Roger Clark: Uploaded

Thank-You's

2009-05-27T14:09:00.003-04:00

Here is a quick picture of all the Thankyou cards people have sent Mom. It an amazing outpouring of love and support. We are all so thankful for the people who have taken the time to let us know how much Dad meant to them.

The cards fell over, just as this picture was being taken!!

From the Memorial Service

2009-05-10T16:56:00.014-04:00

(For the many of you who wanted to be there but couldn't make it. Above is the slideshow that my mom's bro-in-law BG made for the service. Thanks to him for many hours spent scanning, photo-shopping and choreographing many old pics. By the way, you can enlarge the video by clicking on the four diverging arrows that appear at the bottom right corner of the screen.)

What remains when a Christian dies?

Whenever my mother talks about who my father is, and was, the phrase that always seems to emerge is “a man of integrity.” What surer mark of integrity than to have your spouse—the person who knows you at your best and worst—attest to it? It was an expression used again last weekend, as the family was in the hospital room celebrating Mom and Dad’s 25th anniversary, and a testimony others in recent days have echoed. “Your father was a man of deep integrity.” I’ve been pondering this phrase. It doesn’t mean “Your father was a man of moral rectitude,” nor “He was a righteous man.” Dad was that, by God’s grace, yet his integrity wasn’t a matter of morality, but one of authenticity. Dad was almost completely free of hypocrisy, and always so quick to repent when confronted with any kind of conflict between what he said and what he did. Certainly he had his private fears and failings like the rest of us, but when it comes to the person he was, to the question of character, the man inside was the same as the man on the outside. What a simple, extraordinary achievement! Our father was a man with nothing phony or forced about him, nothing in his speech or manner that suggested self-conscious calculation or manipulation. Frank and pragmatic as Dad was, there was also a certain innocence of heart there—not naiveté or ignorance, but a kind of spiritual health that made him all but immune to these sorts of petty vices. Small- or narrow-minded, mean-spirited or conniving my Dad was not, ever. Now that I’ve said it in the wordiest way possible, I’ll share with you what my Dad always used to say to my Mom about himself, though more as a defense than as a boast: “What you see is what you get.”

My Dad was not an intellectual, not, as he used to say, a deep thinker, but he had a careful and wonderful way of thinking, straightforward and cool. The fact that he taught mathematics to thousands of students on two continents over the course of 40 years makes a lot of sense, when you consider Dad’s knack for seeing the simplest and therefore most elegant solution to any problem. This gift was brought to bear on any number of problems, financial, personal, parental, pastoral, theological or automotive. A few of the New Life elders at Dad’s bedside the other day were recalling how, during the inevitable disagreements and negotiations in session meetings, Dad would not be on anyone’s “side.” Rather, he was on the side of unity and harmony. This sounds trite--unless you knew my Dad. He was remarkably apolitical—not because he was apathetic or because he presumed superiority--but because he didn’t care a whit for self-advancement, because when he was most himself he had no agenda other than the truth, the unity of the body, and the good of his friends. He was able to minister to others so directly because he was all but free of self-regard and self-importance. He never pretended to be something more or less than who he was, never fawned and never patronized, and this made everyone he knew feel safe and loved around him, like they could relax and be themselves too. That was the environment in which real discipleship and communion could happen. Less subject than most to the blinding effects of those selfish social vices, Dad was able to cut to the heart of the issue: he could see the truth, articulate the facts of the matter, and identify the surest path to reconciliation or resolution in such a way that that solution was suddenly “obvious” to the rest of us as well.

That uncanny flair for dis-covering the obviousness of the truth is of course a defining mark of a great teacher. But Dad’s gift for teaching had as much to do with his heart for his students as it did with any pedagogical skill set. As one of Dad’s students from his days in Congo told us, “he was not a teacher who was far, but one who was close.” When it came to parental instruction, once we children reached a certain age, he never told us what to do--he either showed us, or he gently spoke the truth, and left it to us to work out the simple equation. Dad had little patience for abstract speculation, but where ideas touched life he was as sensitive and as sharp as St. Augustine. Not a teacher who was far--above you, lecturing you, lording it over you--but a teacher who was close-- alongside you, instructing by example.

