At the moment, I’m surprisingly calm.  It truly must be your prayers and the peace that surpasses understanding. I met with my Lymphoma specialist at Vanderbilt this morning, and round one of our game plan is set.  On Monday morning, I’ll be admitted into Vanderbilt to begin cycle 1 of my R-EPOCH chemotherapy.  I will stay there until sometime on Saturday.  I can probably expect to see the swelling on my right eye and forehead begin to subside after this first course.  And as most ladies can understand, the challenge of hair loss comes to the forefront of concern – although nothing compared to the hopeful anticipation of being cancer-free!  If you know me at all, you know that I have the thickness and coarseness of hair equivalent to two or three women – often a blessing and about as often a curse. 🙂 I also have eyebrows of about the same description.  My unibrow has been an ongoing challenge since age 10. . . Therefore, to lose both is losing a little bit of my identity.

A few months ago after telling my hairdresser that my chemo wouldn’t cause hair loss, she assured my that even if it did, it would be okay.  She explained how she has helped several women transition through it.  After knowing my new treatment has a 100% chance of hair loss, her words came to mind, and I knew I needed to see her.  Today she cut my hair above the shoulders and gave me some bangs to cover what the doctors in Houston described as “impressive assymetry” of my eyes and “deformity” of my forehead.  Amazing how a little haircut can make you feel better!  She also prepped me for picking out my wig at the hospital, and how she and her hairdresser friend will make it look just like my hair.  Such a sweet relief! Plus, who knows maybe after a little re-growth, I’ll embrace a short hairstyle.

I’m thankful to God for all of the tremendous support from my friends, family, “prayer warriors” and medical team.  As I awoke to the scripture-of-the-day this morning (which in timely fashion was also mentioned by my mom as I went to bed last night), I was reminded of how so many of us suffer in so many ways. And often times in ways that are worse than I can imagine.  But despite how hard it can get, God promises us that He is forever faithful, and we can put our full hope and complete trust in HIm. No matter what.

We will be flying out tomorrow for Nashville.  Today we collected medical records and tied up some loose ends by gathering needed information before transitioning to the physicians at home.  I have requested my first return visit with Dr. Reddy, and hope to get that lined up tomorrow.  We are anxious to get the treatment started and healing underway.

I will post again after that appointment and let you know when we get moving onto the next steps – which I’m guessing will be next week.  We are looking forward to being back with our babies, and are very thankful for the good care of our kids by my Mom and Dad and all of the planning and funding they did for this trip.

Well, today has been another long day, but we are very grateful for the expertise and care I have gotten.  My original biopsy slides from last August and October were mis-diagnosed by the Vanderbilt pathologists, so basically we’ve been treating my cancer with the wrong kind of medicine.  Instead of a slow-growing , low grade MALT Lymphoma, I have either a mix of that type with large B-cell Lymphoma, or the MALT Lymphoma has transformed into Large B-Cell Lymphoma.  The characteristics of my Lymphoma are fast growing, aggressive and in need of a complete eradication.

My treatment will include EPOCH chemo.  This will require a 5-day hospitalization each cycle, and it will have the typical chemo side effects of hair loss, lowered immunity, fatigue, etc.  After 4+ cycles, I will most likely have a stem cell transplant followed by radiation.  The goal is cure.  Because of this cancer’s aggressive nature, it is important to completely destroy it – which will involve this rigorous treatment, but more than likely take care of my cancer.

As overwhelming as that information was to us today, we are grateful that the scans did not show any spread to other areas of my body.  We are still looking at just the forehead, right eye area and right frontal sinus.  I will also be able to return to Vanderbilt and begin treatment there.  The Lymphoma specialist at MD Anderson has already spoken to my Lymphoma specialist at Vanderbilt. It is a relief to finally have a clear diagnosis (that’s correct!) and a treatment plan in order.

We are so tired.  Please pray that we will be refreshed and ready for this next phase that we are about to start.  It will be a rigorous journey, but we will remain focused and trust God with each step.

Saturday and Sunday have been quiet days of rest.  As expected, the biopsy from my eye area has left me with swelling, bruising and stitches under my eyebrow – basically it looks like I’ve been in a fist fight. On top of that I have a big area of swelling on my forehead – pretty hard not to feel self-conscious.  I had to get out of our room today, so I sported a low visor and sunglasses – even inside.  Jonathan, in his complete support, tried to convince me that walking around the hotel and inside shops/restaurants like that is completely normal. 🙂

Tomorrow will be another busy day with at least 3 appointments at MD Anderson.  We will meet with a radiation oncologist (surprisingly, we’ve never met with one before), the Head and Neck surgeon again and then follow-up with the Lymphoma specialist who is coordinating all of my care.

Although the pathology results most likely will not be in yet, we hope to get some good insight from the scans, blood work and combined input from so many medical specialties.  I’m sure that there will be discussion on whether additional tests will be needed, and if surgery, radiation and/or more aggressive chemotherapy is the best treatment. We will be sure to post another update tomorrow evening.

