The Struggle Has Ended

Greg Hewlett passed away on January 17th after nearly eight years of battling colon cancer. While we grieve his loss, we are comforted to know that he is with his Lord.

If you would like to leave your thoughts on Greg, please see this thread.

If you would like to make a charitable donation in Greg's honor, please see this thread.

Saturday, December 27, 2003

Pressing On To Joy

Greg took his first steps yesterday as he continues his excellent recovery from liver surgery this past Monday. His progress continues to be remarkable and we all were impressed with his strength, determination, and grit.

Items removed on Friday: Foley catheter, IV in jugular, epidural. The removal of all of these so early signifies that his liver function is good and his blood should clot well. This is great news and a real answer to prayer for swift healing.

Of course, great progress does not mean that there are no difficulties or dangers. Please keep the following requests in mind as you pray for Greg:

* That the doctors would let him out of the hospital at the right time, that he and Christine would find the best place to stay in Houston for up to a week after release from the hospital, and that the transition to the new living situation would go well.

* That the wound from his jugular IV would would heal when the bandage is removed today.

* For dealing with the effects of droopiness and incoherence now that he is on morphine instead of the epidural.

* That he would regularly practice the breathing exercises prescribed for him, and that he would not develop excessive fluid in or around the lungs.

* That no infections would develop.
Greg asked me to pass on his thankfulness for the many notes that came to him as a result of the patient contact system at MDACC. Any notes received are printed and hand-delivered to Greg or Christine and they have drawn tremendous encouragement from them. He is also checking the website as and when he can, and will hopefully make a post of his own very soon.

Tuesday, December 23, 2003

'Surgery Went Perfectly'

That's a quote from the surgeon's report, and by all accounts an accurate one. Greg looks good today and was working on crossword puzzles by 11:00 this morning. Everyone is thrilled by the great outcome and thankful for the answered prayers of many.

However, as with any surgery of this magnitude, the road to recovery will be rough at times. Please continue to pray for both Greg and Christine as they face many challenges:

* Greg cannot yet be moved to a regular hospital room until his urinary function resumes normal levels. This is not unusual, especially given that his blood pressure remains a bit low due to the anesthesia that he is still taking via epidural. Instead, his doctors plan to move him to the ICU, not because of any crisis or problem, but because there he will receive greater levels of exactly the kind of care that he needs right now (not to mention the fact that ICU rooms are more private, have more generous visitation rules and have a TV). Please pray that he would be able to go to a regular hospital room very soon - his nieces cannot visit him in the ICU and there are still quite a few limitations on visitors.

* Greg is in a lot of pain; while they have managed to get it under control, the anesthesia causes a lot of itching. Between the pain and the itching he wasn't able to get much sleep last night, but today they seem to have struck a better balance. Please pray for alleviation of his pain and the ability to slowly reduce the amount of medication he needs for it.

* Greg's temperature this afternoon was just about 101, which is a normal post-op temperature, but of course it needs to go down. His heart rate is also high.

* Christine is also in a lot of pain. Please pray that her pain would be relieved so that she can be with Greg as much as possible.

Time and time again Greg has had to Stan' Up and Git Hit. As he stands once again, pray that by God's grace he will stand strong.

Monday, December 22, 2003

Better Than Expected

Greg's surgery ran from 7:45am to noon, and went better than expected with no complications. The cancer was not touching Greg's diaphragm, so none of that muscle had to be removed. In fact, the cancer does not appear to have spread anywhere else in his body. The right lobe and half the left lobe of his liver were removed, which is about what was planned. The area of the cancer was about 2 1/2 inches in size, having been significantly reduced by the chemotherapy. Greg had no excessive bleeding, and there was no need for a blood transfusion.

Greg is doing so well that he was moved directly to the recovery room and is not going to spend any time in the Intensive Care Unit. After spending the night in the recovery room, he will be moved to a regular room.

Sunday, December 21, 2003

The night before surgery


sarabeth_sm.jpgMelina_sm.jpgHere we all are... Carl, Jim, Sue, Judy, Anne, Melina, Michael, Sarabeth, me, and Christine. Ten weary travellers enjoying celebrating our week of hotels, restaurants, and MD Anderson hospital. Well, not really "weary" -- we're having a great time. This was taken at dinner the night before surgery. It was terrific Chinese food... or so I hear... I had chicken broth to satisfy my pre-surgery clear liquid diet.

Christine_on_phone_sm.jpgMelina and Sarabeth had come from the park, where there were face painters. I told them not to wash their faces and show up tomorrow decorated. Here's Christine talking on the phone with my sister, Julie, as we drew near to bedtime. My heart is so full of thanksgiving for the love with which I have been surrounded.

The appointment with the surgeon went well on Friday. We discussed what I should expect and some of the details of what he will be doing. He expects to take out some of my diaphragm with the liver. This is because some of the diaphragm may be "stuck" to the tumor. This is not uncommon and does not hurt long term prognosis, just increases the pain somewhat. They are also taking out the gall bladder, which I don't really need anyway. Finally, the Dr. Vauthey's assistant explained to us about the epidural, which I will have for a couple days after the surgery. Christine replied to him with a straight face, "You mean he might have a baby, too!?" At the end of the appintment I sang the Twelve Days of Chemo for Dr. Vauthey and his assistants at the urging of a nurse. He got a real kick out of it.

Right now, I find myself sitting in bed again contemplating the unknown in the coming days. It seems like such an ordinary night, and yet tomorrow will be one of the most important days of my life. No experience prepares one for an occasion like this because it is a once in a lifetime deal. There seems to be no "right" way to approach major surgery. So I'm just riding the wave of time until tomorrow I'll find myself in a place where they'll say, "and now you'll feel a little drowsy." My prayers become simple. Just as I'm not sure what to do, I'm not sure what to say. So I sit with a raw trust in the love of the Father.

Christine has fallen asleep. We report tomorrow at the hopsital tomorrow morning at 5:30am. Its going to be a rough day for everyone with so little sleep. I won't really mind because I'll get to sleep all day.

So much of life consists of looking forward. The life of a Christian, especially, is characterized by an anticipation of the coming of the Great King. As my own future is uncertain, I am drawn towards those objects of hope for which I am more certain. One of these, as I've written in earlier posts, is what the Bible refers to as harvest time - the coming of Christ. This morning's sermon at Christ the King Church was on ththis very topic. The pastor related a passage in Revelation to a tune by Johnny Cash, recorded shortly before his recent death. The pastor, Rev. Leo Schuster, actually played the recording to our (pleasant) surprise. I'll leave you with a portion of those words...

The Man Comes Around

There's a man goin' 'round takin' names.
An' he decides who to free and who to blame.
Everybody won't be treated all the same.
There'll be a golden ladder reaching down.
When the man comes around.

The hairs on your arm will stand up.
At the terror in each sip and in each sup.
For you partake of that last offered cup,
Or disappear into the potter's ground.
When the man comes around.

Hear the trumpets, hear the pipers.
One hundred million angels singin'.
Multitudes are marching to the big kettle drum.
Voices callin', voices cryin'.
Some are born an' some are dyin'.
It's Alpha's and Omega's Kingdom come.

And the whirlwind is in the thorn tree.
The virgins are all trimming their wicks.
The whirlwind is in the thorn tree.
It's hard for thee to kick against the pricks.

Till Armageddon, no Shalam, no Shalom.
Then the father hen will call his chickens home.
The wise men will bow down before the throne.
And at his feet they'll cast their golden crown.
When the man comes around.

Whoever is unjust, let him be unjust still.
Whoever is righteous, let him be righteous still.
Whoever is filthy, let him be filthy still.
Listen to the words long written down,
When the man comes around.

Wednesday, December 17, 2003

Contact info at MDACC

mailbox.gifMD Anderson has a system such that you can send an e-message to me (or to Christine via me) while I am an inpatient and the message will get to me in hardcopy form. Click here for the web site. You have to enter my birthdate (02/19/68) and patient # (169996). I assume it works - I'ver never tried.

Also, at some point, I will use my laptop to get email - probably later in the week.

Our mailing address will be:
MD Anderson Cancer Center
Gregory J Hewlett, inpatient
Patient ID #169996
PO Box 300206
Houston, TX 77230

You don't need the room number for the address, but delivery may be faster if you include it. I don't know what the number will be at this point.

I will be an inpatient 12/22 (Monday) until estimated 12/29, 12/30, or 12/31.

Tuesday, December 16, 2003

All I want for Christmas is my liver out

Dr. Vauthey has made his decision. One, I'm ready for surgery. Two, he is "quite confident" that my liver can handle the single-stage surgery. And three, he thinks we should do the surgery as soon as possible. That means Monday.

To avoid having to go down there and back and down there again (although that is the pattern these days), we moved the appointment with him from tomorrow to Friday morning. So Thursday, Christine and I will leave for Houston and we'll stay there until I recover from the surgery.

The surgery will be Monday, Dec 22. It is a highly technical surgery, requiring 6-8 hours on the table. Dr. Vauthey is planning on removing 76% of my liver - all of the larger right lobe and some of the smaller left lobe. The surgery is followed by one to two days in ICU (usually just one night). I will be in the hospital for a week to a week-and-a-half, so I'll probably be out by New Years Day. I then have to stay in Houston for at least one more week before I can leave the area back to Dallas.