The wife of that former student of Dad’s told me, “Your father wasn’t like other missionaries. They wanted us to come to them; he came to us.” She said that whenever a student didn’t show up to school, Dad would go out in search of him. Her husband remembers dad, walking through the winding paths of the villages with a pot of warm tea in his hands, seeking out the home of a sick student. This was a common theme in the reminiscences of Dad’s friends during that last hospitalization, recalling his heart for the ailing and suffering. As Angelo said, during many years of shared ministry with Dad he got very used to hearing, in the church office, “We’ve just found out that ‘blank’ is sick, but don’t worry, Roger Clark has already been to visit him.” It has been such a gift to the family, over the past week or so, to hear many stories about Dad, personal testimonies to the way he was used by God in the lives of so many others. Being someone’s son or daughter, or even wife, it’s all too easy to take him for granted on account of your proximity to him and your immersion in the routine of family. Even knowing him more intimately than most, you often don’t see the forest for the trees. I remember, when I was a teenager, waking up at 10 or 11 on Saturday mornings, and my Dad would be there, mowing the lawn, or doing his exercises—pushups and sit-ups—on the living room floor. Shirtless, of course. (I can’t help but share here an old, running joke among my friends, who thought that my parents' answering machine message should have been, “Hello, this is Roger Clark. I’m not wearing a shirt right now, but if you’ll leave a message at the beep we’ll get back to you.”) Anyway, on those mornings, it was easy to miss or forget the fact that he had been up at six and had already been out to his weekly prayer breakfast with his good friend, and made the rounds of the hospitals and the homes of the sick—all before I even woke up. There are so many stories, stories that each of you cherish, that exist because Dad was the kind of man he was, but that we would never have heard from him...because he was the kind of man he was. The wonderful thing, though, is that it was the same man. Just like our Dad was the same inside and outside, he was, finally, the same man inside the home and outside it. His private and public faces were different, of course, but also unmistakably the same.

“Free” is a word that I find myself using a lot right now, as I think and talk about my father. If he was nearly free of selfish ambition and vain conceit, he was also, more and more through the course of his life, free of legalism and dogmatism. One of the greatest gifts he gave me, personally, was his, again, simultaneously simple and subtle grasp of the spirit of the gospel. Speaking as someone who can get caught up in the letter, tangled in words, Dad always brought me back from the edge of absurdity with the deep and basic truths of the gospel. It was he who best taught me the difference between knowledge and wisdom. He never let himself get paralyzed by grey theory or remain stuck on the horns of a dilemma, doctrinal or personal, but always brought things back to the promise of God’s love and forgiveness, and the reminder that if tongues will be stilled, and knowledge pass away, it is love that will remain.

My Dad was free because he knew “the secret of being content in any and every situation”; he knew what it was to have plenty and to be in need, to be in community and to be alone, to succeed and to fail, to have hair and not to have hair. His secret was his confidence in Christ: I can do all things through him who strengthens me.

Indeed, Dad was familiar with suffering and acquainted with grief. I often think of him in what was probably the low point of his life, returning from the mission field after his marriage had failed, with two young daughters in tow, and having had to leave his two other beloved girls behind. He was living with his parents, and, as he told me, in something close to despair. When my Dad’s brother Wayne shared some thoughts after the burial service yesterday, he recalled the same time, when, he said, Dad was broken, and angry with God, but he never turned away from Him. Given the circumstances, Dad had feared returning to Bethel Chapel, his home church, but he told me he remembered the command of Scripture not to forsake the assembly of believers. When he did return, he was overwhelmed and humbled by the instant love and acceptance he found there. This experience, I think, was one reason that our Dad so treasured the unity of the body.

When my Dad met my Mom, Karen, it quickly became clear that the Lord had prepared them for each other, and that, through deep adversity and heartache in both of their lives, he had instilled in them a hard-won maturity and a determination to do things right and in a way that would please the Lord. So I still remember, back when New Life was in the gym at Abington Friends, how, as an illustration of parenting strategies, the whole family recreated the Clark breakfast table onstage during Sunday worship, all of us polite and well-mannered, with every conflict resolved, with recitations of repentance and forgiveness, all capped of course with a slightly too-long prayer from Mom. I know that over the past 25 years the Clarks may have been regarded by the community as the model Christian family—at times, undoubtedly, annoyingly so--but it is a powerful thing to remember that both of my parents have been around the block more than once, and whatever success they have had in their marriage was due to God’s gracious and redeeming love.

