Relapse

The last vestiges of Ian's platelets and neutrophils are being progressively suffocated by rapidly multiplying leukemia blasts. The biopsy showed a clear relapse of leukemia. This is the update I never, ever wanted to write.

The girls flew in late Tuesday night and were too exhausted for a serious talk, so we decided to tell them the next morning. I felt strongly that we should all go to the clinic together for his first chemo, to face it all together as a family unit. We had a fun morning of favorite breakfast foods, reading stories, playing legos and riding bikes. My heart was breaking throughout though, knowing we had to invade the sweetness of reunion and these simple pleasures with a very complicated announcement. We just couldn't do it, so we packed up and headed to the clinic without explaining the bigger story. Finally, while walking from our car to the clinic, we broke the news. Fiona didn't seem to get it, but Asha's face fell with sadness. Later as we were waiting for the doctor to come, we had deeper conversations and Asha cried in Ian's arms. It was good to see her facing it and grieving and feeling the emotions this time. Last time she never really faced it and her emotions came out sideways. 

Day 1 of a 5-day round of chemotherapy began yesterday. Please pray this chemo is gentle on his liver (and nausea) but superpower strong to kick that AML. Four weeks from now, we will begin round two. The plan is to finish two rounds, then get a boost of stem cells from Ian's brother. If this goes well, we will repeat it. Something like that. It was hard to hear and process these things while also monitoring Asha's emotions. At first she blocked her ears, looked down to the floor, and made semi-quiet mouth noises to keep from hearing anything the doctor said. She was afraid he would say Ian was going to die soon. She finally realized he was just helping us make a plan to get him healthy again, and was able to at least stop consciously distracting herself. But it was emotionally intense. Please pray for the girls as they process these things and our  lives become more restricted.  

Ian is back on medications to help protect him while being severely immune compromised, and we are back on quarantine for the foreseeable future. Please pray protection for Ian as he will be in a very vulnerable place for a while. A bright spot was hearing that the thick, sticky, nauseatingly disgusting anti-fungal liquid medication that was the bane of Ian's recovery last time is now available in tablet form. Huge relief! Also, as long as things go smoothly and are actually effective, he will be able to do these rounds of chemo out-patient. That means we get him home with us between treatments! He has already endured being peeled out of bed this morning and dragged into a "relaxation station" put together by Asha and is currently reading princess stories to Fiona while I try to post this update and make phone calls back and forth with the clinic and pharmacy. I'm realizing it will bring immense complications of its own having his recovery at home in the midst of family life. I'm feeling overwhelmed and frustrated and heartbroken this morning. We need a lot of miracles. Please pray for restful, joyful balance in the midst of all this and a smooth road to successful and complete healing.  

Thank you for your prayers for us as we walk this horrible road again. There is a world of emotions embedded in that small block of medical buildings at UCSF that I never wanted to revisit. The urine smell in the parking garage, the elevators I've cried in, the sympathetic faces of caring nurses who really get it, the growing mound of medications, the fears, the grief, the anger, the questions, the unknowns... they are all coming back to me.  All of these sharp and cutting memories can easily intensify the dread and discouragement of his relapse, but we are trying to have good mental hygiene. We are choosing to walk in hope. We remember the fire, but we also remember God's grace carrying us through it. My prayer is that we get through it again, not even smelling like smoke. 

Thank you so much for your prayers, your texts, your phone calls, your facebook messages and offers of support. It means so much. Thank you especially for reminding us of our hope in those moments when it seems to slip away. We are grateful for such a rich community of friends and family to walk this rough road with us. 

Trust

Things are not looking good. 

Chimerism results which were 100% across the board a year ago are now 99% everywhere except the myeloid cells where his cancer was (not good). There it is only 92%, which means 8% of Ian's old leukemia infested system has returned. AML is no joke, it moves swiftly. His platelets and neutrophils are continuing to decrease steadily, indicating the disease is progressing. 

