battling cancer.

Mike felt the effects of the radiation by Day Two. By the beginning of Week Two he was officially feeling sick. He has not felt like driving on most of our trips into Omaha and has sometimes laid down in the backseat for a rest during the drive. On Monday he wanted to drive home - not because he was feeling better - but because my driving was bothering him. (When you don't feel well, odd things irritate you. My mother says I am an excellent driver.) It is harder on me when I can tell he doesn't feel good. This week also marked the beginning of the mouth sores and dry mouth. One of the casualties in our battle is Mike's left salivary gland. (We are told that eventually his right salivary gland will pick up the slack.)

In light of all of this, I thought that the calendar that Jackie Shumake made for Mike at work is especially appropriate. Since we are in the middle of a battle with cancer, Jackie found a collection of military stickers. Every day on his way out the door to treatment Jackie hands him a sticker to mark another day in the radiation trenches. (We are so very thankful for the support of all kinds that Mike gets at work.)

This is the first day that I have not accompanied Mike into Omaha. Daughter Evian met him in Fremont and drove in with him so that I could have The Little House Day Spa open today. It is actually very hard not to be there with him. I am trying to use the time well between our appointments. I have been kind of emotional today. It is a unique time. Thank you for your continued prayers as we fight this thing called cancer.

cancer humor.

While cancer is certainly no laughing matter, we find that the ability to laugh is part of the success. We would like to share some humor from our first week of Health Camp:

On Monday at noon, Mike was getting ready to leave work for UNMC for his first treatment. While he clocked out he was applying some chapstick. Scotty said "That's not going to help." Nephew Cole added "Yeah, you need like SPF 1000."

Mike's favorite thing to say on Tuesday (to anyone who would listen) was "Today is #2... and it feels like #2." Smile. He added that Wednesday would be the 'turd' treatment

Then we have sister Melinda who wrote a poem in honor of today. It is entitled "27 Treatments to Go - 9/21/11"

There once was a guy named Mike... who loved to ride his bike.

He pedaled all the way to the city... for a little radiation-ditty.

Twenty-seven treatments to go... but we can have fun, you know.

So as you guessed, this rhyme is not done. I'll be adding to it until the battle is won!

xxoo, Melinda

day 1

We are well into our first week of Health Camp - and the campers are surviving. We are even doing well. We thank you for your prayers because WE HAVE FELT THEM. Day One was difficult. The stress of the unknown looms large. Making it through the first day was a big accomplishment.

I heard Mike say to his sister on the drive home: "It's freaky. It kind of freaked me out. I had to have them unsnap the mask a couple times to cut a hole to make it bearable." The photo above shows how tight the mask over his face and head is - the marks show for a good 10 minutes after he comes out. I got a little freaked out when I went into the room before he started to bring him a CD and could see a figure on the table covered with a blanket wearing Mike's shoes with his head attached to the table via a white mask. It is unsettling, especially when they make me leave the room and I could not see that he is comfortable.

Within minutes after his treatment started I did feel a blanket of peace that I can only attribute to the prayers of the saints. As I prayed, God gave me words to ask for Warrior Angels to stand beside Mike and filter any harmful thing away from him. When I heard that the mechanisms on the machine that direct the dosage of radiation are called "feathers", I got even more encouraged to pray that the feathered wings of the Mighty Spiritual Warriors would filter and protect Mike from any harmful radiation.For the first week Mike has a CT scan in addition to the radiation (to confirm that everything is lined up correctly) so he is masked for about 30 minutes. It will be slightly less time in the mask starting the second week without the scan. On the first day (and every Monday) we meet with Dr. Zhen. This Monday he reviewed images of Mike's treatment plan with us. The top photo shows that every time a radiation dose is given, it is in five different gradations from heavy (darkest) to light (lightest.) The middle photo shows the location of the radiation dosage from one angle. Believe me, your understanding of all this is about the same as ours. We are comforted that they attempt to be very precise.