Up until his literal death--and his death was no figure of speech--it was real, and painful, it was shocking and it was tragic, even as it was a beautiful going home--up until that death, Dad’s life was a process, deeper and deeper, of dying to self. The secret to Dad’s joy, even amidst suffering, was twofold. There’s a philosopher in Chicago who describes a key component of living a good life as “stepping outside the shadow of the self.” Dad was very much in his element outside that shadow. The second part of this “open secret” of Dad’s life was the step into the arms of God, into the clothing of Christ, as Galatians says, into the Rock of Ages. Dad’s life embodied John the Baptist’s words, “he must become greater, I must become less.”

The other part of the phrase, “man of integrity,” is of course “man,” and my father taught me what it was to be a man. My Dad was a man in the fullest sense of the word, a real human being. While he could be as tough and as courageous as anyone, he also had a wonderfully tender heart, and it was always a source of some amusement for us kids to hear the sniffling behind us during a family movie time, whether the fare was Oscar-worthy drama or Disney schlock. Dad was never afraid to kiss and flirt with Mom in front of us kids (much to our exaggerated chagrin and secret delight), or to sing old-time love songs and hymns with gusto, or to let his love for us kids break out in a spontaneous, loud, goofy burst of sing-songy tribute or teasing that would always make us laugh. He called Christine “La Grande Dame,” he would sing to Cara “young lady,” and I’ll never forget the mornings he would greet me with “Androso my son!!” Dad could startle you with his idiosyncratic expressions of tender affection. But being a man, a father and husband, to him meant being a provider, and he was often working two or three teaching positions plus one other job all at once, still with energy—what energy!—to serve as an elder, church greeter, visitor of the sick, home demolisher and renovator, encourager, and counselor.

Dad was also a servant, in attitude and deed. We kids were just recalling how the chore my Dad most unfailingly carried out, once a week, was the washing of the kitchen floor. There is no better symbol of my Dad’s way of loving and of embodying Christ to us, and the sudsy water he used to scrub that worn linoleum was as sacred as that in any baptismal font.

Considering Dad’s humanity, and his servant heart, the Bible passage that kept coming to mind for me this week was Philippians 2, where it speaks of the attitude of Christ,

Who, being in very nature God,
made himself nothing,
taking the very nature of a servant,
being made in human likeness.
And being found in appearance as a man,
he humbled himself
and became obedient to death—
even death on a cross!

“Obedient to death”—Could this be God’s most profound identification with us human beings, for him to experience human suffering so fully as to die—painfully, publicly, and not without wrestling with his fate, not without something approaching despair. I was moved, even inspired, by Dad’s honesty with me about his fear of dying. He was always clear that he knew where he was going, but up until the end he struggled with having to leave this life and those he loved. Dad wrestled with the Lord, he sought and interrogated the Lord’s will. He felt and faced squarely the challenge of trying to achieve the acceptance that overcomes stubborn, futile defiance, but that also isn't merely a passive admission of defeat. An eyes-wide-open reconciliation to life and death, which overcomes not only rage but also all the ways we human beings have found of "giving up" on real life. During that time, Dad sought, grappled with, and fell into the arms of a risen Savior, who sustained him all the way to his last breath.

Dad’s death was the completion of a lifetime’s work of becoming one with Christ. Because surely if Jesus identifies with us in dying, then we also finally become like him in death. My Dad’s final test was in his last few days, when the cancer had made him so weak that he could barely walk, then barely move his body in bed, then barely see, or speak, or even groan. The real test of strength is when every bit of physical, mental and psychological strength is stripped away, and one is left, naked, like Christ on the cross. What remains? To see such a strong and capable man so weak, so small in that hospital bed, was to witness Dad’s final passage through the refining fire that made his identification with Jesus complete. To be obedient to death. What remains, for Dad, and for us? What did he leave behind, and where did he go?

We buried Dad yesterday. As Marc Davis reminded us then, we were planting a seed in the ground. Jesus said, “unless a kernel of wheat falls to the ground and dies, it remains only a single seed. But if it dies, it produces many seeds.” Paul, echoing these words, said, “What you sow does not come to life unless it dies.” Like God himself had to die to attain life for us, my Dad had to die to make his unity with Jesus complete, and to enter into that life that is the fruit of the planted seed, of which the resurrected Christ, the Bible says, was the firstfruit.