Needless to say, our already chaotic holiday plans are now scattered in pieces on the floor. Hopefully all the kings horses and all the kings men can work out the logistics. Christine's family from Maryland and New Jersey are all planning to fly to Dallas for Christmas because we couldn't travel up there. The new problem is that when they get here - we won't be here! I'm sure we'll all figure it out. Bottom line is that this is good news.

After surgery, my body will suffer from missing out on a significant portion of liver function. Steve Wei described it to me as "extreme fatigue". Sounds like I will be a weak rag for a while. I hope to be well enough to enjoy my family and Houston friends and to keep up with email.

Dr. Vauthey prepares himself for many contingency plans on how to deal with any discovered cancer when they go in. (e.g. radioactive burning of small lesions in liver remnant, removal of cancerous areas of diaphragm, etc) Please join me in praying that he won't find any such problems in there, that the surgery will be clean, that there will be no major complications, and that my body will be hereafter be void of all cancer. Also, please lift up Christine for strength and relief from pain and for our entire family as we go through this together while celebrating Christmas in a hospital away from home.

There is a curse on my liver. But at Christmas, we remind ourselves, "He comes to make his blessings known far as the curse is found, far as the curse is found."

Thursday, December 11, 2003

Twelve Days of Chemo

On the twelve days of chemo, my doctor gave to me...

Twelve pills for poppingFrosty on Xeloda.gif
Eleven nurses griping
Ten I.V.�s beeping
Nine-year financing
Eight nights a-barfing
Seven aides a-calling
Six hour delaying
Four empty words
Three weak grins
Two port-o-caths
And a bed pan in which to pee.

Tuesday, December 9, 2003

More remarkable shrinkage of tumor

The appointment with Dr. Hoff yesterday was not routine. Chemo is again postponed. But this time it is because of good news...

The tumor in my liver has again shrunk drastically due to the last two rounds of chemo. So much so that Dr. Hoff believes I am now at a state where surgery is feasible. The actual decision will come from Dr. Nicolas Vauthey, my surgical oncologist, who would perform the liver surgery. I would have met with him yesterday, but he is in Europe for an international meeting and does not return until next Tuesday. I will go back to meet with him Wednesday, Dec 18.
The decision that Dr. Vauthey must consider is:
1. I still need chemo to reduce the tumor more, or
2. I am ready for surgery.
If (2), then there are two options for the surgery:
2a. A one stage approach. In this case, there would be one major surgery to cut a large chunk out of my liver. Even though the tumor shrunk, they like to take out every part of the liver that was ever cancerous to better prevent the cancer from returning. So they are talking about resecting more than half of it. This surgery would likely be on Dec 22 (a visit from St. Nicolas Vauthey?).
2b. A two stage approach. If the portion to be removed is large enough, Dr. Vauthey will do a two stage surgery that he has pioneered at MD Anderson. The first stage is called portal vein embolization (PVE). In this stage, they go in and place artificial clots in the liver vein such that the good remnant is fooled into thinking that it is carrying all the load of the liver, so it starts growing. Thus, we get a head-start on the regeneration process. Then, at the time of the actual resection (about a month later), the percentage of liver removed is actually smaller, decreasing complications and increasing chance of recovery. If we do this option, stage one will probably be next Thursday, Dec 18, and stage two will be in mid January. The first stage is not too traumatic - usually requiring only one night in the hospital. The second stage is major surgery. You can read about PVE here.
I asked Steve Wei, Dr. Vauthey's assistant, what he thought Dr. Vauthey would decide. His reply was that he couldn't say because "we don't see this very often." By that he meant they don't see such initially large tumors shrink so much from the chemo. Steve emailed the CT scan report and the digital images to Dr. Vauthey. If the decision is obvious to him, I should hear this week what to expect. But if it is a tough decision, there will be a doctor's conference on Tuesday where Dr. Vauthey will discuss the case with other oncologists and radiologists involved with my case. I get the feeling from the medical team that this is somewhat unchartered territory. I don't think anyone expected that as advanced as my cancer was in June, we would be at this point today.
Because surgery is likely on the near horizon, Dr. Hoff decided that I would not have chemo now. (yippee) I need to be as healthy as possible for what is coming. So after the meeting, I turned around and drove back to Dallas. Mark Dishman accompanied me. Christine unfortunately missed all the excitement due to the bad cold she has. This was very disappointing to both of us.
So what does all of this mean for my overall prognosis? If this surgery is successful (success is declared if they remove all the cancer in the liver and see no other cancer elsewhere when they go in), then my chances of survival are drastically improved from what they have been. Dr. Hoff told me "most of the time" it is successful. However, statistically there would still be a greater than 50% chance that the cancer would come back. I say this not to be pessimistic, but to let you know the urgency of continued prayer. I am continuing to be hopeful. This is now mixed with much thanksgiving. I thank the Lord for the remarkable shrinkage of the tumor. I am thankful for being at MDACC and for having insurance and finances to get all of this expensive care. And in the short term, I am thankful for getting another week off from chemo!

Amateur anatomy

Here is my (very) rough estimate from memory showing what kind of progress there has been.

The lines show the region of cancer visible to the CT scan. My impression is that the surgery will be of most of the large lobe and possibly some of the smaller. They like to get good margin. I continue to be amazed that as small as a quarter of the liver can regenerate quickly back into the full organ.

Saturday, December 6, 2003

Round six on Monday

We decided to come back to Dallas for a few days instead of staying in Houston. I have been feeling great, having had so much time off from chemo. And this is likely the last few days where I will be feeling good before Christmas so we decided to come back. The absence of pain and fatigue is absolutely delightful. Every hour is sweet. Our friend David Clemmons came over last night to provide the muscle behind getting and carrying in a tree - usually a chore, but this year a pleasure. The weeks before Christmas are usually so full of activity, but I had to squeeze everything into this weekend. It didn't fit.

Christine unfortunately was not doing as well and has now come down with a cold, so we are not sure if she'll go back for my appointment Monday. This would be a big disappointment because it is an important appointment for us Monday. The CT scan results will be evaluated and we'll assess how the cancer is doing and make plans for the course of treatment over the next couple months.

Monday, December 1, 2003

Schedule changes again

Christine and I threw a change of clothes in the car and headed to Houston for a quick trip to get chemo. The plan was the same as last time - get out of Houston while the steroids given with chemo were still in effect. That way we only stay in Houston for 36 hours.

Well, today we first met with Dr. Hoff and he decided that it was not wise for me to get chemo today. I was actually somewhat relieved because I still have symptoms from the bacterial infection, and I wondered if I my body could really take another round with the existing problems. He expressed this very concern and delayed this round of chemo until Dec 8 - next Monday. The last thing we need is an aborted round and another stay in the hospital.

Meanwhile, he thought we should go ahead and get the CT scans to see if there is progress in the shrinkage of the liver tumor. At our request, he gave us some more sobering details highlighting again the importance of getting that thing small enough to do surgery. Bottom line is that I need this surgery. So it will be good to get some data on how the tumor is doing.

The catch of this plan is that we may end up staying here for the week for these scans and then chemo next Monday. We'll know the schedule tomorrow morning. I never seem to know much further ahead than one day at a time, anyway.

Saturday, November 29, 2003


annebrinknativityToday is the first Sunday of Advent, a season that the church has celebrated for hundreds of years as a time to focus on the coming of Christ - both his Incarnation two thousand years ago and his promised coming when he comes to restore all things.

My friend Bill Burns, who is our church's worship director, and I have written an Advent devotional guide for use in our church, Town North Presbyterian. He has structured it into four sections, each corresponding to a week of Advent and a theme for that week. And he has included the liturgy that we will use in our church on each Sunday in Advent. I have added to this a set of daily devotionals for the weekdays. Each devotional has a passage to read, a paragraph to help the reader understand the passage in light of the Advent theme of that week, a set of a few questions upon which to meditate, and a short prayer.

I invite anyone to join with us in focusing on the coming of Christ this month, so I have included the Advent guide (click to download). It is formatted for double-sided booklet format. This may be a bit confusing but I'm sure you can figure it out - the pages are numbered. To order, put the pages back to back and fold it like a booklet.

Just like everything else I encounter during these days of trials, this Christmas season has a different taste to me. I am hoping it will be a time of reflecting on the coming of Christ, a hope that is really my only hope.

Incidentally, the joyous art above is that of Anne Brink.

Saturday, November 22, 2003

I'm out

Yesterday, they figured out what was going on with my body. I have clostridium difficile bacteria in my digestive tract. This is a stubborn bacteria, but can be treated with antibiotics. It causes a bad case of colitis -- inflammation of the bowels -- which explains the pain and cramping. Because the antibiotics can be taken orally, there was no reason to keep me in the hospital, so they discharged me late yesterday afternoon, telling me I would have to come back if I developed a fever.

I have great admiration for the local doctor, Dr. Bopanna, who was following me this week. Throughout the week, I continued to press her to release me because I thought it was pretty obvious that my problems were simply a result of my chemo. And since I tested negative for viral infection, I figured I could go home. She persisted, thinking something else weird was going on. And to the amazement of my amateur medical mind, she turned out to be right. I confess that sometimes it actually feels good to be wrong.