Thanks for journeying with us. The encouragement and prayer support are palatable.

health camp.

On our drive to Minneapolis this weekend we pondered the pending start of radiation treatments on September 19th. As we discussed the importance to the next few weeks we decided to view this upcoming leg of the journey as our 6 week HEALTH CAMP.

We established some simple guidelines:

-Radiation five days a week

-Physical Therapy M-W-F (en route home from Omaha)

-Anytime Fitness Workout 3 times / week

-Massage once a week

-Earlier bedtime

-An even stronger emphasis on healthy diet with concentration of protein shakes, protein snacks (string cheese & Greek yogurt) - and reducing / eliminating coffee intake

We like the focus on health (instead of cell death). It is a good focus to keep Mike's muscle strength up, and diet is critical because losing weight is a concern with mouth radiation. We are writing this on the blog because it strengthens our resolve. And because basically we covet prayers for all of this.

Let's start HEALTH CAMP!

good medicine.

This weekend Mike and I went to Minneapolis, Minnesota for the season opener of a Prairie Home Companion. The first live performance and radio broadcast of the season are always followed by the Annual Meatloaf Supper & Street Dance. It was the third time we had the privilege of attending these opening festivities and it was wonderful as usual. The music was amazing, the humor & stories were wonderful, the weather was perfect.

At the beginning of each Prairie Home Companion show, guests are encouraged to write comments / greetings to the host and they select some for Garrison Keillor to read aloud on the air during the broadcast. This is the second time they have read Mike's on the air! The first was last October when Mike asked for "God's Speed and protection for Marine son Baker Blanc as he left for Afghanistan" - and if you listened to the broadcast this weekend you heard Garrison read "And Mike & Karen happily welcome our Marine son home after a tour in Afghanistan - thanks for keeping your head down."

I thought I would tell you what I wrote:

"Husband Mike starts radiation treatments on Monday, but I think the best way to cure cancer is a big dose of Prairie Home Companion - so here we are. Mike & Karen Blanc Oakland, Nebraska". Even though GK didn't read it on the air, I thought you could read it on the blog. smile.

keep praying.

We just got a call from UNMC and Dr. Zhen is still working on Mike's treatment plan and asked if we could postpone starting until Monday, September 19th at 2:15pm.

I cannot help believing that Dr. Zhen is feeling your prayers and guidance for the perfect plan for Mike. I am glad to think much time, energy and thought is being put into Mike's plan. Please keep praying... we are humbled and blessed to know there are prayers being lifted up for us - and guiding the doctors.

embrace what scares you.

If you don't think this is one of the scariest things you have ever seen - we have different buttons. It is scary, but God is there.

On Friday Mike had a CT scan and had his radiation mask made. The CT scan will be used along with the pre-surgery CT scan to map Mike's treatment area. The mask is used to hold his head tightly and securely in place during the radiation treatments (so he doesn't move his head and have radiation shot some random place we wouldn't want it to go.) The bottom photo was taken by the nurse right after the mask was formed around Mike's face and they are cooling it with towels to harden it faster. Mike's comment was comforting to me: "I like the mask for the reason that it will keep my head perfectly still. If they told me to 'hold still' on my own I am not sure I could do it." He did say it was even hard to swallow in it because it is so tight. (I get light headed just writing that.)

We start our treatments this Thursday, September 15th at 2:15pm. And we will have them five days a week for six weeks. The 2:15 time slot was picked because 1.) Mike wants to go to work every morning whenever possible and 2.) there is a certain machine that they want to use that is available at that time. We got to visit the room where Mike's treatments will be administered. The walls and ceiling are painted like it is a tranquil outdoor setting. There is an iPod port so Mike said he is starting with Alan Jackson's Hymns CD to be playing in the background. They said we should plan on about 20 minutes treatment time every day. That allows for getting on the table, and the machine starting, stopping, and changing positions, etc..