What remains? This is 1 Corinthians again: “But where there are prophecies, they will cease; where there are tongues, they will be stilled; where there is knowledge, it will pass away. For we know in part and we prophesy in part, but when perfection comes, the imperfect disappears. When I was a child, I talked like a child, I thought like a child, I reasoned like a child. When I became a man, I put childish ways behind me. Now we see but a poor reflection as in a mirror; then we shall see face to face. Now I know in part; then I shall know fully, even as I am fully known.
“And now these three remain: faith, hope and love. But the greatest of these is love.”

For tonight:

2009-05-04T09:26:00.003-04:00

Just a few logistical points. We hope to start promptly at 6:30 this evening, and to keep the service itself to 1 hour. There will be a receiving line, but our hope is that folks will move quickly through it, greeting the family but not lingering too long, because there will be several opportunities to share your memories of Dad. Our plan, after most people have had a chance to get something to eat and the receiving line ends, is to open up a microphone for those who are so inclined to share publicly their thoughts and memories of Dad and how God used Dad in their lives. There will also be notecards available for the meeker among you, or those who need more time to collect their words; these can be left in a basket there or mailed to the Clark home. And there is of course this forum as well, where you can continue to leave comments after Joe's posting. Thanks, and we look forward to seeing everyone tonight. There is much to celebrate.

Share Your Stories About Roger

2009-05-01T15:58:00.003-04:00

Our family is so thankful for the outpouring of loving support as we continue to both mourn the loss of and celebrate the enduring legacy of Roger's life. To that end, we'd like to invite you to share any memories you have of Roger here on this blog. We hope this will be a fitting way to publicly testify to how he exemplified God's love through all of his various roles (husband, father, church elder, teacher, missionary, neighbor, etc.), as well as enable those who cannot join us for the memorial service on Monday evening to participate in this remembering process.

To post your story:
1. Click on the comments link below this paragraph
2. Type your message in the Leave Your Comment box in the right column
3. Click on the orange Publish Your Comment below the box.

2009-04-30T14:57:00.003-04:00

The service is set for 6:30 PM on Monday at New Life Presbyterian Church in Dresher (2015 Limekiln Pike). There will be some dinner-ish and desserty food at the reception, so plan accordingly.

Several folks have asked about donations in Dad's honor. In lieu of flowers, contributions may be made to the Deacons' Fund at New Life Glenside (467 N Easton Rd, Glenside, PA, 19038).

For those who are traveling by air and need the information for the "bereavement fare," things are being handled by Joe Schlupp at the Baron Rowland Funeral Home in Abington, phone 215.887.7375.

Feel free to contact me with any other questions about travel or logistics. My number is 773.682.8725.

Funeral Plans for Dad

2009-04-30T08:56:00.003-04:00

Our just-about-final plan at this point is for the family to bury Dad on Sunday, and then to hold a memorial service on Monday evening (May 4th), open to all who would like to attend. It will be held at New Life Dresher, which is at Limekiln and Susquehanna. Details and directions will be posted/linked here. The exact time is still TBD, but will be decided today.

2009-04-29T12:25:00.015-04:00

After the many family and friends had gradually and reluctantly left Dad's side last night, Nana, Dad's mom, was one of the last to leave. After a long day of expecting that the end could come at any moment, we were all starting to wonder if Dad might be sticking around with us for a while longer. Nana had been sitting in a chair by Dad's side, holding his hand, never moving for the entire day. At about ten o'clock she was waiting to board the elevator to go home with Sandy and Joe to get a few hours sleep. I said to her, "I'll see you tomorrow, we may have him for another day." She looked at me and said "No. I don't want him to be here tomorrow, it's too much. I told him my last good bye. It's time for him to go home."

In the end it was Cara, Katherine, Mom and I settling in for the night with Dad. The three of us kids had been making calls and plans and arrangements, and we came in to the room to find Mom in her pajamas lying next to Dad in the bed, talking to him. She said that this was her last chance to feel him next to her, "in this body that I have loved." Of course she was sort of squinched in between him and the railing, so we eased him over and made room for her. It was like he was home in bed with her, in the bed where he jokingly pointed and told Cara last week "Right there. I'm dying right there, next to your mother." We were talking about Dad, and the day, and the way things were, while Katherine got comfy and squeaked around in her sleeping bag on the air mattress, and Cara got ready for bed. Mom was describing something a friend had been thinking about, how in heaven there will be no more faith, because we'll have "sight," and no more need for hope, because we'll have the Object of our longing. How the one that will finally "remain," of that trinity of spiritual gifts, will be love.

