Liquid Nutrition

Hi Everyone,
I was able to have surgery on Tuesday April 21 and Dr. Russell put in a PEG tube (which I mentioned in the last blog entry) and also removed the NG tube – YAY!! This G-tube allows my stomach to drain any excess fluids into a bag and thus bypass the area of the GI tract where the partial obstruction is. In conjunction with this G-tube, my main source of nutrition will be a liquid called TPN or total parenteral nutrition from now on. I can take in some liquids (clear soups and broths), but this will be for comfort mostly and not for nutrition. This is really hard – I have been “mourning the loss of eating” this past week. It is not easy to change the way I eat. However, this TPN will make me stronger and more able to receive chemotherapy. The chemo hopefully will shrink the obstruction so that eventually I will be able to reverse the G-tube and go back to eating. I met with someone from nutrition the other day and she mainly gave me a long list of things I can’t take in – like fruit, veggies, cheese, pizza, etc. This is not easy. But the Lord knows and His grace is sufficient..
To infuse the TPN, I also had a double lumen PICC line put in my left arm last Tuesday. The 2nd line is a power PICC line - which allows me to have the contrast for CT scans and also will give the TPN nurse a line to draw blood. However, they are having trouble with this line (not the TPN line but the other line). Hopefully they will get this resolved today and I will be able to go home tomorrow.
In all these changes, we are continuing to set our hope on Him in Whom all things subsist, that He would be glorified both outwardly and through His transformation and building work within.

Change in plans

Hi Everyone,
Well, I went down to have the g-tube inserted and when they attempted to insert it, they found that they didn't have room in my abdomoninal cavity for the device. They fill the stomach with air and then then try to locate a place for the g-tube. However, since my small intestines kind of spill up over into the space they thought they had for the g-tube placement, they couldn't insert the tube - at least in the radiology unit. Needless to say I was disapppointed since I will have to delay the chemo a few days since I will be having surgery. But the Lord knows. I was so frustrated with all the delays and incompetencies of the teams. However, Dr. Russell will be doing the surgery tomorrow and they will be be doing one of two kinds of surgeries: one is a Percutaneous endoscopic gastrostomy (PEG) - a surgical procedure for placing a tube for feeding without having to perform an open operation on the abdomen. The other is an open gastronomy procedure. They will do one of these procedures on Tuesday sometime. Please continue to pray for this procedure and for all the decisions that have to be made over the next few days. I will also be having a line put in for the nutrition as well. O Lord Jesus.

I just love this psalm - I thought I'd share it with you:

Psalm 84
1 How lovely are Your tabernacles, O Jehovah of hosts!
2 My soul longs, indeed even faints, for the courts of Jehovah;
My heart and my flesh cry out to the living God.
3 At Your two altars even the sparrow has found a home; and a swallow nest for herself,
where she may lay her young, O Jehovah of hosts, my King and my God.
4 Blessed are those who dwell in Your house; They will yet be praising you.
5 Blessed is the man whose strength is in You.
6 Passing through the valley of Baca, They make it a spring;
Indeed the early rain covers it with blessings.
7 They go from strength to strength; each appears before God in Zion.
8 O Jehovah God of hosts, hear my prayer; Give ear, O God of Jabob.
9 Behold our shield O God; And look upon the face of Your anointed.
10 For a day in your courts is better than a thousand; I would rather stand at the threshold of the house of my God Than dwell in the tents of the wicked.
11 For Jehovah God is a sun and a shield; Jehovah gives grace and glory; He does
not withhold anything good from those who walk uprightly,
12 O Jehovah of hosts, blessed is the man who trusts in you.

There was footnote for verse 3

A home is a place of rest, and a nest is a place of refuge. Through the two altars God's redeemed can find a nest as their refuge and a home with God in rest. The cross of Christ, typified by the bronze altar, is our next our refuge, wherewe are faved from our troubles and there we lay our young - that is produce new believers through the preaching of the gospel. When we experience the resurrected Christ in His ascension, typified by the golden altar of incense, we are accepted by God in such a Christ and find a home, a place of rest, in the house of God. This house is the processed and consummated Triune God united, mingled, and incorporated with all his redeemed, regenerated, and transformed elect to be the body of Christ in the present age and the new Jerusalem as the mutual dwelling dewelling place of God and His redeemed in eternity.

I realized this week with so many visits from brothers and sisters in the Lord that as the Lord's dwelling places, they are so lovely!

Much love lovely ones!-
Joanne

Update

Hi Everyone,
It seems that things slow down on the weekend so this will be a weekend of rest - which is always a good thing. Monday I will have a pick line inserted in my arm for the TPN (total parenatal nutrition) - the total nutrition that I will be get needs a dedicated line that will only be used for that purpose hence the need for a new line. I just heard that the gastric tube - which will replace the nasal gastric tube which is inserted into my nose - will also be placed or inserted on Monday as well. Please pray for the accurate insertion of these tubes and for the directing hand of God on each of the doctors involved in the surgery.