There is some good news in all this: the chemo was not a direct cause of the problem. It merely created conditions that made me more susceptible to stuff like this. Dr. Hoff's current plan is for me to keep taking the chemo as long as (a) the tumor keeps shrinking, and (b) my body can handle the chemo. Then, if the tumor is small enough, they'll perform surgery to remove it. This week, it was looking like (b) was unfortunately no longer true. But because it turns out that my problems are due to this bacteria, once we get it cleared up, I shouldn't expect these severe symptoms again. Still, Dr. Hoff has decided to delay my next chemo round by an extra week to let me recover. To begin chemo next Monday, he said, would be like pouring salt on an open wound.

On the way home from the hospital, Christine and I went out for an early dinner. She dropped me off at Mom's because I still needed some care. Christine had a bad migraine, so she didn't think she could care for me. When I got to Mom's, I immediately crashed (recall my earlier post about hospitals being a place where one gets no rest). Two hours later I woke up very hot. My temperature was 102. Ugh. I called Dr. Bopanna and she told me a few things to do to reduce the fever. An hour later I was to check my temp again. I did, but the fever hadn't budged.

So at 10:30pm, Mom and I did what we did last Tuesday - headed to the ER. Groundhog Day. Needless to say, I was in a terrible mood about having to be readmitted. They evaluated me in the ER for six hours, during which time the fever subsided. They figured it had to be something new - maybe the flu. Only time will tell if it develops into something. They decided that with the addition of another antibiotic for me to take, I could return home. So this week's hospital tales ended when we got home at 5:30 this morning. Or at least I hope that is the end of the tales!

Thursday, November 20, 2003

In hospital another day

Ugh. I just got word that my blood levels, particularly the magnesium level, is low enough that I won�t be released until at least tomorrow. This week has been a real bummer. On the bright side, Christine gets in this afternoon. It will be better having her back.

Live from room 507, it's wednesday night

�Hi!� The sharp loud voice woke me suddenly last night, sometime between midnight and one. I opened my eyelids and found myself looking into the eyes of another human hovering over me. I jumped. �I�m new nurse. How you feel-eenk?�

�Is this Candid Camera?� I wondered. I wanted to answer her honestly, but kept my thoughts to myself: �I was feeling fine, considering I was sound asleep!� It wouldn�t be the first time she unnecessarily woke me last night.

I sometimes feel like hospitals are real-life Saturday Night Live skits. Things that go on here do not need to be spoofed. This place is a spoof of itself. Maybe I was dreaming, but I could have sworn I saw someone mopping my floor with ammonia this morning at five. At around six, I awoke again to someone wheeling in a large clanging fork-lift looking object. They wanted to weigh me. I�m not making this up. Apparently, after being here for thirty-six hours, it was now urgent that they know how many kilos I weigh.

One has no choice but to take all this as entertainment. After all, television doesn�t have much to offer at five in the morning, especially considering I only get a few local channels on my room�s television. However, if I want more channels I can pay $9.95 a day. It�s called �GetWellTV�. They take all major credit cards.

Wednesday, November 19, 2003


I was hanging in there yesterday, not doing too bad, albeit with concern about the continuing diarrhea. My doctor was concerned about dehydration but not quite enough to send me to the hospital. Then at 10pm, I developed a fever. My doctor (actually the doctor on call for Hoff) said to go right away to the ER. How is it that these things always seem to happen late at night! Mom took me. Neither of us had much sleep through all the night's activity.

Long story short, they kidnapped me and I am currently being held hostage at Richardson Medical Center in Room 507. My captors tell me I will probably be here until Thursday. Quite frustrating - this is my "rest" week before round six on Monday. They gave me a weak excuse for this captivity ... something about possible infection. However, my captors are treating me well. The fluids they are pumping into me for dehydration are making me feel much better.

Still, if this gets out of hand, I may ask some of you to organize a rescue mission. You could wear camos and helmets with green infrared cameras and carry me down the staircase to make it look heroic.

Monday, November 17, 2003

Didn't quite make it through the round

I had to abort this round of chemo treatment last night when I had just one day remaining. The diarrhea spun out of control on day 13 of the 14 days of chemo and my doctor had me stop this round to avoid my becomming dehydrated. This is a bit frustrating, as we'll probably reduce the dosage somewhat for next round. I remind myself it is a small bump in a long road. As we look back at all the chaos associated with my getting obstructed and having to stop chemo a couple months ago, it now seems to be as good as any plan the doctors could have designed. Those first few rounds instead of immediate surgery were not a mistake - they cleaned my blood system of the cancer and shrunk the liver tumor considerably before the six week break for surgery. Still, my comfort today is the same as it was during that setback - to pray with David, "All the days ordained for me were written in your book before one of them came to be." (Ps 139)

I'm very glad that Christine was able to visit her family. She's enjoying herself, but she also wishes with these recent troubles that she could be with me. With her absence, she requested I stay the night with my parents in case I get too dehydrated. So after watching the Cowboys get shellacked by the Patriots (what a waste of time), I went over there for the night.

My doctor, answering my page from Boston last night, discussed my situation with me and emphasized repeatedly the importance of getting better to avoid checking into the hospital today. The remedy was simple - stop the chemo, take higher than indicated doses of over-the-counter Immodium, and drink as much Gatorade as possible to rehydate myself. This is reminiscent of my previous battle with cancer in 1982-5. After twenty years and billions of dollars in cancer research, the best help dealing with chemo is still Gatorade. I can imagine a new advertising campaign. Tough looking cancer patients ... no hair ... chugging Gatorade ... cool blue sweat dripping down their foreheads. "Is it in you?"

Thursday, November 13, 2003

Helen Grace

Helen_small.JPGWe mourn with the Mantegnas at the loss of Helen Grace, Christine's grandmother and the mother of Sue Mantegna. Our prayer is that God's peace that passes understanding would comfort Sue and her family during this difficult time.

Christine left yesterday for Baltimore to be with her mom and family for the funeral, which is today. She'll stay up there until Thursday. I only wish I had the physical strength to be there, too.

Thursday, November 6, 2003

CEA 3.4

It has been a while, but I'm still here pushing forward! I finished off my fourth round of chemo and this week began my fifth. I decided to try things a little differently this round by driving down to Houston and coming right back after the intravenous chemo was given. This takes advantage of the small window of opportunity of feeling well due to the the steroids I receive with chemo. This plan allows me to work and rest from home rather than from Houston. I decided to give Christine a break and Mark drove me down. She is continuing to suffer from serious migraines.

My check-up appointment was relatively uneventful. The good news was that my CEA level (a marker for the cancer activity) continues to go down. It is now at a level of 3.4, which is a "normal-person" level. This indicates the chemo is still working. I have been having some more serious side-effects (diarrhea) this past round, but not quite at the level of having to stop chemo for a break. Because I am on the edge with this symptom, Dr. Hoff was inclined to reduce my chemo dosage. I resisted and talked him into continuing at the full dosage. After all, the symptoms have been kept in relative check. He replied that if it gets any worse, I will have to abort the round and spend time in the hopsital to recover. But he agreed to continue at full dosage and see how it goes. I don't think he would have given in to my persuasion if he thought it was a foolish decision. I'm in day three and have not had any problems yet, so my gamble is paying off so far.

After one more round, we will do the range of diagnositc tests to see how the liver tumor is doing. That will be mid-December. Dr. Hoff doesn't want to do radioactive testing any more frequently than that because the iodine contrast used in the liver CT scan is bad for my kidneys. So the next solid news will not be until that time. As you may recall, the plan is to continue chemo until the tumor size no longer shrinks or until my body cannot handle the side effects. Then, if it is small enough, surgery will be performed to remove it.

For those inclined to pray, please petition for continued tumor shrinkage and overall healing, no serious side effects, and Christine's battle with migraines. Thanks.

Friday, October 24, 2003

DLP award

caution - this is a shameless ad

nav_logo_dlp.gifFor those who don't know what I do for a living (when I'm not fighting to live), I design digital video projection systems at TI. Our brand is called DLP and we are celebrating today for receiving our second Technology Emmy last night. This is the nerd version of the regular Emmy. So if you've got $3000 to blow on watching television (an activity Frank Lloyd Wright once called "bubble gum for the brain"), then you won't find a better television to buy than ours. Right now, Samsung is our leading producer for television sets.

If you like going out to the movies instead, you may be able to watch our technology at work at a local theater that supports our digital projection. To find out, enter your zip code at our DLP Cinema web site.

Thursday, October 23, 2003

Stan' Up and Get Hit

Few of my entries have generated as much response as Cool Hand Luke. My Uncle Ron sent me an item he ran across in the 1966 Farmer's Almanac by a fellow named Sam Foss. I found it pertinent and amusing:

Luck loves the hard hitter and glorifies grit.
An' smiles on the man who stan's up an' gets hit;
Though fate strikes out strong, with a blow 'twixt the eyes.
It loves the stout soul who still fights and defies.
The fight is not gained by the strong or the fleet,
But by the grim chap who don't know he is beat.
This life is a fight that has got to be fit,
The best thing you can do is stan'd up and git hit.