For a while I had been thinking about the meaning behind Dad's many exhalations and vocalizations, as we listened for days to his murmurs and groans, and later to his labored breathing, as he tried to speak, or else to express something deeper than speech. I remembered Romans 8, and the idea of "groaning" there. Like all creation groans to be set free from "bondage to decay," like a mother groans in childbirth--the pain that is necessary, always, to give birth to great joy--like we groan for "the redemption of our bodies," and even the Spirit of God himself intercedes for us with "groans that words cannot express." Amazing that groans can be more expressive than words, and that words can fail to articulate the longing that a groan embodies. Groans "too deep for words." I think it was these deep longings that Dad's groans expressed--the longing to remain with his wife and his children and mother, along with the longing to be finished, home, to be free of his ruined body--the longing to be done with suffering and to see it turned to joy--the deep longing for resurrection and to see the face of his Savior.

We talked about all of this, and then started talking and laughing quietly about Dad, while still shedding tears, like we had done many times over the past few days with Sandy, Christine and Daisy--and with Julie over the phone as she drove the 1800 miles to get here. We were talking about who he was, what was so wonderful about him and why we liked him, and the things people had said about him that day, the hymns we'd sung--"When peace like a river," "My Jesus, I love thee," "My hope is built on nothing less," "On Jordan's Stormy Banks," "In Christ alone my hope is found." We were marveling at Dad's ability to cut to the heart of the matter, how he was capable of seeing the truth so clearly in situations where others got hung up on details and overwrought scenarios and pride and politics. How Dad was actually apolitical, because when he was most himself he had no agenda other than the truth, and the unity of the body of believers, and the good of his friends. He was so able to minister to others because he was all but free of self-regard and self-importance. There was no pretense whatsoever about him: he never pretended to be something more or less than who he was, never fawned and never patronized, and this made everyone he knew feel safe and loved around him, like they could relax and be themselves too. That was the environment in which real discipleship and communion could happen.

So we all unwound a bit after the big groups and the intensity of the day, and I think Dad sensed that, and as we relaxed he relaxed too. I was saying to Mom that Dad seemed to be lingering on even though we had started to pray that God would take him once Julie, Rob and the kids had arrived and spent time with him--but that it was nice. We were just spending time together and reflecting, and a burden was beginning to be lifted. At that point we said to each other that as long as Dad wanted to linger, to tarry with us there on the shore, we would linger with him, because we were still reluctant to let him go, even though we were praying for an end for him. Cara was saying what would turn out to be a last, tearful good bye, and she was by the bed sharing some time with him and Mom. Katherine was remembering the waterskiing incident of many years ago when she (claims she) almost drowned, and how Dad jumped in to save her, but right after that, being Dad, told her to get right back up on those skis. We were talking too about how the next moment for Dad, the next time he opened his eyes, all the pain would be finished, and he would be with Jesus, "face to face."

And moments later when the end came it was very swift and almost miraculously peaceful. Shortly before midnight there was a pause in Dad's breathing, and then he started breathing again, smaller and smaller, with spaces in between, but quieter and quieter. It felt different, and we knew he was very close. We called Kate over from her bed where she had been lying as we chatted, and we all held on to Dad as he breathed his last breaths and the pulse in his neck slowed and then stilled. It was perhaps 45 seconds from when we first noticed the change in his breathing. Immediately after, it was like a huge burden had been lifted off of all of us, and it was eerily quiet. Dad's breathing had created a rhythm of life, however fragile and tenuous, in the room, but that breathing was also the voice of pain, and it was the groanings of a longing deeper than words. So to hear it stilled was both a relief from suffering and a symbol of loss, but the silence signified joy for Dad--to die is gain--and the fulfillment of his deepest, life's desire.

Thank you, thank you, thank you to everyone reading this for all the love you've shown Dad and us over the past decades, months and days. We are so grateful to be in the midst of such an amazing community. More from us later, as there is much to do. We will be posting more info here about funeral arrangements and the memorial service this weekend. Peace.