I wanted with all my heart to be present with Ian during the bone marrow biopsy yesterday. He chose the manual procedure (screwing it in by hand) verses the drill gun which is quick but can leave more pain in recovery. My heart sank. It's hard enough to watch them plunge the large needle of numbing fluid in and out, in and out and all around again and again until it doesn't hurt anymore. Then the exacto knife goes down deep into his hip bone. But when they started screwing the bloody ice pick down I couldn't take it anymore. Watching Ian suffer, remembering all the suffering of his past treatment and realizing we are back on that road again...it was all too much to take. My hearing faded and everything got fuzzy and I gently whispered "I think I'm passing out" as they quickly wheeled me away from my husband and onto a bed in another room so I wouldn't distract from the procedure. As I returned to consciousness, the inner fountains broke wide open. I wept and wept, and continued weeping off and on for the remainder of the day until I crashed in exhaustion last night. The nurses there were amazing, so comforting and present and compassionate. One of them stayed by Ian's side to hold his hand since I was MIA and tenderly kissed his forehead as we left. They all adore Ian and ask about the girls and are rooting for us like cheerleaders. Honestly, it was hard to leave that warm nest of maternal nurture. On the other hand, we can't wait for the day when we never have to go back. 

We are still waiting for news from the biopsy, to assess the damage. We should have initial results Tuesday. The girls fly home Tuesday night (we haven't told them about any of this yet). Even with the best case scenario of no leukemia detected, which is highly unlikely, he begins chemo Wednesday to try to restore his graft in the myeloid cells. The intensity of chemotherapy they can use will be tricky due to his previous liver failure from its toxicity. They also want to boost him with more of his brother's stem cells, and possibly another bone marrow transplant from an unrelated donor. The decision tree depends on results of his biopsy and what his liver can take.

So those are the details. Not what we were hoping for, by any means, but it is what it is and we are seeking to burrow into Jesus for comfort and grace for the day. Ian is faithfully reminding me of the words of Jesus- that if we want life that is truly Life we are not to worry about tomorrow. He gives grace for each day, not for future days. So we are seeking to trust him in each moment and cast those burdens of future days onto him. It's not easy, but it's much better than any alternative. It's trust...or fall apart. We are choosing to trust, and praying for grace to trust when we wander from that place. 

Thank you all for listening, for caring, and for praying. 

Sad, Scary News. Please Pray

My heart is broken and it is so hard to write this, but I feel compelled to let our community know that Ian is very much in need of prayer right now. To summarize, his platelets keep falling and this is a likely sign of leukemia returning. They did a chimerism test to see if the percentage of his blood has dropped from 100% his brother. We should get the results at clinic this Friday, but they called today to schedule a bone marrow biopsy as well. Things are not looking good. Please pray his immune system returns to a clear and healthy normal and we don't have to face that ugly battle against leukemia again.

Here are further details if you have time to read:

Ian's recent clinic labs were suspiciously low on platelets and white blood cells, but he was in the middle of a round of antibiotics for a tonsil infection and both the medication and infection were possible reasons for the lower counts. They wanted him to get more labs done in 10 days, once his round of antibiotics was over plus a few days for it to be out of his system. I was about to leave on a trip to Thailand to look for a home for our family to move at the end of summer, and I was ready to cancel the trip until we knew what was going on. We called the clinic hotline in the middle of the night, saying we need to know what is going on and can't wait another 10 days to find out. His doctor emailed us the next morning saying that he was not too concerned, and that they found no leukemia in his blood sample and that I should continue with the trip as planned. So off I flew to the other side of the world one week ago today, while my precious mom took our girls for a two week sleepover at her home in Oklahoma. 

Talking to Ian from Thailand, I could tell he wasn't doing well. He started to get a cough that was the exact same cough he had at diagnosis and that had tortured him through chemo. It was breaking my heart. After a couple days in Pai, I knew I had to return. As I was searching tickets, Ian discovered a rash on his legs from low platelets. I booked the fastest series of flights I could find and started the journey home while he checked into emergency at UCSF.  At each airport along the way, I received texts from Ian updating me on his labs and situation. It grew progressively worse, especially his platelets. With each update, I felt like a thick sheet of glass shattered into a million pieces on the airport carpet. I also had a deep peace that sustained me through each leg of the journey, punctuated by weeping at airports in between. 