I just have one thing to say - those wonderful words by Fanny Crosby

All the way my Savior leads me;
What have I to ask beside?
Can I doubt His tender mercy,
Who through life has been my Guide?
Heav'nly peace, divinest comfort,
Here by faith in Him to dwell!
For I know, whate'er befall me,
Jesus doeth all things well,
For I know, whate'er befall me,
Jesus doeth all things well.


Amen! Jesus does all things well. Thank you for praying and for standing with me during this past week and a half. I am really experiencing the reality of the body life. What a rich, rich inheritance we have in the members of the Body! Thank you all!

The surgery is out-patient and should be in the afternoon, I believe.

Much love,
Joanne

We will keep you posted.

Spirit of His Resurrection Life

This week began with some considerable discouragement. It ended in resurrection through the bountiful supply of the Spirit through the continuing prayers of His Body and the visits and care of numerous friends and brothers and sisters in the Lord.
Some evidence of Joanne’s small bowels opening began to appear on Saturday. However, the consensus of the doctors involved with Joanne’s case is moving toward a surgical intervention involving the insertion a feeding port to provide liquid nourishment and a G tube from the stomach to drain excess fluids that cannot empty out of the small bowels due to a continued partial blockage. Pray that God’s will be worked out.
This week we experienced some influence of a cloud of darkness from a spirit of death that is pressing in around us. We also realized the covering and spiritual fighting to subdue this element through the prayer of others. Pray that the Spirit of His resurrection life would reign over all thoughts and emotions and fill the atmosphere around us with His Life as we continue to exercise our faith in God and claim the fulfillment of God’s calling in Joanne for His purpose.

Our faith is in the Lord, Who is our Healer.

Our faith rests in Him above all things. We are grateful for what He will do through the doctors and our cooperation, but in reality, our confidence and faith is in Him alone. He is the Healer and has made us His new creation in Himself for His purpose.
Joanne's oncologist has encouraged her to be realistic about what is manifest at this time, but optimistic (holding on to hope and a positive outlook for each day). We are at a difficult decision point having to find a solution to the painful symptoms of a third episode of a small bowel obstruction in the last month.
There are essentially 2 roads:
1. The bowel obstruction clears up (Joanne will be on a limited regime of clear fluids for nourishment, possibly TPN) and continue with chemo.
2. A GI surgical intervention is required to remove the obstruction (open a pathway) or at a minimum install a G tube replacing the current NG tube. Once a system for delivering nutrition is established, chemo would resume.
The OB/GYN team led by Dr. Berkowitz along with Dr. Berlin (her oncologist) will respond to the GI surgeon’s team recommendations on Friday depending on the results of her current bowel rest facilitated by the NG tube.
We believe that God would grant Joanne more time and this obstruction would be cleared. Pray for this in the next two days. Pray also that all the unlawful, renigade cancerous cells would be eradicated through chemo and the Lord’s healing which we decree in the faith of the One in us.
Now is the time O Lord to glorify Your Name once again as we rest and set our hope in You and all that You have accomplished.

Update

My mom is still in the hospital with a partial bowel obstruction which is making it difficult for her to eat or drink. The CT scan on Saturday confirmed that there is a partial obstruction. She still has the NG tube to help rest her bowels. The GI doctors are considering some surgical interventions but need to coordinate with the oncologist who is dealing with the treatment of the cancer. Please pray that the doctors would be headed up in Christ and for His perfect will to be done. Also pray that my mom would be strengthened with Christ as her living hope. She has been feeling low and discouraged as the doctors have been giving her mixed messages. Her anxiety has been exacerbated by new pain medication as well. Pray she would be guarded from any attack and that her joy would be maintained.

In all likelihood she will be in the hospital through this week and possibly into next.

Thank you for your prayer and support.

Anna

Prayer Request

My mom was admitted to the hospital today because of pain and dehydration after meeting with the GI doctor this morning. There is concern of an obstruction and doctors are investigating how to proceed as well as how to provide a better pain management regime.

Tomorrow morning at 6AM my mom will have an "NG" tube inserted to put contrast into her bowels for a CT scan scheduled for 8AM. This is a very uncomfortable procedure and is often painful. Please pray that the discomfort will be minimized and that the findings of the test will be conclusive.

Thank you for your continued pray, support, and love.

Anna

Home again!

Hello everyone,
I was discharged from the hospital yesterday (Friday), feeling better, with less pain, and a strict eating regimen (only pureed food). I will have chemo on Wednesday if all continues to go well and then I will see the gastroenterologist on Friday the 10th. She was out of the country this past week while I was in the hospital, so I am anxious to see what she says about what the GI problem was. Basically this week I rested, and enjoyed visits from many friends. I didn’t have an endoscopy because the GI doctor taking her place didn’t feel it was necessary. The CT scan from last Thursday showed a partial obstruction in the small bowel that has apparently cleared. When I know more, I will let you all know.