Also, here is a text on the same theme from 2 Corinthians:

But we have this treasure in jars of clay to show that this all-surpassing power is from God and not from us. We are hard pressed on every side, but not crushed; perplexed, but not in despair; persecuted, but not abandoned; struck down, but not destroyed. We always carry around in our body the death of Jesus, so that the life of Jesus may also be revealed in our body. For we who are alive are always being given over to death for Jesus' sake, so that his life may be revealed in our mortal body.

Saturday, October 18, 2003

Returning to Dallas

Our Houston hosts, Pete and Sally Rasmussen

It is hard to believe it has been over a month since I came to Houston. At the same time, it seems like so long ago.

On September 8, I came down for observation after a temporary obstruction of my digestive system. Many things were uncertain at the time and the doctors were worried about emergency surgery. Now after a successful surgery, recovery, and a round of I.V. chemo, we're headed back to Dallas under far less serious conditions.

This week my surgeon worked on a pain problem I have been having for over a week at the base of my right rib cage. An x-ray showed some fluid in the lung at that spot, but he said that was not uncommon after my surgery and was probably not the source of the pain. The pain is also near the liver tumor, but that is probably not the source of pain as it has shrunk, not enlarged over the past few months. He was concerned it could be a pulmonary embolism (clot) in the lung, so I had a CT Scan, but that turned out to be negative. Bottom line is that the pain remains a mystery, but considering how much my body has been through, they think we should just wait, watch, and hope it goes away. Pretty high tech, huh? Not too far from the two-cent assessment of a non-medical friend of mine - "they opened up your gut and cut a bunch of stuff out, what do you expect?"

Our survival over the past month was made possible by the service of our dear friends, Sally, Pete and Chris Rasmussen. I was deeply moved at how they modeled Christ in sacrificing their lives on our behalf. We invaded their home and life and they were nothing but gracious. Sally became my personal nurse, changing wound dressings, planning meals according to my diet, and shuttling me back and forth from MDACC. Pete and Chris were also always there to help and are driving us back to Dallas today. Since being diagnosed, I have found it to be very difficult to be vulnerable enough to receive help. They made us feel safe doing so.

Monday, October 13, 2003

Cool Hand Luke

Well, I'm back on the chemo track. In fact, I'm taking it as I write...

I'm in a private mini hospital room with Christine - they use these rooms to administer outpatient chemo. They've hooked me up and the chemo is just beginning. Soon, I'll feel sick, but right now I'm feeling fine. In fact, I�ve been feeling steadily stronger day by day.

Last week, I spent a lot of time resting in between eating and trying to keep up with work. While watching TV, I caught a favorite old movie of mine, Cool Hand Luke. It has a classic scene that I find fascinating. Paul Newman plays Luke, who is sent to a low-security prison for sawing the tops off parking meters. Shortly after arriving, out on the grounds of the prison, Luke gets caught in a boxing-style fight with Dragline, the local prison bully. It is not much of a contest. With the other prisoners gathered around in a circle watching, Dragline hits Luke again and again without much resistance. The pounding continues to the point where every blow causes Luke to fall to the ground. Again and again he is knocked down, yet he always manages to stand up again, against the advice of the sympathizing observers and even Dragline. �Stay down, you�re beat,� utters Dragline. �You�re gonna have to kill me�, Luke replies. The remarkable outcome is that Luke has such an iron will that the bully finally just walks away. While the technical "loser", Luke comes away the psychological winner.

Later, Luke wins with a bad hand in a poker game and Dragline says it was just like the fight. "He kept comin' back at me with nothin'." Luke's response results in his new nickname, "Yeah, well sometimes nothin' can be a real cool hand."

I think fighting cancer is a lot like that fight scene. The cancer-chemo bully hits you every time you get enough energy to stand up. Again and again this continues. Here I am just getting to my feet after the surgery and I'm about to get hit by the bully again. The goal of the process is to be like Luke - keep getting up until the bully gives up, even if you got nothin'.

Monday, October 6, 2003

Date for restarting chemo

I met with Dr. Hoff this afternoon. He thinks I have recovered well and decided I am ready to begin chemo again on Monday (9/13). It will be the same 21-day cycle as I did before, with the IV chemo (irinotecan) on day 1 and the oral chemo (xeloda) twice daily for days 1-14. This cycle will continue as long as the chemo is continuing to shrink the liver tumor. At the point when it seems to be no longer shrinking, we'll do the liver surgery.

Friday, October 3, 2003


My life seems to revolve around the issue of poop lately. The doctors and nurses are all quite interested in it. They anticipate it, analyze it, measure it, time it, and are even willing to clean up accidents with it. At first I was even embarrassed to speak of it with them. I have now become somewhat desensitized to the existence of poop. Yet I still have concluded that dealing with poop is near the bottom of human existence.

As a Christian, I naturally ask if Scripture has anything to say about poop. Some might laugh at such a thought, but remarkably the Bible does address the topic. While the majority of clean-cut Christians would not mention such topics, the Bible indeed deals at this level of reality without such avoidance.

Of the many places where the Bible addresses the topic of poop, one particularly interesting place is in the New Testament book of Philipians, where Paul writes,

What is more, I consider everything a loss compared to the surpassing greatness of knowing Christ Jesus my Lord, for whose sake I have lost all things. I consider them rubbish [may be trans. "poop"], that I may gain Christ� I want to know Christ and the power of his resurrection and the fellowship of sharing in his sufferings�

I really admire the Apostle Paul. He likes to tell things how they are. Direct. No candy-coating. I think he came from Philadelphia. The word that he uses here is only found in this verse in the whole of the New Testament. It is likely an expletive, but is rendered by the euphemistic �dung� or �rubbish� in English translations. Paul says, in effect, �Look, everything I have in life I consider to be at the level of poop compared with knowing Christ and his resurrection.� He puts it on the line. Life ain�t worth poop without knowing Christ and his resurrection. The more I personally have to deal with poop, the more clearly I understand this passage - an unexpected advantage to having colon cancer.
When the church has strayed from its fundamental elements -- Christ and his resurrection -- it has by definition ceased being the church. Sometimes it has become oppressive, sometimes it gets caught up in endless political battles, and sometimes it has become simply a bland institution of nothingness with marshmallow smiles pasted on the faces of its members.
It has become commonplace in segments of mainstream Protestantism and elsewhere to push aside the person of Christ and particularly the event of his resurrection. Now, mind you, such leaders are usually careful enough not to outright deny it. But they will at least discount it as irrelevant in practice. As long as you find community, as long as your kids have a place to learn right from wrong, as long as you have a support structure to help you through suffering, as long as you are nice to everybody and they are nice to you, as long as you have faith (no matter who or what it is in), then the church is considered a good thing. It doesn�t matter whether or not God revealed himself in Christ or whether or not he raised him from the dead. I like to imagine Paul�s response to such lines of thinking. I think it is safe to make an educated guess as to what he might say: �that�s a bunch of poop�. It may be appealing to the masses, but it is not historic Christianity. Call it �religion� if you want. Call it �country club living� if you want. Call it �hypocrisy� if you want. But don�t call it authentic Christianity.
As I continue to have areas of my life stripped away during this time of suffering, I am afforded the opportunity to observe my life more clearly. Things around me become less and less important in the final perspective: my dreams, my finances, my career, the consumer goods I�ve collected, my house, my reputation. Most all that is left is the reality of my Creator and his revelation to humankind in the person of Jesus. Aside from this, I have concluded that my life has little meaning. Aside from Christ, my life really is a pile of poop.

Tuesday, September 30, 2003

Visitor Pics

Here are a couple of photos at the Rasmussen's home...

Araceli and her boys visited us at the Rasmussens a couple days before surgery. The boys are Marco, Tomas, and Mattias, left to right.
Charles Burck took his parents, Julie (my sister) and Michael, to come visit us shortly after I was released. Here's me with my nephew fighting over the remote control.

Monday, September 29, 2003

Infection; under control

Yesterday, Christine was feeling poorly again, so she stayed home while I left with Pete and Sally to go to church. On the way, I noticed more pain than usual and the leaking of my belly wound. So instead of church, we headed over to the Temple of MDACC to check out their magazine selection in the waiting room. The on-call surgeon investigated the problem and determined it was an infection. He decided to remove four staples and probe around to see if the infection went deep. I wanted to hit him, but he was such a nice fellow. Thankfully, the infection was superficial - limited to skin and fat layers - so he cleaned it up, showed Sally how to dress it and sent us on our way. I was shocked they would just let me go with an open wound, but they acted like it was no big deal. The wound reminds me of Matthew Brady photos from the Civil War. I don't even want to look at it, not to mention having trouble leaning forward to clean it. Christine has a difficult time looking at it, as well. So Sally has risen to the occasion, drawing on her nursing background, and is lovingly redressing it twice daily according the surgeon's instructions.

Just a hiccup... we're rolling once again.

Friday, September 26, 2003

Out again on parole


I'm being released today. They held me here for the last day or two due to problems eating due to nausea and cramping. These symptoms have cleared up dramatically in the past 24 hours since they took me off I.V. pain meds. I think these problems were side effects of the medications. Every solution seems to have an associated side effect - you can only really get better when you escape, which is what I'm doing today. We're headed back soon to Conroe to stay with the Rasmussens.