I arrived last night and am so thankful to be back by Ian's side and to be present to comfort and support him as we wait for news to unfold. It is sad and scary. I want to believe it is all going to be ok, that his labs will show continued improvement from here and we will all exhale a massive sigh of relief. Please pray for us as we wait. Ian has a local blood test tomorrow to see what is going on with his platelets and white blood counts. Friday morning we will meet with his doctor and work through results and possibly decision trees of the future. 

Please, please keep us in your prayers and petition heaven for good news, for mercy and healing. 

Thank you.

Sa-wat-dee Kah!

We've been home for almost a week now, but our hearts are still soaring from an amazing 5 weeks in the Land of Smiles :D

Here are a few highlights from our trip:

We spent our first week on the coast and I'm convinced we chose the perfect spot to rest and recover from travel and jet lag. I usually prefer simple low budget guest houses, but this time we splurged a bit and stayed at Dolphin Bay in Hua Hin, which is basically a waking dream for families with small children. Playground, grassy areas, pool with slides, kids room with toys and giant beanbags, an endless stream of little girls to make friends and play with, yummy Thai food, Thai massage, and right across the street from a calm sandy beach filled with crabs of all kinds, clams, starfish, jellyfish, and beautiful seashells. We were able to settle in and breathe deep and just be together for a while with nothing to do but relax and enjoy ourselves. What a blessing!

A surprise rainstorm only added to the fun, with puddles to stomp in and lots of little frogs to catch!

After Dolphin Bay, we took an overnight bus to Chiang Mai and then a 3 hour crazy curvy minivan ride up to Pai, our main destination in Northern Thailand. Some dear friends of ours were away for most of December and offered for us stay in their home, so we were welcomed with a beloved home to move right into. The kids jumped right into playing with friends, exploring the land and catching butterflies and grasshoppers. 

 

 

 Ian and I were inspired by the rich community and Christ-centered meditations at Shekina garden three times a week. Here are some pictures from our Christmas Eve celebration:

New Year's Eve in Thailand is dazzling, the sky sprinkled with paper lanterns and exploding fire crackers!!! 

And now we are home, facing the lingering jet lag by grocery shopping at 1am, going to bed at 5am, letting the house go, eating out more than usual, and crashing out on the floor mid-day without warning.

But oh was it worth it!!!

Happy Thanksgiving!

We have so many things to be thankful for this year, but there's one thing that clearly tops the list. Ian's labs continue to remain clear, and apart from a short stint of shingles he has come through this past year unscathed. How grateful we are for all the prayer, support and Divine grace that has carried us through these past two years.  

Now that Ian is clear to fly internationally, we are making the most of it with a family vacation. Our flight to Thailand leaves in half an hour, and we are more than ready to get a month away together! How appropriate that this trip of celebration begins Thanksgiving Day :)

Initial Biopsy Results

We are still waiting for the chimerism report from his recent biopsy to make sure his bone marrow is still 100% donor, but all the initial biopsy findings look clear. So thankful!

Day 366: Birthday!!!

Today is Ian's one year "birthday" - can you believe It has been a full year since his transplant? My heart flutters with thankfulness as I remember where we were a year ago and to see how far we've come!

We were taking a walk as a family the other day, the same walk we often take. As we rounded a corner toward home, I had a flashback to exactly a year ago as we were preparing for transplant with so many scary unknowns ahead of us. I remember Ian's bald head covered with his down jacket hoodie to keep him warm, and I remember my mind swimming with a million questions.

This time, a year later, we were walking carefree with Fiona riding playfully on his shoulders and Asha chattering behind them on her bike. I could almost hear music playing in the background, like it was the perfect happy ending scene to an emotional movie.

