just saw dr. haughey.

We started today with an appointment with Dr. Bruce Haughey. He told us that two of the six lymph nodes that he removed contained cancer cells, which we were expecting to hear. He also said that the pathology report showed lymphovascular invasion which means that the cells were found in the lymph node channels, as well as in the lymph nodes themselves. This is why Dr. Haughey is recommending low-dosage radiation to this area (left neck). He said that this area works well with radiation.

We are currently waiting to see Dr. Thorstad, the radiation oncologist who works with Dr. Haughey. Note: It is sobering and scary in the radiation department of the hospital.

just what the doctor ordered.

We are just finishing a relaxing week in St. Louis after last Wednesday's surgery which included Cardinals baseball, lots of reading, sleeping in and delightful meals shared with great friends. What a gift... If we would have been in close proximity to work or the new house, Mike would be working. It has been the perfect medicine to be 500 miles away for Mike to have the opportunity to lay low and heal.

good medicine.

Providential. Daughter Emily sent Mike the book "Unbroken" for his birthday last month. I have never seen Mike more captivated by a book and it is the perfect medicine for him right now. He spent hours yesterday sitting on the third floor sofa reading his book. He went to bed reading it last night. He woke up this morning and finished it. I could not have been happier. One of my most difficult jobs as Cancer Coordinator is keeping Mike from lifting and working and breaking the 10 pound rule. It is hard to keep him down. This book was a God-send.

He just came down and reported that he finished the book - and to his delight a Marine buddy was listed in the credits at the end. Author Laura Hillenbrand said "I also thank my dear friend Colonel Michael C. Howard, USMC (Ret.), who worked with... (others)... to find information on Everett Almond, the navigator who was killed by the shark while trying to save himself and his pilot." Mike loved this book.

Side note about great books: We saw the movie "The Help" yesterday afternoon with friends Sharon & Randy Mayfield. (CC has determined that movies are a great recovery & healing of stitches activity.) The book is great AND the movie is great. That is rare. Hope you will both read the book AND see the movie if you haven't.

God things.

Ever wonder how we fly back and forth to St. Louis like this? Answer: Southwest. 45 minutes in the air. Non-stop. No baggage fees. Usually we make our next flight arrangements before we even leave St. Louis which enables us to use the WANNA GET AWAY fares. These are the best deals but have to be scheduled 14-21 days out.

Yet another God thing was securing flights for this surgery trip without losing our shirts with less than a week's notice. I called Southwest and asked if I had enough Rapid Rewards points for this flight. To my amazement she said "You actually have a ticket and a half from the old system and it expires on September 12, 2011." (Mouth dropped open.) Without this surgery I would never have known or suspected that I had a free plane ticket ready to expire. It would have vanished into thin air without me knowing it. So we flew on the rewards from the old system + 9000 points from the new Rapid Rewards system. Total cost of tickets: $5 each.

'The Lord's mercies indeed never cease and His compassions never fail." Lamentations 3

count 'em.

These are actually Mike's first stitches. After his first surgery he had these knarly-cool quarter inch staples holding his neck together. I thought "wow, what a wicked cool scar..." and then by the time we landed back in Nebraska you could barely see it even 10 days out of surgery.

I have decided to post the stitches photo (I tried to make it small) because by the time you see him his scar will be invisible again. The drain comes out today and the stitches on Tuesday (Lord willing.)

When Dr. Haughey said that this would be a simpler procedure, after the last surgery we could not conceptualize how non-painful it could be. On every level we were pleasantly surprised - no hospital stay, no swallowing issues, no sleeping issues. He has not taken any pain pills. (He only took two Alleve after the surgery for what I believe could have been a caffeine headache.)

We have an appointment with the radiologist who works with Dr. Haughey on Tuesday and Mike's stitches are scheduled to come out on Wednesday. We just changed our flights to stay through the weekend because basically it would cost $700 to come home today and fly back early next week. (More on that later.)

Just know that the patient is doing great! By the way, there are 20 stitches.

fast progress.

We took this pic this morning while we were waiting for our spot on the surgery schedule. Mike was wheeled into the surgery room just before 11am.

Dr. Haughey came out to report that everything went great about 12:30pm. Like the previous post reported, the node(s) were successfully removed and Dr. H was able to take a good look at the primary site while Mike was on anesthesia and find that it looks "perfectly clear". By 2pm I was able to go back and sit with Mike as he came off the anesthesia. By 2:30pm he was dressed and eating the cookies I had packed for him - Oatmeal Scotchies. By 3pm Tom Vespa was shuttling us home from the hospital!