Pathology reported some good news and not so good news. The good news is that the primary tumor they took out was only 20% viable - it had been nearly obliterated by those few rounds of chemo. Viability has to do with what percentage of cancerous cells are alive and kicking. The bad news was that some of the lymph nodes surrounding the tumor were cancerous. But we had suspected that was the case as this type of tumor goes first to lymph nodes, then to the liver. For good measure, he took out all the surrounding nodes.

In my estimation, this week went very well. Another difficult step successfully taken. Thank you, Lord.

Wednesday, September 24, 2003

Some hopsital pics

From earlier this week when Mom, Dad and Susan came down for a visit...


System working

Hi everyone. I feel as if I've emerged from the pit. Late last night my digestive system showed that it has figured out its new route. Thanks for your prayers for this. The last major hurdle this week has thus been cleared. Now things are geared towards getting out of here. Yesterday they disconnected the morphine and toradal and replaced them with a less potent pain killer. They also took me off the supplemental oxygen. Today I had my first shower and first meal - some apple sauce. Tonight I had some eggs and a piece of bacon - my first real food for over a week. I'm still in pain and feeling lousy, but I am in a great mood. I'm now going to be weaned off the pain med and continue to see if my body can handle solid foods. They think I may be out of here by week's end. I hope all continues to go well so that I can leave. Christine is moving into the Rotary House for the next two nights so that she can get some much needed rest. Thanks everyone for your prayers this week. I am deeply thankful to the Lord tonight.

Saturday, September 20, 2003

Better Than Expected

Dr. Rodriguez visited Greg today and said the surgery was successful. Everyone is happy that there were no signs of cancer beyond what the CT scans showed. The surgery ran smoothly enough that Greg did not need to go to ICU, but went straight to a standard bed. After a tough evening last night Greg was doing surprisingly well today. The pain got under control and he enjoyed hanging out with Christine, Susan, Mom, and Dad. He was alert today with generally tolerable pain. The doctors and nurses were very pleased with his condition. Greg is very thankful that things are going so well.

Friday, September 19, 2003


Greg's surgery went as expected today. There were no surprises and it proceeded according to plan. Greg is now in recovery and Christine will be able to see him around 6pm tonight. Watch this space.

Thursday, September 18, 2003

The night before surgery

It is an odd night. Dark, quiet, surreal. I sit in bed at the Rotary House across from the hospital. It would be too crazy (even for us) to try to make it to downtown from Conroe early tomorrow morning. Christine is sleeping - a long day today and a longer one tomorrow. I feel so, well, healthy and pain-free. Can't it continue? Oh yes, I remember... this pain is necessary to remove the silent threat.

I'm familiar with being put under for operations. I counted today - this will be the 22nd time I have been given general anesthesia. This one will be the most serious yet. Seventeen were for an intra-arterial chemo treatment I had with my previous cancer. The other five were miscellaneous cancer-related operations. Seems there ought to be a prize or something.
My anesthesiologist told me that my surgeon, Dr. Rodriguez-Bigas, is one of the tops in the whole institution. "He could probably be chief, except that he is a family man." I am thankful once again to be able to be treated here.
Do I fear? Well, I do fear the pain. Although the anesthesiologist told me today that this surgery is much better than the liver surgery will be. That was comforting... in a short term way. Also strong on my mind is what they might find. I am praying and hoping that they will not discover any cancer they do not already know about from radiology tests.
Strangely enough, I'm also feeling something akin to excitement. This surgery is the next step on the road to recovery. I made it through the first step - diagnosis and getting started at MDACC. I made it through the second - almost three rounds of chemo that worked great. Now, I thankfully made it through these last two weeks with no further obstruction. The waiting is over. Now its time to take the field and play. I'm determined to take step three.
I have been thinking much about the Resurrection the past few days. The past few months, actually. In it, I find the only hope in this tough world. No place else. When things were getting tough for Jesus and the Twelve, he asked them if they wanted to abandon him. Peter answered, "Lord, to whom shall I go? You have the words of eternal life. We believe and know that you are the Holy One of God." It is in this dark night that I especially realize there is no place to be but in the arms of our Creator. In these arms I feel a deep joy, albeit a joy sometimes clouded by immediate circumstances.
For those joining me in prayer, my requests for tomorrow are
- That Christine and I would have the peace that Jesus gives (John 14:27) in our souls in the coming days.
- For the hands of Dr. Rodriguez. That the surgery would be successful with no leakage, infection, or other complications.
- That his search for more cancer would come up empty and that this operation would be a step towards full recovery.
- That I would quickly gain strength, recovering fully, and soon be able to get back on chemo.
I'm signing off for a few days. I'll be loopy on morphine. (Aah, the sweet sound of that word. A melodius sound, really... mor-pheeene... a common grace gift from God that mercifully oozes through the body erasing pain).
Mark will keep you up to date in the meantime.

Surgery Schedule

Greg will go to the hospital at 6:30 AM tomorrow for colon surgery. The surgery is expected to last from 8:00 AM untill 11:00 AM.


This guy uses the C-Leg, which is the prosthesis I use... C-Leg in the news

The knee resistance is controlled by a microcomputer. My niece, Avery, calls it my "blue leg".

Monday, September 15, 2003

Relaxing in Brenham

This weekend I was without internet access. Christine's sister, Anne, flew down from Newark Friday and the three of us stayed at a vacation farm house out near Brenham, TX, for the weekend. The house belongs to the Jobes, a family friend of a friend of ours from Houston. They generously allowed us to stay at their house. We had a wonderful time with Anne for our little get-away.

Anne, Christine, and Greg at the Rasmussens before our trip to Brenham
Those of you who know me well, know that I am really a city boy at heart. Of the many places I've lived, my favorite was surrounded by human activity in Boston. So I must admit that I was a bit panicked in my little Volvo as I drove down a muddy road and through a cow pasture (with cows; no road) to get to the farm house Friday night. I had no business being out in the middle of nowhere, I thought to myself. But by the next morning, as the sun rose above the pond out back, my soul quieted. It is indeed refreshing to be in a place where the only sounds are chirping and an occasional moo.
We slept in, read books, and just sat on the rocking chairs out on the porch. Christine tried to pet the cows, but they ran away from her. We enjoyed a couple of great restaurants: Volare Italian Resaurant in a downtown Brenham restored saloon, and the Brazos Belle restaurant in a restored general store in downtown Burton. Christine and her sister stayed up late into the wee hours of the night talking. It was a relaxing time for all of us.
This was a good weekend for me during a time when an hour does not go by when I do not look forward to Friday wishing the clock would go a bit slower. When I met with the surgeon Tuesday, I tried to get him to assure me that the many complications he detailed were rare, but he would give me no such false assurance. It's serious business opening up one's gut, and I'm not excited about it, even though it is clearly better than the alternative.
I had a scare Thursday as the abdominal pains began increasing as they did last time. I called MDACC and they told me to go to liquid diet and come in if the pain becomes "unbearable". Fortunately, the cramps faded away! The next day I was back on solid foods.
One morning this weekend, I read Psalm 13. It allowed me to accurately express my thoughts in a prayer to the Lord:
Psalm 13
How long, O LORD?
Will you forget me forever?
How long will you hide your face from me?
How long must I wrestle with my thoughts
and every day have sorrow in my heart?
How long will my enemy triumph over me?
Look on me and answer,
O LORD, my God.
Give light to my eyes,
or I will sleep in death;
My enemy will say, "I have overcome him,"
and my foes will rejoice when I fall.
But I trust in your unfailing love;
My heart rejoices in your salvation.
I will sing to the LORD,
for he has been good to me.

Wednesday, September 10, 2003

Surgery scheduled for Sept 19

After meeting with my clinical and surgical oncologists Monday and Tuesday, it is clear that the unanimous decision is to go forward with surgery to remove the colon tumor. The surgery will be the morning of September 19. After surgery and recovery, I will resume chemo to shrink the liver tumor. Liver surgery will then be at some future date. The hospital stay for the surgery next week is typically 5-7 days, followed by home rest for 2-4 weeks.

I am currently in Houston, staying with our good friends, Pete and Sally Rasmussen. Should the unfortunate situation arise where I become blocked again before surgery, I want to be close to MD Anderson rather than be in Dallas.

Christine is in Dallas recovering from her serious migraine attack last weekend and will hopefully join me in Houston today or tomorrow.

Saturday, September 6, 2003


They released me last night from the hospital. My attending physician was supposed to sign discharge papers around 3 or 4pm, but he got pulled into a major surgery and didn't show up until 8. He apologized and told me it was an unfortunate change of schedule. "Big tumor we had to pull out..." he recalled, "rough surgery." Made me wonder for a moment what they'll be saying when they open me up.

