giving her a break to improve her quality of life.    

Frankly, these results are the second to the last thing we had hoped for (last thing: it is spreading).  But no improvement and increased radioactive tracer uptake are quite discouraging.   Still, she feels OK physically.  We are all just getting reoriented to a new tack, to borrow a sailing term.  We are hoping that the Cytoxan will hold things in check for a while.  It's still tough on the immune system, so she needs regular labs as before, and must avoid being around anyone who is at all sick or has been exposed to a sick person at home/work.  It is also associated with some nausea, which may lessen after the first week (or may not).  We're hoping and praying for the best.

Well, friends, I wish I had better news to report, but that's not always the case.  I know many of you have been asking about Gabrielle lately, praying for her, and giving her (and all of us) much support in other ways (thanks for all the great fudge, by the way).  It means so very much to know you are with us in this very difficult journey.  

Daniel sent Gabrielle a song this morning before her doctor visit.  It is by the group, Casting Crowns, and is a perfect theme song for how we are feeling today.  Perhaps you can relate to having felt this way, or even feel this way now.   Let us encourage you with our firm belief that those tears we cry, God holds in His hand, and that He is by our side through all the joys and sorrows of this life.  The lyrics go like this:

I was sure by now, God you would have reached down

And wiped our tears away,

Stepped in and saved the day.

But once again, I say amen

That it's still raining

As the thunder rolls

I barely hear your whisper through the rain

I'm with you

And as your mercy falls

I raise my hands and praise

The God who gives and takes away

And I'll praise you in this storm

And I will lift my hands

That you are who you are

No matter where I am

And every tear I've cried

You hold in your hand

You never left my side

And though my heart is torn

I will praise you in this storm

I remember when I stumbled in the wind

You heard my cry you raised me up again

My strength is almost gone how can I carry on

If I can't find you

As the thunder rolls

I barely hear you whisper through the rain

I'm with you

And as your mercy falls

I raise my hands and praise

The God who gives and takes away

And I'll praise you in this storm

And I will lift my hands

That you are who you are

No matter where I am

And every tear I've cried

You hold in your hand

You never left my side

And though my heart is torn

I will praise you in this storm

I lift my eyes unto the hills

Where does my help come from?

My help comes from the Lord

The maker of heaven and earth

I lift my eyes unto the hills

Where does my help come from?

My help comes from the Lord

The maker of heaven and earth

And I'll praise you in this storm

And I will lift my hands

That you are who you are

No matter where I am

And every tear I've cried

You hold in your hand

You never left my side

And though my heart is torn

I will praise you in this storm

And though my heart is torn

I will praise you in this storm

  Casting Crowns - Praise You In This Storm Lyrics | MetroLyrics 

12/26/16 To die, to live

Dear Family and Friends,

At our Christmas Eve service last night we sang a carol I was unfamiliar with, “Where Shepherds Lately Knelt.”  The last verse of this song really spoke to me.  It goes like this:

“Can I, will I forget
 how love was born, and burned
 its way into my heart
 unasked, unforced, unearned,
 to die, to live, and not alone for me, 
to die, to live, and not alone for me?”

Even more specifically, I have been reflecting on the paradoxical words “to die, to live.” 

Christians celebrate Christmas so that we will never forget how love was born, the night God came to earth in the form of a newborn babe lying in a manger.  While love may have been born that night, love was put to the ultimate test when Jesus willingly gave His life, in the most inhumane, excruciating manner, so that we could live a life reconciled to God.  John 15:13 puts it this way:  “Greater love has no one than this: to lay down one’s life for one’s friends.” Jesus loved us so much that He died—so we might live as people of faith and hope who have the opportunity to get to know God in a most personal and life-giving way.

The concept “to die, to live” may have started with Jesus’ death, but it doesn’t stop there.  There are two deaths each of us must consider.  The first is a spiritual death—a dying to oneself.  We are asked by God to give up the idea of controlling our own lives and destiny, and realize we belong to Him, and were made to be in relationship with Him.  The Bible says that because of Him we live and move and have our being (Acts 17:28).  Even common sense should tell us that the air we breathe, the complex way in which our bodies are formed and function, and the sleep that renews us each night, are just a few of the multitude of things required to sustain our lives, and yet which, are totally beyond our own ability to control.  So why do we work so hard to believe that we have no need for God?

In C.S. Lewis’ book, The Great Divorce, citizens of Hell are offered a chance to take a bus trip to Heaven for a day.  At the end of the day’s sightseeing, the tourists are offered the chance to stay in Heaven, but under one condition.  They must give up control and lordship of their own lives and submit to the authority of God in their lives.  Surprisingly, most of the tourists prefer to re-board the bus and return to Hell, where they don’t have to answer to anyone but themselves.  To be reconciled to God through Christ’s death for our sins requires that we die to self and give up control of our lives and hearts to God.  “I” must die, to live. 

The second death required of us is our physical death, whenever that time should come.  While the spiritual dying to self is not a requirement, but a choice, if we want to have a relationship with God, the physical dying is required of each and every one of us, whether we believe in God or not.  But the good news is, for those who have given their lives to God, this second dying also produces life—life everlasting with God in Heaven.  As someone living with a very serious cancer, I give a lot of thought to this second death that will be required of me.  When will it come?  What will it feel like?  Will it hurt?  Will I feel afraid?  How will my family handle the grief of losing me?

When these thoughts come, I can turn my thoughts to the words of that Christmas Eve carol.  I can remember how love was born that starry night, and burned its way into my heart, unasked, unforced, unearned.  How Jesus died, that I might live.  How at age 14, I gave my life back to Him, that I might live a life filled with purpose, and the love and closeness of God.  And how, when that final dying comes, there lies a life eternal with Him in Heaven that is beyond my wildest imaginings. 