By 4pm Mike was on the porch with Tom drinking coffee and snacking on Janice's peach scones. We are elated with this quick recovery. He does not like how the anesthesia feels, but it is wearing off a bit more by the hour. This truly was a MUCH simpler surgery.

Dr. Haughey said that the nodes were entangled in some sensory nerves that he had to work around (so Mike might have a numb spot for a while) but the motor nerve was not in the area (so Mike possibly might not have any severe setbacks with his physical therapy.)

Such a remarkable day - with so much to be thankful for!

out of surgery - everything good.

Dr. Haughey just came out to tell me that everything went great. He removed the enlarged lymph node and a few surrounding ones. He said it went very well. He said he put in a drain that he will remove on Friday. We do not have to spend the night at the hospital - yeah! He will let us know when we get the results of the pathology report which will dictate what we do next.

He was very pleased to tell me how absolutely clean the primary site (at tonsil area) was and even showed me four photos of the area. All showed different angles of the site and all looked like healthy & perfect baby skin. That was pretty thrilling! While surgery is a bummer it did provide a great opportunity to get a picture (literally) of the primary site at close range.

My heart is doing a happy-dance rejoicing thing. Mike is coming off of his anesthesia and I will get to see him soon.

mike just went into surgery.

It is almost 11am on Wednesday, August 10th and they just wheeled Mike into his surgery. We both felt a bit nervous this morning as we waited at the surgery center, but after Dr. Haughey came on the scene it is like you can breath again. He explained again that this is a fairly simple procedure today. He will get the bad nodes out and then just take a look at the main site with the Steiner Scope while Mike is on anesthesia. He said he is confident that the area is perfectly clean, but it is an ideal opportunity to take a look.

We told Dr. Haughey that many were praying for him.

I will update when I know something.

a bit more surgery.

Dear friends & family riding with us... thanks for your love and support. We are feeling it!

We head to St. Louis on Tuesday afternoon for our surgery on Wednesday, August 10th at 10am. I can tell that Mike is a little blue about it, but he is still the strongest, cheeriest cancer fighter I know.

This is not a recurrence of the disease but likely a microscopic bit of disease left from the neck dissection. We know that the cancer was removed completely from the throat area with the last surgery, but the lymph nodes are trickier. The previous surgery was two part: removal of cancer mass in tonsil area and neck dissection for cancer cells that had migrated to the lymph nodes. Mike had cancer cells in 4 of the 33 lymph nodes removed. We will know more when Dr. Haughey gets back in there but he will for sure be removing the enlarged node and possibly some surrounding ones.

We will also meet with the radiologist that works with Dr. Haughey after the surgery on Thursday. After the pathology reports are back they will make a recommendation for a radiation treatment to Mike's left neck only to mop up any disease that might be left. We will post more when we know more.

We continue to be thankful that we can limit the dosage and placement of the radiation because of the surgical options we have had. When you have spent time at Head & Neck Cancer clinics you know first hand how disfiguring and debilitating head & neck radiation can be... We heard of a man this week who had throat cancer and hasn't eaten for 12 years. (The radiation destroyed his ability to do so.) ...And on our first visit to UNMC we met a wonderful fellow and after talking a bit Mike asked about his "accident". We guessed that he had taken a grenade to the face serving in Afghanistan. Actually what we saw were the effects of radiation from sinus cancer. It is uncomfortable to tell the morbid stories but it is the realities that come with head & neck cancer & radiation. We are thankful for the minimal amount of radiation we will need because of our surgical path.

Mike has been on the prayer list at our church this whole time and two weeks ago a good friend said in good nature "Why are we still praying for you - you look great." Steve was one of the first people we called when we got out of Dr. H's office last week. Thanks to all of you for hanging in there with your love and your prayers!

the ride continues.

We just heard back from Dr. Haughey's nurse and we have surgery scheduled for next Wednesday, August 10th. We are to arrive at the Center for Advanced Medicine at 8am for the 10am procedure. This is the building that Dr. Haughey's office is in and we snapped this photo yesterday. While we were ready to rally if a surgery space opened up this week, it also feels kind of good to be heading back home tonight to get our bearings for "the ride" next week.

This is all a bit numbing. Mike said that in reference to MikesLongRide, he felt like he was nearing the end of his ride on the east coast and they turned him around and said you have to go back a bit. (For those who have been blogging along the journey with us, MikesLongRide is his analogy of the cancer journey being like the challenge of his bucket list goal of riding his bike across the US.) Friend Janice Vespa suggested this morning that maybe we should view this as just stopping for a tune up! We like that.