A friend's perspective

2009-04-29T11:18:00.002-04:00

Andrew asked me to share my perspective on Roger's last day here on earth. Here are a few of my thoughts:

I will never forget yesterday. For 10 hours I hung out in Roger's room as we walked my dear brother most of the last mile in his six year fight with the Unwanted Visitor that ended my wife Nancy's life last year.

It was agonizing. Once more I heard the labored, crackling noises that a person utters in their last hours of breathing. I remembered our nine month battle with cancer. I remembered the many miles we have walked with Roger and Karen since they welcomed us home from Ireland in 1992. I ached for the hours of grieving Karen was to face. And once more my soul raged against the insult of death.

It was glorious. I saw the fruit of this humble, loving man as friends, relatives and even a former student from Africa came to say farewell. The day was thus filled with stories, songs, scriptures and sobs. Roger was dying surrounded by those he had loved and served. God led me to share many scriptures during that watch, including passages from Psalm 48 and 142 that had been impressed upon me during the passing of others whom I deeply loved. Such a departure affirms the truth of the gospel. It also contrasted vividly with the other death occurring on the ward yesterday. We were walking Roger toward the Light, the other family was shrouded in dark gloom.

I left the hospice at 9:30. Karen wanted quiet time with her best friend by then. That was only fitting. So, I left her there with Roger and three of the kids. Yet, I am thankful that he let me help Roger take the final steps. You see, when Jesus came for Roger just a couple of hours later, a friend and I were praying for the race to end.

Again, that was fitting, we can walk one another to the Door, but in the end HE opens it for the fortunate one who is taken Home. Well done, good and faithful servant. You ran a good race. As my daughter KJ said, "he is with my mommy." --and many others who loved him. Most importantly Roger sees the face of the One who loved him best of all. Roger, thanks for helping blaze the trail for us to follow in His good time.

Dan Macha

Neighbor, Fellow New Life Elder, and Brother in Christ

Tuesday Afternoon

2009-04-28T16:17:00.002-04:00

Last night Sandy and Cara stayed with Mom and Dad in the room. It was a long night as they slept fitfully and listened to Dad's breathing change to a rattling sound. Since then his breathing has become more labored, and the rattling sound fills the room. It is hard to watch him as his body slowly shuts down, to remember the man he once was and to see him lying in bed, so near to death.

We don't know when the end will come, but we are so encouraged by your comments, and the prayers we know you are praying.

Andrew, Daisy, Katherine, and Nana joined them at various points through the morning. It has been a long day with many visitors (Ellie, Ed, Aunt Florence, Sue, Glen, Bill, the Hollands, the Julianis, Karen Keller, Marlene Hammerschmidt, Terry Traylor, Jim Spaulding, Joe, Diane and Chuck Marsh). Dan Macha has been here through the day, faithfully praying and encouraging Dad in "finishing the race". Nana has been sitting by Dad's side holding his hand, quietly letting him know that she is there. We are singing hymns and other songs, reading scripture and telling Dad that we are there for him. There have been many moments of tears, but also moments of praise as we recall God's promises, and are reminded of the hope of heaven.

The facilities here are really quite nice, and it enables us to step out of the room and gather on the couches in the family room to decompress, and then step back in to be with Dad again. We have just received dinner, and are looking forward to a warm meal after a day of eating snack foods- it is such a blessing.

We feel that the end is near, but that Dad is holding on, waiting for Julie to arrive. She has been driving since Saturday from Texas with her family of 8. They are due to arrive anytime now.

We will keep you updated if his status changes.

2009-04-27T19:01:00.004-04:00

I just wanted to say thanks to Becky Wilson for her encouraging comment last night about Dad's likely ability to hear us and to sense our presence, even when he is unable to speak or even to respond clearly. We had a powerful confirmation of this this morning when, after we had heard the bad news, Dad had a period of about two hours of relative alertness and responsiveness. It started about when Dr. Stadtmauer came in and was able to rouse Dad right away by saying once, directly, "Roger." The other three of us were completely surprised, because the doctor yesterday was unable to get Dad to come around, even by speaking much louder and applying several firm pats and shakes to Dad's body. But right away Dad opened his eyes and looked directly and for about a minute at Dr. Stadtmauer, squeezed his hand, and murmured, as if to acknowledge and thank him for everything they've shared over the past 6 years.