Ian's birthday bone marrow biopsy is sometime next week, but all his blood work looks good so far. We aren't out of the woods yet, it will take another year for his immune system to mature and at least a couple more years before he is considered cured.  But as you can imagine, we are incredibly thankful for how far we've come! I feel like God has carried us, sometimes through quiet Divine graces and often through the loving support of community, family and friends. Thank you all so much for walking this with us and helping to carry us through!

Our dads are in the heat of the battle right now, however. Ian's dad is in the ICU with heart and lung issues.  My dad recently began a stronger round of chemo to treat his aggressive lymphoma. It is painful  to see our parents going through this and to be so far away. The girls and I were in Oklahoma with my parents this past week and a half, hoping to add a helping hand and some cuteness therapy, but it is such a short time compared to the long journey they have ahead. 

Fiona's first experience of snow!

I pray the Lord carries our parents through each of these difficult days as he has carried us this past year. It's been a crazy long season of reminders that these bodies are so ephemeral, and that every day with each other is precious. Every day. 

Especially the past 365 of them...

Happy Birthday Ian!

Day 316: Merry Christmas!

We're back! We flew in last Wednesday, but it feels like yesterday since we are still considerably jet lagged. Ian had his latest clinic last Friday with all labs still looking great. Best Christmas present we could ask for. He's also now graduated to monthly clinic appointments, which makes life a lot easier now that he is back at work full time especially. This weekend we plan to drive to Tahoe to buy a car and then up to Reno to celebrate the holidays with family. I'm glad there are 12 days of Christmas, because we just started decorating our tree tonight :) 

What a journey we've had these past few weeks! It's been a bit of a whirlwind, but a wonderful one well worth the moments of sanity stretching delirium. We've played on an island beach with dear friends and sipped fresh baby coconuts, we've taken an elephant trek through river and jungle, we've fed parrots and even baby tigers by hand. But the best part of our trip by far was just spending time with good friends who made us feel right at home while half way around the world.  Here are some pictures from our recent adventures: 

A little crazy but...

The girls and I are at the gate at San Francisco Airport waiting to board a flight to Bangkok, Thailand. We are going to visit a dear friend in the north who sent her husband to be Ian's caretaker for a month at the monastery, and get a little fun time away after a long, crazy year. I'm excited and a bit nervous, and already missing Ian after saying goodbye an hour ago...

Yesterday was our 9th anniversary and this year we were able to truly celebrate! 

So thankful...

Please pray Ian's health remains strong while we are away and that our trip goes smooth. 

Thank you!!!

Day 292: Thanksgiving

Last year, Ian took Thanksgiving week off for a family road trip for the holidays. He was scheduled to go back to work the Monday after Thanksgiving. He never did. Tomorrow, the Monday after Thanksgiving, Ian is returning back to work.  His "doctor's note" (required by the company for his return) officially declares he has made a full recovery. Needless to say, we are very thankful!

On a sad note, our car was destroyed in a five-car-pile-up on a Los Angeles freeway yesterday. At impact, there was a semi truck on the right and no shoulder on the left due to construction. Our family walked away without a scratch.

 

Although we are a bit shook up and sad to say goodbye to our beloved family car, we are thankful there were no obvious injuries and that we made it through alive(!) We are also thankful that Ian works  close to home and can ride his bike to the office now that we have no car.

I confess, the kids and I are a little sad that we won't have Ian around as much anymore...

But I am super thankful that he still has a full-time position to return to, and that he enjoys his work. The people at Riverbed have been AMAZING, over-the-top, extravagantly supportive throughout this entire ordeal and I cannot express how much they have cared for us. For this we are incredibly thankful.

And so we will begin a new season tomorrow, off of quarantine and returning more to life as it was before leukemia took us for a spin.  Since returning to work full time will take a lot of energy for Ian, we will be slowly making our way back into social life and not jumping in all at once.

Thank you so much for all of your prayers and support this past year!