To die.  To live.  And not alone for me.  The gift of Christmas is for you, too.

Love,

Gabrielle

12/25/16 A Christmas homily

Steve here with a short Christmas homily.

I just looked up "homily" and came up with two potential definitions:
1.  A tedious moral discourse.
2.  A religious discourse which is intended primarily for spiritual edification rather than doctrinal instruction.

I will let you decide which of the those definitions to apply to the following.

We went to Renee's church last night (Phinney Ridge Lutheran) for a delightful Christmas Eve service.  The children's choir was out in full force, along with wonderful instrumental music and great singing all around.  People were dressed in the festive best and there were smiles all around.  What's more, even the communion bread was homemade and there was real wine!  How cool is that?  I realize that you aren't supposed to rate communion on how good the elements taste, but thought I would throw that in just as an aside.  And one more thing:  there was no sermon!  Apologies to all you hard-working pastors and ministers out there who burn the midnight oil to come up with interesting sermons each week.  Just saying that last night, I was happy to skip it.  So instead, you dear folks get one this morning.  It won't be a long one.

I just wanted to say that singing the songs about Joy to the World, Away in a Manger, and those dear heralding angels really drove home the point of what all this Christmas hullaballoo is about.  God stepped out of eternity into time to bring any who ask into a state of grace and love through His dear Son.  Lost souls being found.  And that's the Christian message pure and simple.  A huge corollary to that, is that we, too, are creatures of eternity.  One day each of us will breathe our last and at that point, we will step from a world of time into eternity.  That's an awesome thought.

In the recent weeks and months, being faced with the terror of a cancer that just doesn't want to give up easily, it is a welcome meditation to reflect upon the fact that life here on earth is but a vapor as St. James so eloquently wrote.  And that, my friends, is something worth rejoicing over. 

As Gabrielle faces a very daunting and scary scan on the 29th, this is a good time to step back and realize that God is behind everything and that He has Gabrielle, and all of us, in the palms of His hands.  What better place to be than that?

Merry Christmas!  Or as Tiny Tim would say, "God bless us everyone!"

12/20/16 Christmas thoughts

Dear Family and Friends,

This Christmas season I find myself once again thinking a lot about the juxtaposition of joy and sorrow, pain and pleasure.  And about the things that cause our hearts to overflow with happiness and break in despair. 

The month began with great joy.  Steve and I were able to spend a week on Kauai with my sister, Marti, and her husband, Merle.  It was my pre-chemo week, so I felt great!  I was able to hike a beautiful trail along a bluff overlooking the ocean and swim laps in a giant saltwater lagoon.  I got to eat puka dogs (get one if you go to Hawaii!), mouthwatering fresh fish at an open-air restaurant overlooking a koi pond, and to share an enormous ice cream sundae at Lappert’s with my sweetheart.

Then, the day after my return home, my blood counts were again too low to get my chemo.  That week was filled with five days of stomach injections of the drug that stimulates my bone marrow to make blood cells—and in the process, produces a truckload of bone pain!  Remember those growing pains you had as a child as your bones stretched and lengthened?  Well, multiply that pain by about 100!  It was a tough week, followed by chemo on the 15^th, which brought yet another rough five days, this time with extreme nausea, fatigue, and no appetite.  On the positive side—I have unintentionally lost four pounds in five days!  So much for my usual Christmas weight gain!  J

In the midst of my own modest sufferings, I have encountered people this month whose sufferings are far greater than mine.  People who cause my heart to break.  The day before chemo I was well enough to attend my volunteer day at Children’s Hospital, where I was assigned to a 4-year-old boy with cancer.  We played Legos, and he led me on a “tour” of about 10 bedpans scattered about his room that were filled with water and contained all manner of plastic sea life!  He knew the names of each animal and told me that his Make-A-Wish was that he wanted to ride a dolphin.  Can you think of anything sadder than a child gravely ill with cancer who will be spending Christmas in his hospital room?  Or the heartbreak I saw in his father’s eyes when he returned to the room after my time spent playing with his son?  Having cancer myself, after the blessing of living more than five wonderful decades without it, is so very much better than the thought of my children—or any child—having to face this dreaded disease at a young age. 

And yesterday, Steve and I joined five friends for a volunteer day at Hope Place, a residential program for homeless women and children run by the Union Gospel Mission.  We worked in the kitchen, chopping bags of oranges and onions, wrapping potatoes in foil, making cheese quesadillas, and Steve, master griller that he is, put perfect grill marks on 70 mammoth rib eye steaks that had been donated for their Christmas dinner party later that day.  As I was serving lunch and chatting with the residents, my heart ached for these women who, through poverty, abuse, mental illness, and addictions, had arrived at this place in life with their precious children in tow.  I have so much.  They have so little.  Plenty and want.

I read in my advent reading this week that “A broken heart isn’t necessarily a bad thing.  You can think of it as something broken apart and shattered, like glass, or as something broken open, like a crack in a seed about to sprout.  Opening our hearts to pain increases our capacity for hope.”  I definitely feel that the brokenness our family has experienced throughout my battle with cancer has been an opening through which we have come to experience God’s presence in a deeper way, through which we have developed greater empathy for all those who suffer, and through which we have come to feel an exponentially larger sense of gratitude for each day, and each blessing, large and small. 

May the heartbreaks we experience allow us to see that through the cracks, the light of hope can emerge, and may we be a beacon of light and hope for others. 

“The people walking in darkness have seen a great light; on those living in the land of deep darkness a light has dawned.”  Isaiah 9:2   

Love,

Gabrielle

Steve, Marti, and Merle at Kauai Lighthouse Park

Mini Golf in December...and I won!

Hiking on a rainy day in Kauai.

Poipu Beach.

Lappert's sundae!