Shortly after Dr. Stadtmauer said good-bye to Dad, Dad was looking at us in a way he hadn't in days--his eyes still foggy and not quite focused, yet actually seeing--looking at us--and his murmurs and groans were expressive, and not merely the monotone, seemingly unconscious sounds of pain, discomfort or confusion that we'd become accustomed to hearing from him. We raised the bed to a sitting position, and Christine and I were able to talk to him on our own, and he was reaching out to us, and hearing and watching us, and murmuring in response. It was difficult to see him trying to talk and incapable of finding speech, but at the same time we were talking to him, telling him we loved him and knew that he loved us, and that we knew what he wanted to say--and hoping that we did. And Mom came around the bed, and he perked up still more, and tried feebly to reach out, so she hugged him and I put his reaching arm around her and held it there. And he tried to speak, and she kissed him, and held his head, and prayed with him and cried and told her she loved him, and that it would all be alright, that Jesus was near, and he was crying too, crying sounds but no tears. It was all a terrible, beautiful moment of shared pain, and love, and mutual comfort.

2009-04-27T15:19:00.009-04:00

The decision was made, this morning, after consulting with Dr. Stadtmauer and our attending physician, to move Dad into hospice care. Though the CTscan of Dad's head came in negative last night, and Dad was looking livelier this morning, it quickly became clear that in fact Dad's condition had only deteriorated further.

The new attending, Dr. Nair, took the situation in hand immediately on seeing Dad and looking at his charts. She examined him carefully and explained his status to us, frankly and clearly, including many details that the doctors over the weekend had neglected to share with us. The long and short of it was that, while Dad's brain did appear to be clear of any bleeding or tumors, an older MRI indicated that there was cancerous growth within the actual bones of his skull. In addition, he has apparently been in acute renal failure, and his liver also is failing, in both cases due to the plasmacytoma discovered last week. In short, the doctor said, Dad's body is in a self-induced coma, and is essentially in the process of shutting itself down. The cancer, Stadtmauer said, is now moving throughout his body, and its effects are at this point non-reversible, including its effects on his mental state.

We questioned him carefully on what measures might be available to Dad now, and he said that the few things they could do could not save Dad, and would be so invasive and cause so much discomfort and additional suffering--with only a slim chance of success--that he could not really recommend them. We had to agree, especially given that these procedures, even if they "worked," could offer no promise of any real increase in his quality of life for however much longer he might survive. Add to that the fact that Dad, in his living will and in conversation with Mom and us kids, had indicated that he did not want his life prolonged merely for prolongation's sake, i.e. with no real hope of recovery. Dr. Stadtmauer said that what Dad is going through now is the "natural" way the body brings things to a close in this situation. In the end, we felt that the decision to move Dad to hospice and halt any further medical interventions in the course of the myeloma was the merciful and loving choice, and the choice Dad himself would make.

Christine had spent the night with Dad, and Mom and I arrived this morning at around 7:30; by about 9:30 the call had been made. Katherine, Daisy, Sandy and Cara have joined us here, along with Dappie (Mom's Dad), Uncle Chuck (Mom's brother), Aunt Diane and Colton. Dad's brother Bill is arriving from France in about an hour, and Nana, Uncle Wayne and Aunt Sue (Dad's bro and sis) will be coming in this evening. Marc Davis came to encourage and pray with Dad this morning, and stayed with Dad while Christine, Mom and I grabbed some lunch and spoke with the folks from hospice. John Yenchko and Mom and Dad's friend John Freeman also came to pray with Dad and say good-bye to him.

Dad will be transferred to Penn's brand new Rittenhouse hospice unit this evening. He will have a large private room, one of just 12 in the facility, which has large common areas, a kitchen and a dining room where the family can gather and be near him during this time. Please pray for Dad, for courage and confidence, and peace and relief from any suffering, that the Lord would make his presence felt to him. Pray for us as we seek to love and bless him in these final moments--however long they may turn out to be.

Sunday Afternoon

2009-04-26T15:12:00.003-04:00

Dad's condition remains serious and the exact causes of his symptoms uncertain. He has now been basically unconscious for about 24 hours; he has moments where he opens his eyes, but rarely with anything like "seeing" going on; he has been reduced mostly to non-verbal vocalizations, and when he did speak to Mom last night it was nothing coherent. This morning he was aware enough to respond "hospital" and "HUP" when the doctor asked him where he was, but he then went on to answer "hospital" to all her other questions. Over the past four or five days there has been a gradual, but, when seen altogether, dramatic decline in Dad's overall mental and physical state.

