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.

Thursday, July 29, 2004

C-Leg Folklore

My leg makes its way into the American political fray...

D o o n e s b u r y. T h u, J u l 2 9, 2 0 0 4

Tuesday, July 27, 2004

Procedure today for Christine

Christine_bw.jpg While my health improves the further I get from chemo, Christine's condition continues just as it has this past year of cancer. And just as it has since long before. She is affected by migraine headaches several times per week and almost daily suffers from other body pain. Last week, a migraine as bad as she ever has had sent us to the E.R. so she could get an intravenous treatment called in by her neurologist. It knocked her out for 24 hours and got the pain back to a manageable level.

An MRI taken several months ago revealed a bulge in between two vertebrae in her neck. Her doctor thinks this may be a trigger for her many headaches. This afternoon, she will be having an epidural steroid injection into the spot under the guidance of a CT scan. There are no guarantees it will do anything, and if it does the relief is not permanent. Nevertheless we are hoping this will help. The improvement takes around ten days to kick in. She has had to keep canceling this procedure due to accommodate my ever-changing medical calendar.

Chronic pain such as Christine's is an odd thing. It does not have the urgency of deadly disease such as cancer. But often in the past year I have thought that it is in many ways worse than cancer. To be sure, cancer can kill. But it usually lasts a relatively short time before it is gone - one way or another. And it makes you into a hero. Chronic pain, on the other hand, just lingers quietly and mercilessly for years, trying to break the will required for daily living while the active world around you seems to just leave you behind. (Christine jokes that she was going to title her autobiography "Left Behind" until someone stole the title).

My heart is broken over Christine's condition. Perhaps the reason I have not said much about her pain in my entries is because I have not been thinking a whole lot about anything beyond my own serious condition. Or maybe I just don't know what to write -- there is not much about another day of migraines that can be said to be "news". In any case, I hope that those who are praying for my cancer to stay far away might also ask the Lord for relief for Christine. She really needs a break.

Saturday, July 10, 2004

Roses e'er blooming

rose_sm.jpgA couple of weeks before Christine and I left for our trip to Houston, I noticed my rose plant had a serious case of black spot fungus (Diplocarpon rosae). So I drastically pruned the plant back, removed all leaves showing the disease, and cut out the parts that had already died. As a novice, I had no idea whether it would survive. When we returned this week from Houston, I was greeted in my backyard with an abundance of roses on the plant. I'm so delighted by it's strong recovery.

Even my backyard seemed to be rejoicing at my good news.

pots2.jpgOur neighbor Joanne continued watering our potted plants past when we told her we would return. The original trip was only to be a few days, as you may recall. While in Houston, we totally forgot about it. Late in the trip, we remembered and figured everything would be dead. Instead, upon return, the pentas were much larger - pink and full. The red hibiscus was just about to bloom this morning when I took this picture.
And I cannot resist including a photo of my gardening assistant...dolce_backyard_sm2.jpg

Friday, July 9, 2004

Good news just got a little better

I spoke this week with Steve Wei, the physician assistant of my surgeon. My case was inadvertently presented to two different conferences (once by Dr. Hoff and once by Dr. Vauthey). This gives everyone more confidence as both teams came up with the same conclusion. The nodule has become less of a concern, because both teams studied my CT scan history and noticed that the size of this nodule has been shrinking and growing - it was smaller in Dec 2003 and Mar 2004, but was as big a year ago as it is now. They aren't sure why, but this made them all the more assured this is not a cancer recurrence. I offered to Steve that it might have something to do with baseball season, but he didn't think so. Also, the preliminary thought that there was scar tissue was a misunderstanding of some sort. The official report says all the biopsies showed normal, healthy cells.

The conclusion of the matter - definitely no more biopsies on the nodule and I don't need to go down there for three months instead of two. "October" sounds so wonderfully long from now.

AJJ.jpg Last night Christine and I got together with some family for a small celebration. We should have taken more photos, but Mark did take this shot of Avery, Jordan and Jeremy. They seem happy about the news, don't they?