It was kind of confusing this week because while I had a GI problem, Dr. Berkowitz (the gyn-oncologist) was in charge. The residents do most of the rounds and are very new to patient bedside care – they are quick, sometimes abrupt and just young. I’m sure over time, they will learn that they are treating people and not diseases. Dr. Berlin came by a couple of times to explain what was going on as I was pretty much in the dark about who was in charge and who was deciding what treatment I was getting.

Thank you all for your prayers and support. Because of the prayer I really experienced being at peace regarding all that has occurred in the past week. Today I was encouraged looking at the sparrows outside my window. There are verses in the gospel of Matthew and Luke about sparrows: Here are the verses from Luke 12:
6 Are not five sparrows sold for two assaria? And not one of them is forgotten before God.
7 But even the hairs of your head have all been numbered. Do not be afraid; you are of more value than many sparrows.

I was particularly encouraged by the phrase “Do not be afraid” since it is hard these days to stay strong and courageous. Another verse that really encouraged me was a phrase from 1 John 4:18 –“there is no fear in love…..perfect love casts out fear...”

I am endeavoring these days to sink down into the perfect love of God.

Here is a hymn of comfort which I enjoyed today. Here is the link: http://www.hymnal.net/hymn.php?t=h&n=676&f=mid

1 All thy griefs by Him are ordered,
Needful is each one for thee;
All thy tears by Him are counted,
One too much there cannot be;
And if while they fall so quickly
Thou canst own His way is right,
Then each bitter tear of anguish
Precious is in Jesus' sight.

2 Far too well thy Savior loves thee
To allow thy life to be
One long, calm, unbroken summer—
One unruffled, stormless sea;
He would have thee fondly nestling
Closer to His loving breast,
He would have that day seem brighter
When alone is perfect rest.

Much love,
Joanne

Need for Prayer

The results of the CT scan didn't show new cancer growth as a cause for the severe abdominal pain I'm experiencing. Dr. Berlin and the GI doctor felt I should be in the hospital to find out what is wrong. Please pray that they conduct the right tests and interpret them correctly. I'm in Brigham's and Women's hospital, Connors Center, rm. 776. Call Missy for an update.

I appreciate all your prayers and support. Looking away unto Jesus, the author and perfector of our faith. Jesus is Lord!

Joanne

Update and Spring

Turns out Wednesday's upper GI series or fluoroscopy showed a narrowing of the stent but not an obstruction. I still have pain and discomfort but food is traveling through. I was able to have the chemo Thursday, and there were no complications. They really knocked me out and I slept almost the entire time. I will be getting the gemzar on a different schedule than the taxol - it is still on a 3 week rotation but I have day 1 - Carboplatin and Gemzar, day 8 gemzar (except for this week which will be on day 7) - and then on day 15 a blood test, then back to day 1 for the next round. Please pray for the effectiveness of this drug to kill the cancer cells, and eliminate the tumors.

The other day out by my driveway I saw these bumps in the garden. At first I thought skunks were at work digging up the bulbs - but when I investigated I saw the tiny, green tips of spring bulbs pushing up through the cold earth toward the sun. The bumps were the earth on top of those little tips being pushed out of the way! All through this past winter it has seemed almost hopeless that the bulbs would come again - they were buried beneath several feet of snow, frozen and subjected to harsh extremes in temperature. We all wondered if they would ever come back this year. Even the side of the house where they are planted doesn't get a good deal of sun so they weren't really warming up very much. But still, in spite of all these obstacles, the life in those bulbs is pushing forth - pushing up through the earth to the sun. It is so encouraging. I thought we are like those bulbs. We go through cold, dark seasons with harsh weather, and are buried by our circumstances. But we have a life gene in us! This life is an overcoming life! We don't depend upon how well we can survive the elements, but rather we depend upon the functioning of that overcoming life to triumph, burst forth, and live! So rather than focus on the dark environment or harsh weather, may we enjoy the functioning of that victorious life within!

Here is a wonderful hymn about the victorious life of Christ which is operating in us! Hallelujah! Here is a link to the hymn's tune:
http://www.hymnal.net/hymn.php?t=h&n=1174&f=mp3

1 What a victory! What a triumph!
God Himself became a man,
Clothed Himself in human nature
To fulfill His mighty plan.
He through death destroyed the devil;
Risen now, the Son of Man!

2 Jesus by His human virtues
Did the subtle one arrest;
He as man withstood the tempter,
Fully passed through every test.
Now in spirit I can take Him,
All His virtues to possess.

3 In the Spirit of this Jesus
Is His human life so fine.
Human virtues have been added
To the Spirit all divine.
What abundance in this Spirit,
Rich supply for all mankind!

4 How mysterious! Yet how real!
Such a man now lives in me.
Into all my heart He's spreading—
He, my human life, to be.
Hallelujah! Hallelujah!
I will praise unceasingly.

5 Oh, what wonder! Oh, how glorious!
God in flesh is manifest.
We the members of His Body
His humanity express.
For the building of God's dwelling
We His human life possess.


Thank you all for your consistent prayer and stedfast love - what a blessing to be in the body of Christ in reality.

Much love,
Joanne