Christine and I were planning on going out to celebrate, but by the time I got home I was exhausted and crashed for about 11 hours. Even though I had been in bed for a week, I still needed to rest. Ironically, hospitals are terrible places to rest. They come in the room for all sorts of reasons almost hourly to wake you up and talk to you, stick you with needles, probe you or just take out your trash. I've thought carefully about it this week and I think this is how it works: They have a sophisticated system of timers - one for each room. A given timer is set for 90 minutes when they leave a patient's room. When your timer goes off, they think of a new reason to come in to make sure you don't go too long without interruption. It is a remarkably well-organized operation that requires great teamwork.
Christine awoke today with an unbearable headache that responded to no meds she had. I had little energy to help, and called our friend Tom Kistner. He was kind enough to drive her to the ER to get a narcotic treatment. So right now, a mere 18 hours after I was released, Christine is at the hospital. And I'm at home facing the task of packing as soon as possible to get the Houston. I may fly down ahead of her so she can be relieved of having to prepare in half a day for a month trip. I hope she comes soon. She was a wonderful companion in the hospital, sleeping in the room most nights, overseeing my care, and giving me great comfort.
It looks like I'm going to spend the next month or two in Houston. I'll go right away so I can be there in case another obstruction occurs. Surgery is scheduled for the 19th, but that will be confirmed once I meet with my doctor on Monday. I believe recovery takes a few weeks - the first week or so in the hospital and a couple weeks rest. Then, I'll get back on chemo.
To be candid, I am terrified of being obstructed again. The pain was about as severe as any I've encountered and the vacuum "treatment" was nearly as bad. I wouldn't mind fasting for two weeks, but they want me eating, so I am back on solid foods. Please pray that I would not be obstructed again and that the surgery or whatever they prescribe will be successful. Also, pray that Christine will recover and will be able to join me there soon.
On a good note, Dr. Hoff called me yesterday afternoon to discuss my situation. He advised me not to panic and told me that surgery is a good thing to do now. I asked if this was a major setback as far as the long term prognosis goes. He answered with an emphatic "no". The chemo is just as effective after surgery as before and it is just as well that we get that primary tumor out of there and eliminate the chance of another interruption like this one.
I'm thankful to be out of pain and at home right now. It is a wonderful feeling to be home.

Thursday, September 4, 2003

Out tomorrow

Today, I'm feeling even better. I've also been promoted from ice chips to a liquid diet. After making sure that works for one day, I should be released. So Friday is estimated departure date. My attending doctor here has made it his goal to get me back in shape enough so that I can get to Houston. He agrees I should get back to my primary team. So immediate surgery here seems unlikely. I hope to travel this weekend. Monday and Tuesday I am scheduled to meet with my doctors at MDACC. It seems that surgery might be a good plan. I've had good response from the chemo, and to continue good response, I can't continue interruptions like this week. So colon surgery followed by resumed chemo and eventual liver surgery seems a likely route. But I'm going to count most on what Dr. Hoff says on Monday.

Wednesday, September 3, 2003

What's for dinner?

So how am I surviving while fasting day after day? Well, the secret is not ice chips, but Total Parenteral Nutrition (TPN). TPN is a milky looking potion that they feed directly into my veins. Its everything I need for daily nutrition. Cool. Who needs food? I wonder if this is the stuff the Matrix feeds to all the people hooked up to itself? In fact, you could all be receiving TPN right now and just think you're eating steak and fries. I'm the only one who really knows what I'm eating...

"You know, I know this steak doesn't exist. I know that when I put it in my mouth, the Matrix is telling my brain that it is juicy and delicious. After nine years, you know what I realize? [Takes a bite of steak] Ignorance is bliss. " - Cypher

Done with colonoscopy

Thanks, Mark, for keeping folks up to date.

I finished the colonoscopy this afternoon in which they rexamined the size of the "hole" through which everythinig must pass. Even though the tumors have shrunk drastically, the hole size is pretty much the same. There is also a growing consensous among the docs here at UTSW that I had a temporary obstrcution and the painful symptoms that drove me to the emergency room Monday morning were because at that time, everything was clogged at the site of the tumor. They managed to get it under control and my system running again via vacuum tubes (I've found that everyone here at UTSW likes sticking tubes in various places, just like they do at MDACC)

The nose-to-stomach vacuum tube kept me from talking much and was extremely irritating. The tube worked well for a couple days and was supposed to remain in all week, but it came out as I was I blowing my nose last night. Not sure if they believe that I didn't just take it out myself! (I can't say that the thought hadn't crossed my mind...). This reminds me of the hole-in-one I hit at a Delaware golf course one year after leaning to play golf. Par 3-149yards. I was golfing alone at the time, so my story is all anyone can go by. You'll just have to take me at my word on both the tube and the hole-in-one story. Anwyway, the tube was supposed to remain "just in case", but I'll just enjoy not having it and pray there won't be a "just in case". I have considered this accident as a merciful gift from my Lord. Meanwhile, I've only eaten ice chips since Sunday, and the big question still remains - what will happen when food is reintroduced?

We are now trying to make the difficult decision of having the colon part of my necessary surgery here in Dallas (very soon) or getting ourselves to Houston to see what they think, with possible liquid diet and surgery there on the 19th. Or even possibly treat this as an isolated event and keep going with chemo on a more restrictive diet. The decision is difficult and the stakes are high. In any case, our smoothly running plan has hit a speed bump. Hopefully it turns out to be a small bump. I'll be trying to get more input from doctors here and at MDACC by tomorrow.

So we may be headed to Houston again as soon as I am able to travel. We'll see how the next day goes. That's really the best plan I've been able to come up with anyway - get through today... "Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own." -Jesus (Mt 6:34)

Greg, writing from my hopsital room

Tuesday, September 2, 2003

Staying Until Friday

Greg remains in the hospital, and the current outlook has him staying there until Friday. A colonoscopy is planned for tomorrow (Wednesday) to confirm the exact status of his intestine and they are focused on getting his digestion and aftereffects functioning properly again. Any resumption of chemo is pretty much off the table until he can eat and Christine can give a good report to G'pa.

Thankfully, Christine has been able to remain at his side apart from a trip home to get some necessary items. Please pray for her stamina and for relief of her pain as she ministers to Greg.

Please pray for the entire family and the church as we struggle to support both Greg and Christine: that our hearts would be filled with compassion, that our service would be unstinting and without selfish conditions, that we would find the balance both to support them and to take care of ourselves and our families, and that in this time of difficulty the Lord would draw us closer together when the stress threatens to drive us apart.

Monday, September 1, 2003

No Labor Day Rest

This morning Greg was admitted to the emergency room at St. Paul with severe abdominal pain. What was initially feared to be an intestinal blockage now is thought to be side effects of the chemotherapy. We hope he will be home either later today or tomorrow; for the moment, chemo has been suspended (though it may resume in a few days after consultation with the doctors).

Please continue to pray for both Greg and Christine in their suffering. Pray for the family and the church as we seek to be the body of Christ, a real physical presence and comfort, to them both. And pray for daily wisdom in deciphering the myriad symptoms of unknown origin that can so easily cause panic.

Wednesday, August 27, 2003

Middle of third round

I haven't written since the good news, so here's a little update. I took the intravenous chemo Friday evening. It caused some gastronomical discomfort the following day, but my brother-in-law, Michael, was with me to distract with video games, chess, and baseball. During the chemo infusion I was doing pretty well against him in chess, but then the Zofran kicked in so I'm using that as an excuse for my strategic collapse. Saturday night, we went to see the Astros at the new Minute Maid Park... caught the last two innings... I wasn't moving too fast that day. The tickets were complements of some friends from Rice - Tyler and Ruth Reitmeier. Ruth has come down to the hospital to help out a couple times and I stayed at their house before the chemo. Another friend from Rice, Glen Ragan, came down to stay with me Sunday night at the hotel, because Michael flew back to Philadelphia Sunday.

Monday I felt OK to drive back to Dallas. Since then, I've been continuing the oral stuff twice a day, praying that it will continue to eat away the cancer. I'm feeling more intestinal and stomach discomfort than previous rounds, but still nothing major enough to hold off the chemo. But enough to keep me working quietly at home these days.

Today is a blood drive at my TI site. A friend from work, Darren McCosky, encouraged those giving to donate in my name, which I appreciated. Blood supply is scarce these days, so all this support is helping the community as well as me.

Christine is still not feeling too well. We take care of each other as we can. Thank you for your prayers.

Thursday, August 21, 2003


I met this morning with Dr. Hoff and his crew to find out for the first time how the chemo is doing. The verdict is - the tumors are responding very well!

The doctor and the P.A. were using words like "incredible" and "remarkable" to describe how much the tumors had shrunk... and after just two rounds. As you recall, there was a 50-50 chance that the chemo would even work - and for me, it is working "so well", in Dr. Hoff's words. Both the primary tumor and the liver tumor have shrunk to almost half the size that they were just 6 weeks ago. The liver tumor reduced from 19x12cm to 12x10 and the colon tumor reduced from 6x4 to 3x2.5. As I looked at the scans it was indeed hard to believe just how much change can occur in the body in such short time. In addition, the entire liver had reduced back to a more normal size and it is functioning better as evidenced by the blood work. The lymph nodes looked less swolen (they are possibly cancerous) and the two small lung spots are no longer visible. The good news about the lung is that the spots are gone; the bad news is that they probably were cancer and not something else. Finally, the CEA blood marker, which was 123 the day before the first round and 14 the day before the second was 4.3 on Monday - almost normal level!
While the liver tumor has reduced consdierably, it is still not small enough to be operable, according to Dr. Hoff. But he is hopeful that the trend will continue and we will be ready for surgery after a few more rounds. "We need it to shrink just a little more," he said. It is good that I have tolerated the chemo well, so that we can continue full dosage. So the plan is to take three more rounds (9 weeks). Then if all goes well, we'll likely go to surgery to cut out all the bad stuff.
So once again I find myself in the odd position of being happy to take chemo. Tomorrow afternoon at 4:00 I take the intravenous goop and tomorrow night I begin the oral goop.
The road is long but it seems we're starting strong. I think it's like scoring three runs in the top of the first inning - there's still eight more innings, but it is a great start.
Meanwhile, Christine's migraines have been relentless and severe. As a result, she did not come down to Houston with me. This was very disappointing for both of us. My brother-in-law, Michael Murray, is flying down from Philadelphia this evening to care for me during the chemo and days after (and to play endless chess with me!)
There is more to share, but I'll leave it at the bottom line good news for now. For those praying, my request is that you please continue! Join with me in thanking the Lord for these results and pray for continued response to chemo, continued toleration of chemo in terms of side effects, and complete healing. Also, please remember Christine in your prayers.
The same words of Isaiah remain as our motto. Christine reminded me of these words late last night as we spoke on the phone and discussed my anxiety about today's appointment: "You will keep in perfect peace him whose mind is steadfast, because he trusts in You." (Isaiah 26:3)

Sunday, August 17, 2003

Second round complete

Friday morning I finished my second round of chemo. The proper way to celebrate such an occasion in Texas is to stand on the nearest table, lift yer hat to the sky and declare, "yipee-aye-ay!" I never really fit the Texas mold. I took my wife out to dinner instead.