Please Pray:

-For the Dosimetrist & Dr. Zhen this week as they design the actual treatment plan. THIS IS SUPER IMPORTANT. This is what determines exactly what gets radiated and from what angles and for how long. The Dosimetrist is the person who actually designs the plan - the one who avoids the critical structure and targets only the potentially cancer-laden areas. Dr. Zhen works with him and sets up the fractions per day and the total dose. Please join us to pray for these critical decisions.

-And for inner and outer strength for Mike. For effective radiation with as few side effects as possible. For "not a scratch to be found on him" at the end. (Daniel 6:23)

the answer: in omaha.

The answer to the radiation question is: UNMC. We have officially decided to have Mike's radiation treatment to his left neck at the University of Nebraska Medical Center in Omaha.

After having UNMC agree to the lower dosage of 60 grey, and after having Dr. Thorstad confirm that he would have to target the entire surgical bed as well, we had a peace about staying in Nebraska for our treatment.

This was a harder decision for me because I did not want to make "convenience" a factor over "most excellent medical care". I think we can do both here.

What stands out most in my mind is a conversation that Mike and I had about ten days ago where he took time to tell me that radiation might be hard on him and he would like to have the support of family and a caring community around him while he did it. He said he would like to sleep in his own bed, and eat my food around our table if he didn't feel good. He said that he wants to be able to go into work as he can. He wants to be around to watch progress on the house. He said that the traveling back and forth made him tired to think about... I think that all of the above will help him to heal and cope.

We have an appointment with Dr. Zhen on Friday, September 9th at 10am to have Mike's radiation mask made which will hold his head still during treatments. Please pray for us - because this is a scary thing.

daniel and michael.

A big factor that comforted me in this decision was a verse that leaped off the page at me when I was doing my Daily Walk.

"Not a scratch was found on him because he had trusted in his God." Daniel 6:23

It is hard to explain how it works, but sometimes God takes His word and spears it straight into your heart. When it happens, you know that you know that you know. smile. Anyway, God comforted me with these words from the book of Daniel and I am praying that the radiation will eradicate the cancer, but without leaving a scratch on Mike.

the tumor board.

It is time I get around to updating the blog. The decision to decide where to have our radiation treatments weighed heavy on me...

There were three issues for the UNMC Tumor Board:

1. Radiation + Chemotherapy: Everyone agrees that the 3-5% edge (probably smaller) is a dealer's choice with a p16 consideration. They agreed to let us opt out of their recommendation for chemotherapy AFTER radiation.

2. One Side or Both Sides: The board agreed that it is reasonable to NOT radiate the right side of Mike's neck with the left side.

3. Using a Lower Dosage: This is where Dr. Zhen and the board did not feel comfortable. 66 is the standard lower dose at UNMC and we asked for 60. We heard Dr. Zhen and the board say that they were not comfortable with 50-55 which were numbers that Dr. Haughey uses in his research because they fear it might fail to kill the cancer.

After hearing the tumor board's recommendations I had to call Dr. Ken Zhen and find out what number he was comfortable with. He wasn't comfortable with 50-55 and we weren't comfortable with 66. After some discussion Dr. Zhen agreed to 60 grey maximum, but said that he would want to treat Mike's entire neck area / surgical bed and not just target the affected lymph nodes and areas immediately surrounding.

So I made another call to St. Louis where I talked with radiation oncologist Dr. Wade Thorstad. You have no idea how much I appreciate his kind, wise and caring counsel. The bottom line is that Dr. Haughey and Dr. Thorstad are pioneers in their field and their numbers will probably be the standard for p16 positive cases in about 10 years. For now the bulk of the cancer community feels comfortable using old clinical trials even though they don't reflect the unique behavior of the p16 cancer. Dr. Thorstad said that without a CT scan taken before Mike's second surgery, he would create a treatment plan similar to Dr. Zhen's (targeting of larger neck area) because he would not have the "map" to localize the treatment area.

This was the last piece of this puzzle.