When you start a long journey like this with cancer, you really do not know where the ride will take you... but we do like knowing the One who is sovereign over the Ride and rest in the fact that He is holding on to us.

Words that comfort today:

1 O LORD, You have searched me and known me. 2 You know when I sit down and when I rise up; You understand my thought from afar. 3 You scrutinize my path and my lying down, And are intimately acquainted with all my ways. 4 Even before there is a word on my tongue, Behold, O LORD, You know it all. 5 You have enclosed me behind and before, And laid Your hand upon me. 6 Such knowledge is too wonderful for me; It is too high, I cannot attain to it. 7 Where can I go from Your Spirit? Or where can I flee from Your presence? 8 If I ascend to heaven, You are there; If I make my bed in Sheol, behold, You are there. 9 If I take the wings of the dawn, If I dwell in the remotest part of the sea, 10 Even there Your hand will lead me, And Your right hand will lay hold of me. 11 If I say, “Surely the darkness will overwhelm me, And the light around me will be night,” 12 Even the darkness is not dark to You, And the night is as bright as the day. Darkness and light are alike to You. 13 For You formed my inward parts; You wove me in my mother’s womb. 14 I will give thanks to You, for I am fearfully and wonderfully made; Wonderful are Your works, And my soul knows it very well. 15 My frame was not hidden from You, When I was made in secret, And skillfully wrought in the depths of the earth; 16 Your eyes have seen my unformed substance; And in Your book were all written The days that were ordained for me, When as yet there was not one of them. Psalm 139: 1-16

today .

Mike and I flew to St. Louis today for our second post-surgery check-up. We were eager. Several days ago Mike noticed a bump on his neck close to his incision. He told me on Sunday. When Dr. Haughey entered the room, after greeting us we were eager for him to examine the bump with his knowledgeable fingers. He reported the size and position of the "ovoid mass" and "BB module" to his nurse Nicole. After doing a scope down his throat (routine at these check-ups) he said that "yes we need to get that out". He started explaining the surgery that we need to do to take care of this. This might be hard to understand but we trust Dr. Haughey so deeply that these very hard words were at the same time comforting because he was helping us take care of this. We talked about how this surgery would not be as invasive... how it would be a much more simple maybe 3 hour procedure... maybe 1 night in the hospital... that we knew there was some lymphs affected further out... that he would open just the upper end of the incision to reach and remove the affected node(s)... that his recovery would be much faster... and that he would recommend following up with a helper-dose (mild dose) of radiation on the left neck only after the surgery. At the end of the day I am so tired that I am not sure I am making sense but I wanted to say something so that we could ask for your prayers. Dr. Haughey's nurse Nicole will call us in the morning to let us know when Bruce has a window in his schedule to do the procedure - maybe even this week while we are here. We won't know until tomorrow, but after we have processed the news we decided "let's get this done as soon as we can."

On the plane today I had brought my calendar and had finally taken the time to fill in the events that we have on our calendar over the next two months and we reviewed them together. Feeling proud and satisfied I think I even said "It sure feels good to get this stuff written down to see what we are doing.." After hearing that another surgery was in front of us and we were pondering the reality of it, one of my favorite verses from James swirled through my head: 13Now listen, you who say, “Today or tomorrow we will go to this or that city, spend a year there, carry on business and make money.” 14Why, you do not even know what will happen tomorrow. What is your life? You are a mist that appears for a little while and then vanishes. 15Instead, you ought to say, “If it is the Lord’s will, we will live and do this or that.” James 4:13-15

Good lesson. We are going to bed tonight thankful that we have the care of a great doctor... thankful for the goodness of a sovereign God we trust our lives with...and thankful for great friends to pray for us as we continue the journey.

heading to st. louis.

We have our second post-surgery appointment with Dr. Bruce Haughey on Tuesday, August 2nd. We very much look forward to these appointments as Dr. H is only one who can tell us how Mike is really doing. At our last appointment on May 17th we were given instructions to "watch for throat pain, ear pain, lump in the neck or anything that seemed different".

A couple days ago Mike did find a lump close to the incision on his neck. When he told me yesterday, I almost passed out at hearing the words, and then got my bearings and decided that I would wait to hear what Dr. Haughey had to say before I got sad or scared. We are hoping it is scar tissue that has nothing whatsoever to do with cancer.

Please pray for traveling mercies and for wisdom & guidance for Dr. Haughey. Thank you...