I am thankful that this round was better than the last. I was even able to work throughout this round and make some good progress on projects at work. My body's response is remarkable because the effects are expected to get worse over time. I'm a bit physically beat right now, but am glad to have a rest week from chemo.

Tomorrow morning we are headed to Houston. Christine is not feeling well, so we postponed driving until tomorrow morning. Monday afternoon and evening I have a series of diagnostic imaging tests that will determine if the chemo is working. They're going to go looking for more trouble and I hope they fail this time! Thursday we meet with Dr. Hoff to find out the results and chart the next steps. If the chemo is indeed working well, we will continue the current protocol and I will receive the intravenous irinotecan on Friday. If not, surgery and/or a different chemo protocol may be the best next step.

Thank you for your prayers.

Tuesday, August 12, 2003

Change in instructions for blood donation

Apparently, MDACC did a poor job of telling us what was needed to properly credit my account if you give blood. The info you need is in the following file: Blood_info.doc

Date of birth is supposed to suffice instead of SS#, which I would rather not post.

I updated this in the original post.

Monday, August 11, 2003

How to give blood

There is a good chance I may need blood transfusions in the future, either due to chemotherapy effects or as part of the colon/liver surgery. If you are able to give blood, there is a way you can donate and credit it to my account from where you live. Blood supplies in general are critically low in many areas right now, so you will be helping me as well as those in your community who are in need of blood.

You must donate to a member of the American Association of Blood Banks. You can find the nearest center to you by going to the AABB web site. Notice that the database is specific about the city. For example, Richardson is listed as well as Dallas.
The following file has information that must be presented for me to be the beneficiary: Blood_info.doc
Date of birth is supposed to suffice instead of SS#, which I would rather not post. If actually give at MDACC, you will want my patient ID, which is 169996.
You do not have to have my particular blood type. The credit, not the actual blood, will be transferred to my account so that I might receive blood of my type donated in Houston.
[ADDED NOTE on 02/13/04]: Blood supply is typically low, so giving is always needed in the community. However, after my surgery on 12/22, I am personally no longer in need of blood - thanks.]

Friday, August 8, 2003

No vacation with cancer

Well, unlike what I told you in an earlier post, it turns out that we will have to cancel ... er, I should say postpone... our tenth anniversary trip we had planned to go to Yellowstone and the Grand Tetons. Here is the cabin we were going to stay in part of the time. It was a ten day trip scheduled for late August and we had been looking forward to it since February. But to tell you the truth, we are more looking forward to getting rid of the cancer. Dr. Hoff said that with potential emergency surgery and chemo side effects, the last place I need to be is Montana. Meanwhile, we're working on a consolation vacation. Something closer by time to MDACC and for not as long. Ideas?

I went to a "dealing with chemotherapy side effects" class while at MDACC last week. One eager woman sitting up front was wearing a hawaiian shirt and a hot pink hat with a button on it that said "cancer sucks". It got a chuckle out of me.

Tuesday, August 5, 2003

The movement

I really hate to talk about the bowel movement, but this story needs to be told...

After the colonoscopy and barium enima last Tuesday, nothing had been heard from my digestive system. Food went in, nothing came out. The low fiber diet was probably a cause, as was the fact that these tests required the complete emptying of my system. By yesterday, my doctor became quite concerned, as did I. After all, the biggest fear right now is obstruction, which is dangerous while on chemo. It was getting scary.
The good news is that this morning, my system showed itself once again to be working. Now many of you know that parenting is the only other occasion where one might exclaim joy at the occasion of a bowel movement. To be silly, Christine called up her father, who was concerned with us at the dangerous situation, and exclaimed on the voice mail, "G-pa, Greggy made a poopy this morning!" She became horrified with embarrasment when she realized that she had just left that message at the wrong number. She laughed as hard as she ever has.
Perhaps some stranger out there is rejoicing with us.

Low residue diet details

For those who are generously making meals for us, the file below has the details of the diet I am now on. Generally, it is heavy on meat, light on breads and veggies, no whole grain or seeds. Where possible, please keep in mind Christine, who should be eating fiber - I don't have to eat everything prepared. Thanks for your service to us.

Click to download file: LowResidueDiet.doc

Saturday, August 2, 2003

Two hearts

Christine snuggled up to me on the hospital bed as we awaited the chemo bag to be emptied and we prayed. Her love sustains me. Late last night, I wrote this...

Two hearts broken
Curled together on the chemo bed
Nothing to hold but each other.
The poison to drip
Man versus demon
Oh, but that the serum
Would as ruthless be
As the silent alien inside.
We pray.
Jesus weeps.
We wait,
Daring to hope.
Christine and I.

Chemo went well

Just a quick update...Yesterday evening I tolerated the chemo very well.

I had to get a rush x-ray first to make sure the port-o-cath was in the right place, as this was the first time I would use it. The port-o-cath is the permanent I.V. that they imlpanted in my chest. I could not believe how quickly they got the x-ray - possibly the fastest things ever moved here. And a good thing, because a delay would have meant chemo today instead, for it was the end of the day.
They kept a close eye on me for two hours for serious side effects - and nothing! Just some sweating and nausea, but nothing to keep us from moving on full speed, as we need to do in the long run. I stayed up pretty late - probably a combo of the chemo and the fact I had many things I wanted to think through. Many of you know - I do nights. I also watched one of the Ken Burns Civil War episodes - it's amazing what a different world it was just 140 years ago. I find it very challenging to get in the minds of the people fighting and leading that war.
We'll stay here close to MDACC until Monday. Thanks for your prayers. I am attributing my good response to prayer. This chemo is supposed to get worse over time. This time was clearly better than last.

Friday, August 1, 2003

First meeting with Hoff

Yesterday, I had my first meeting with my new clinical oncologist, Dr. Hoff.

We decided that we were not comfortable working with Dr. Xiong and his team and were able to switch to Dr. Hoff, who had moved back to MDACC last week after being out of the country due to visa problems. Incidentally, Dr. Hoff is the leading researcher who discovered that the oral chemo I am now taking, Xeloda, is just as effective as its intravenous alternative, 5-FU, which causes worse side effects. Ironically, his work is why I am taking the regimen that I am.
We had very good meetings with his nurse, his P.A., a nutritionist, and with the "Pharm-D" (the pharmaceutical PhD member of his team). I have great confidence in him and the team he has assembled. Dr. Hoff reiterated in a clear manner the gamble we are currently being forced to take. The decision from the beginning is chemo first or surgery first. He indicated neither is obviously better, which is why there seems to be confusion from doctor to doctor. Chemo first is better if it works, which is 50-50. If it does not, it would have been much better to do surgery first due to the risks of emergency surgery while taking chemo. Dr. Hoff actually said he would have probably had me do surgery first if he had seen me in the beginning, but now that we have some early indications that the chemo may be working, then we should continue the course we are on.
In the meantime, it has become increasingly important that I not get obstructed. So they put me on a very restricted diet of virtually no fiber. It is nothing less than an upside-down diet. In the cereal category, Cocoa Pebbles are good, raisin bran should be limited, and shredded wheat is not allowed. I can eat all the steak, eggs, and sausage I want. But in the vegetables category, it says "none". It was a funny moment when the nutritionist had to sort of force her mouth to say "no vegetables". "You know it's hard for me to say that", she laughed. This diet is temporary while I am on chemo before the surgery.
In the good news category, we spoke with his P.A. about my CEA level. She said this is definitely a good sign. The change from 123 to 14 is something for which to be thankful. Also, Dr. Hoff thought the colonoscopy pictures from this week looked encouraging compared to those of two months ago.
Last night, Christine, her parents, Judy Wu, and I all went to a Spanish tapas restaurant in Rice Village. We had great food (albeit no veggies for me!) and enjoyed the Flamenco dancing.
This afternoon I go in for the I.V. chemo at 4pm. We'll stay here over the weekend at the Rotary House to monitor side effects while staying close to the hospital.

Wednesday, July 30, 2003

Or maybe Cypher...