Tuesday, July 6, 2004


I met with Dr. Hoff yesterday and he has decided that I will take no more chemotherapy. Thus, I am done with treatment and am considered to be in "complete remission". The term he used for my status is "Stage IV cancer, NED". (No evidence of disease). It is an oxymoronic term, as Stage IV is cancer at it's worst, but NED indeed starts with a capital "N". I shall bear the label gladly.

I now begin a period of returning to MDACC often so that they can watch carefully for any recurrence of the cancer. This will be something I will be doing for a long time to come (hopefully!). At the start, I will go down there two months from now. I went through a similar process after I had bone cancer as a child.

As for the lower abdomen nodule that seemed to grow, they have no explanations. The biopsy showed some scar tissue, which was perplexing because I did not have surgery there. This is something they just want to keep a close eye on.

I was a bit surprised Dr. Hoff decided against chemotherapy. The bottom line for him is that there is no good evidence that more chemotherapy at this point would make any difference in long term survival. Some doctors give as much as they can get away with -- "just to be sure". (Reminds me of the motto of a certain father-in-law - "anything worth doing is worth overdoing.") Dr. Hoff's response to this is "show me the data." If there were no detrimental effects of the chemo, he said he might be inclined to give me more. But the Xeloda I took after liver surgery was really wearing on my liver. Not only did the CEA climb, but my liver enzyme numbers were telling a story that the drug was damaging my body. To Christine and I, he seemed overall to be making the most life-affirming decision.

Dr. Hoff tells me that there is about a 50% chance that I am cured. We will not know until years have passed. This is far better than the dismal numbers (under 10%) I started out with. I thank you all for your earnest prayers for me. Would you continue praying that this will not return?

Saturday, July 3, 2004

"Good news"

When Dr. Vauthey opened the door to the examination room, it ended a nine-day grueling wait. "Good news", he said. All six biopsies tested negative for cancer. I sat stunned, overwhelmed with relief, gladness, and thanksgiving. After the short conversation and departure of Dr. Vauthey and his cohort, Christine and I sat there quietly for a moment. There were no words. Together we whispered "Praise God from whom all blessings flow..."

Around here, there always seem to be cautious nuances to be made, and this case was no exception. It is possible that the six biopsies missed the nodule. As you may recall, it was nearly impossible to see the nodule with the ultrasound. But that is why the doctor took six shots at the area. Also, there was an odd finding of scar tissue in the area. This area happens to be one of the places where I have actually not had surgery before, so that remains an unresolved question. Because of these two issues, my case will once again be presented at the weekly GI oncology conference next Tuesday to determine whether further investigation is needed. Dr. Vauthey indicated that he is content that we are not looking at a recurrence and that I will most likely not need any further investigation at this time.

We will stay here through Monday, when I will meet with Dr. Hoff to chart out our plan of attack from here and decide whether more preventative chemotherapy should be taken at this time.

The past week has been one of intense struggles deep in my soul. Parts of my mind were constantly in combat with others. Trains of thought were stopped by reminders of truth, which were in turn undercut by chaotic deconstructions. The dark cloud of death, which is ever present in all of our lives, seemed so close to me. Engaging in intentional distractions or platitude thinking only seem to make things worse for me. I need something stronger. Scripture was usually the place where stability could be found. Additionally, my wife and my dear friend pastor Robert Cook from Christ the King Church helped me in my deep tactical maneuvering. Also helpful were expressions of support from those sharing my burden - the Jonssons and Ragans, my family, and many others of you. I believe that I reached a rare quiet point of spiritual victory the morning of the appointment. That morning was quite sweet even though I did not know the outcome of the test.

It is only after the battle that I realize just how difficult the struggle was. In the hours since the appointment, every ten minutes or so, I breathe a hearty sigh and drink gladness that this particular battle is over. I look back on this week with great thanksgiving. I believe I have a greatly improved arsenal of applied Christian truth. I believe it was a very cathartic week... a time of getting to know myself clearer and my Lord closer. This is a good thing, as there will be more battles to come.