If you wonder what in the world that picture is that Jonathan posted for Day 5 – that’s just a little taste of his artistic and humorous personality. That is simply the blood pressure cuff I had on my arm.  I think he thought the illustrations were intriguing.  🙂

We are overwhelmed by your love and support!  Thank you for the many many prayers and the comments of encouragement.  Love, April

p.s.  I may be clothed with a hat and sunglasses today, but my long-term goal is from Proverbs 31:25.

I can definitely say that MD Anderson is thorough and very willing to schedule as much as they can in a short period of time.  We have had a 7:30a-9:30p day, with continuous shuffling to accommodate different tests, consults, and convincing insurance to pay for new scans.  Today we:

• Had the pre-op physical with the ophthalmology nurse practitioner.
• Had more blood tests – didn’t know there were anymore to be had. 🙂
• Had a consult with the Head and Neck surgeon
• Had CT of my head through shoulder area
• Had a full body PET scan
• Enjoyed a great meal after fasting all day with some pretty good company (Jonathan). 🙂

Today I kept thinking of the Apostle Paul and his request to God to relieve him of his long standing affliction over and over again.  I remembered God’s Promise of Grace in 2 Corinithians 12:9, My grace is sufficient for you, for my power is made perfect in weakness. This is such a great reminder that my (and your) true strength is in Him and not measured by my strengths or limitations.  God is good.

Tomorrow, we check-in at 5:30 am for my surgical biopsy of the mass near my eye.  Thank you for your prayers!  We should have some answers from everything on Monday.

I had an appointment today with a world class Opthalmic Plastic Surgeon at 12:30, but somehow we did not leave the appointment until 5:15.  Needless to say, we are exhausted.  It was very thorough, so of course we are grateful for that.  Here’s today’s synopsis:

• All TEN tubes of blood were normal.
• Today’s MD agrees with scans and biopsy being needed to see if this is truly the type of Lymphoma that we think it is, or if it has “transformed” or if it is a completely different cancer all together.
• Scheduling is a mess, but we are trying to get a CT scan & PET scan tomorrow, a consult with the Head and Neck Surgeon, and a pre-biopsy physical and anesthesia consult (and I thought today was long).
• We have a biopsy scheduled for Friday with today’s doctor.  She plans to only sample the area near my eye – a tumor on the lacrimal gland.

Thank you for your continued prayers and encouragement.  We are so tired, and we appreciate your uplifting words.

Here’s a quick bullet point synopsis of our first day in Houston.

• Met Lymphoma specialist, Luis Fayad, MD and his P.A. this afternoon
• They both listened to my history from where we started last spring/summer until now
• Had TEN tubes of blood drawn for varying tests
• Scheduling is pending for:
• A new PET and CT scan (insurance wants a peer-to-peer review, because initially denying again)
• Head and Neck Surgery Consult for biopsy ( to see if original diagnosis is correct or if it has “transformed”) and “making me pretty” – wants to fix the asymmetry to my eyes
• Ophthalmology Consult for blurry vision and mass near eye
• We were encouraged to know that my treatment at Vanderbilt parallels what they probably would’ve done at MDA
• All of the consults and imaging/testing results will help Dr. Fayad determine the next best steps for treatment

We feel very blessed to be in an amazing medical center area.  We had no idea that not only is MD Anderson in this proximity, but many many other high level hospitals and research centers.

Thank you for all of the encouragement and prayers!  We are trusting God one day at a time to give us a clear path for answers and the best treatment.

The chemo/immunotherapy treatment that I completed three cycles of was ineffective (the usual effectiveness rate is 90%).  Since receiving the news on Monday, we have been waiting to hear on the plan for a biopsy and next course of treatment.  Meanwhile, my family has felt very strongly that it is time to get more aggressive.  They have generously initiated and funded a trip for me to be evaluated at MD Anderson in Houston.

The people at MD Anderson do not fool around.  In a matter of hours, we were in full communication getting my appointment scheduled, records sent to them and flights/hotel all arranged.  Jonathan and I will fly out on Sunday and have my first appointment on Monday with Lymphoma specialist, Luis Fayad, MD.

Through prayer and what we believe to be nudges by the Holy Spirit, as a family, we agree this is the next best step.  After a long, informative appointment this morning with my general oncologist/hematologist, we can anticipate a thorough review of my records, more diagnostics (which may get intense) and a treatment that may be a clearly defined path, or one of their new innovative treatments that are more aggressive.  We can definitely head there knowing that we are going to be working with a team full of the best of the best.

We ask that above anything else, that you continue to pray.  Please pray for our safety as we travel, wisdom for all of the medical personnel that will have input in my care, Jonathan’s and my faith, stamina and discernment as we are given choices.  We ultimately want God to have the glory, and hope for a complete healing too!