Maybe it is more of a Cypher look than a Morpheus look. Here is Morpheus, Joe Pantoliano, who plays Cypher, and a new character from the next Matrix movie.

Morph_h.jpg Joe_h.jpg Greg_h.jpg

Tuesday, July 29, 2003

No stent and some promising signs

Early this morning, I had a procedure at MDACC during which the medical team evaluated the possibility of obstruction of the digestive tract. They were prepared to put in a stent if it looked probable that I would become obstructed in the next few months, forcing surgery at an inopportune time.

The Procedure
It was immediately apparent during our pre-op discussion with Dr. Lahoti, who performed the procedure, that he felt my situation did not warrant a stent. The problem with a stent is that if my chemo shrinks the tumor, then the stent could become dislodged, causing a realm of serious problems. A stent, he said, is usually not used unless the chemo is found to be ineffective. Because it appears that I will continue chemo, as my side effects in the first round were tolerable (albeit not enjoyable!) and early indications are that it may be doing something good (see below), he wanted to hold off on placing a stent. The risks of waiting were better than the risks of putting it in.
Unfortunately, he was not able to get the probe through the narrow tunnel at the tumor location. He got some pictures and then after I woke up from the anesthesia, he sent me to get a barium enema (BE). More fun. I remarked to the technician that MD Anderson seems to enjoy sticking tubes up peoples butts. But to tell you the truth, these unpleasantries (yes, an understatement) seem smaller and smaller in comparison to the big picture. I am recalling how, in the process of treating cancer, one's modesty and sensitivity to pain go down as one gets carted off to this and that procedure. During the BE, the few times I groaned at bad cramps, they asked if I was alright. I always answered yes because I wanted them to take their time to get the best pictures possible. The BE indeed gave us a good idea of how long the tunnel was through the tumor and assured the doctors that things were not ugly on the other side.
The combination of procedures revealed that the narrowest point in the tract is 4mm across and about 2-3cm long. This corresponds to an approximate 85% blockage at that point in the colon. This sounded pretty narrow to me. However, I was told by Dr. Rodriguez that pretty much everything that goes through this point in the colon is liquid. That�s why I�m not currently having any abnormal symptoms of blockage. As long as the tumor is held in check by the chemo (or better, if it shrinks), I have a decent chance against becoming obstructed.
The consensus between Dr. Lahoti and Dr. Rodriguez (my colon surgeon) is for me to get back on the chemo plan full throttle and continue to keep a close eye on the blockage. Part of this will be a more restricted �low residue� diet. This will assure the liquidity of what gets to that point in the colon. I was also coached by both doctors on recognizing the earliest symptoms of obstruction so that if this occurs, we may be able to put in a stent at that time, holding off emergency surgery.
Is the chemo working?
They have told me several times not to put too much faith in the CEA blood level - that it should only be considered serially over time. This is a marker for indicating the overall aggressiveness of my particular type of cancer. In general, if it goes up, the chemo is not working and if it goes down, it is. For the first month I knew I had cancer, it hovered around 60-75. The normal non-cancer level is below 5. Mine moved as high as 123 just before beginning chemo. At that time they said I shouldn�t be concerned or surprised � after all there was nothing keeping the cancer in check. Yesterday, after one complete round of chemo and a week of rest, my level was 14! I�m interpreting this on my own (we haven�t discussed this with a doctor yet), but that seems to me to be a good sign. My impression of the chemo drugs I�m taking is that sometimes this type of chemo doesn�t work at all, sometimes it only works for a while, and sometimes it works well. The big drop in CEA to me is a good indicator that my cancer is currently in retreat. For now, I am very thankful that it plummeted far more than I even imagined it would. Thursday I will listen to the doctor's interpretation of this number.
Another thing that I noticed was a big difference in the colonoscopy photos of this morning compared with those of two months ago. Yes, it has been that long. Dr. Lahoti did not want to make any qualitative assessment because they were different kinds of photographs. But my job at TI is evaluating digital images and the ones from today looked much better to me, even given the difference in image capture devices. I thought today�s photo clearly showed less bloody walls and a tumor that is less out-of-control looking in form. To me, it looks like the chemo has been stabilizing, even neutralizing the tumor.
�So was it a good day?�, people ask. Well, the 4mm opening is a big concern, but can be overcome if we monitor it carefully and the tumor does not grow. The two indications that the chemo may be working, while not interpreted by a doctor, were encouraging� Two small indicators. Two reasons for thanksgiving. Two small steps towards the goal. And the way to walk 1000 miles is one step at a time.
The rest of the week�
Wednesday is a day off. Christine�s parents are here and we hope to enjoy some time away from MDACC together with them. Thursday I meet with a new clinical oncologist (we are switching from Dr. Xiong and his team). Friday I take the intense IV chemo, followed by the 14 day oral regimen. We will stay in Houston over the weekend because of how I felt last time I took the IV chemo and so that we will be close to the hospital should any problems arise.
Christine and I cherish your prayers. If you are praying, please ask the Lord that my digestive tract would not become obstructed and that the coming second round of chemo would be very effective and would not cause serious side effects. Also, please pray for Christine's migraines. The past weekend was very bad, but today was pretty good.

Susan Dishman


Our hearts go out to the Dishman family at the loss of Susan Dishman, our dear sister in Christ. Susan and her family are dear friends to Christine and I, especially as we fought cancer together. We will miss her dearly.

It has been difficult for us to watch her fighting that horrible disease, as it is the very fight we are now waging. We have been encouraged at how they clung to the promises of God during the fight.

I remind myself regularly of one thing her husband John told us that they had learned in their battle. Don't get too excited at the highs or too depressed at the lows... the only true hope is in Christ.

Sunday, July 27, 2003

Counting hairs

GC1_quarter.jpg G_Dad_quarter.jpg

Jesus spoke of God's knowledge of every hair on our head. Well, my count started going down very quickly this week as a result of my chemotherapy. Within a few days, it was quite patchy. So I decided to cut it off. I call it my Morphius look. Here's me with Christine and with Dad.

But I wasn't the only one...

Saturday, my father-in-law, Carl, drove me to the barber for my haircut to remember. He was in town to drive me and Christine down to Houston for the week at MD Anderson. To my surprise. as an act I interpret as a gesture of solidarity, Carl got the same haircut. Here we are the next day...
G_Carl1_quarter.jpg G_Carl2_quarter.jpg

Monday, July 21, 2003

Outrage at suffering

some thoughts about suffering, evil, and the existence of God

I have been recently thinking about how I consider the presence of suffering in the world - or more specifically, my own. (Yes, it seems a bit odd to think about one's own thoughts, but doing so is sort of a hobby for me.) To put it mildly, I am unsettled at the injustice, or at least the unfairness, of my situation. But I know I am not alone in these thoughts. It seems that everyone else also has an inner outrage at something in the world relating to suffering or evil. For some, it is a simple inner revulsion at a particular form of political oppression or hypocricy. For others, it is an inner angst at the unfairness of suffering. For still others, the presence of injustice in the world causes them an uneasiness.
Much is made about the presence of evil and suffering in discussions concerning the existence of God. It is often said that the presence of suffering is inconsistent with the existence of God. But I would submit that outrage at suffering or evil is inconsistent with the non-existence of God. We humans have a sense that things in the world are not "right". We cry out to our Creator and ask "why?", either consciously or subconsciously. We have a sense of what "ought" to be, even though it is not. This oughtness, I submit, is based on a degree of knowledge of our Creator and his purpose.
C.S. Lewis puts it this way: "When I was an argument against God was that the universe seemed so cruel and unjust. But how had I got this idea of just and unjust? A person does not call a line crooked unless he has some idea of a straight line...Atheism turns out to be too simple. If the whole universe has no meaning, we should never have found out that it has no meaning. "
As to whether the presence of evil is inconsistent with the Christian God, who is said to be loving and gracious, I would simply point to the reference source of Christianity, the Bible. I will readily admit that the light-weight, simplistic, Christianity found in much of America is indeed inconsistent with the presence of evil. But authentic, historic Christian faith is not. The Bible is full of honest reckoning with evil. It does not deny evil and suffering, unlike the situation where no one wants to speak about the 500-pound gorilla in the room. Rather, the Bible confronts evil directly and presents Christ as interacting with, confronting, and having victory over evil. While some might say the Christian God cannot exist with suffering in the world, the Bible implies that we cannot even conceive of the true Christian God without it!
This victory over evil as described in the New Testament is not yet complete. The resurrection of Christ is called a "first-fruit", which happens to be one of my favorite Biblical terms. As a first-fruit, the resurrection is both the taste and the guarantee of the ultimate consummating victory over evil. Whether one agrees with this is one thing. But one cannot say that Christianity is inconsistent because of the existence of evil and suffering. After all, it only exists intertwined with it.
All this is to say that authentic Christian faith cannot be shaken by the presence of suffering. In fact, it cannot exist apart from a true reckoning with suffering. This is not to say that the heart does not wrestle with these things. Mine certainly does! I even find solace in the idea that the heart must wrestle with suffering if it is to find God. One might even say that only in suffering is God most clearly understood. Drawing again from the words of C.S. Lewis: "God whispers to us in our pleasures, speaks in our conscience, but shouts in our pains: it is His megaphone to rouse a deaf world.