The doctor and his team came by this afternoon, and Mom and I got a chance to hear his assessment and ask direct questions. He was unable to rouse Dad at all, and thought that his sluggishness might be caused by the medication, specifically the Oxycontin and the Ativan, so he prescribed Narcan, which would reverse the narcotic effects of these drugs. He said it may also be caused by blood viscosity, itself a result of calcium being shed from the bones into the bloodstream, as well as the increased protein numbers, both the result of myeloma activity. On the other hand, other tests seem to point away from significantly increased blood viscosity, and the specific lab result for that won't be available for a while. It's also possible that there's some bleeding in Dad's brain resulting from the lowered blood counts, but again, the doctors say that the platelets are not all that low--though he's just received a transfusion to replenish them--suggesting that the root cause is still likeliest to be plasmacytoma--myeloma tumors--in the brain or upper spinal column. The doctors are contemplating a spinal tap to analyze his spinal fluid for signs of the myeloma, but in the meantime expect that the CTscan will show any hemorrhaging or cancerous growth.

As it turns out, the Narcan didn't enable Dad to be much more responsive--he woke up, but was mostly just agitated, without very much ability to interact intelligibly. This seems to suggest that his problem is, as the doctor said, "organic" rather than narcotic. We should know more after the scan results are analyzed.

Sandy, Christine and Erin were in this morning, and Daisy, Ed, Cara and Katherine will be arriving soon via train. Erin and I are supposed to fly out in the morning, but we will still keep all of you updated. Thank you as always for your prayers and many kind calls, emails, comments and other gestures of sympathy and solidarity. Please continue to pray for all of the same things--insight and imagination for the doctors, stamina, encouragement and faith for Mom and Dad, and, still, for some measure of healing for Dad. Pray that he would not be in distress, physical or emotional, and that he would be able to have some mental clarity, some ability to interact with Mom and the rest of us, that he would know that we are with him in this, and that he is loved.

Newer News

2009-04-25T10:05:00.005-04:00

The attending doctor from oncology has come by to see Dad, and he believes that Dad's symptoms are a result of the increased activity of the myeloma, and probably not specifically linked to any tumor growth farther up his spine. His protein levels have risen further, and because he hasn't been drinking fluids, his blood is actually thicker, making the effective level of proteins in his blood still higher, only aggravating his symptoms. The hope is that as they rehydrate him via IV, his sluggishness and discomfort will abate somewhat. In the meantime, they have begun administering a new round of steroids to reduce the tumor growth that is presumably behind all of this.

Thankfully, Dad has been transferred to a private room. The doctors no longer think that an MRI is necessary, but the ear, nose and throat specialist is checking him out now.

More soon. Please continue to pray for Dad's strength and spirits, as this is discouraging news for a very tired man. We'll keep you updated.

Saturday Morning

2009-04-25T09:52:00.002-04:00

They were able to fit Dad in for a CT scan last night, and it didn't show anything out of the ordinary, but the MRI, scheduled for today, should tell them more. They also expect a specialist to come look at his throat. Mom ended up coming home at about 1:30 last night because Dad was placed in a very small double room and there was no way she could sleep there. She's back at the hospital now; the rest of us will be visiting later in the day.

2009-04-24T23:26:00.002-04:00

E and I are just back from Penn. After a long sit in the ER waiting room, we were finally seen by an ER physician, who ordered some tests and conferred with the folks in oncology. They took blood for labs and tested Dad's coordination. They hope to get Dad in for an MRI tomorrow, to look for signs of the myeloma further up his spine and in his brain. For the past couple of days Dad has been exhibiting symptoms suggesting that the myeloma is advancing--extreme fatigue, disorientation, slurred speech, and trembling hands, as well as lack of appetite, gagging and difficulty swallowing.

When we left Dad was about to be placed in a room, though not in the oncology ward as we had hoped. Please pray that he will be transferred there, where "his" doctors and nurses are, as soon as possible, and that he would get a room where Mom can stay with him comfortably. She is spending the night with him tonight...accommodations dubious. Pray for her as well, as she assumes the bulk of the burden of caring for Dad and sees to it that he gets the treatment he needs and that he doesn't get lost in the swamp of red tape that is the hospital system.

The kids are having breakfast together tomorrow, and may all go see him later in the day. Pray that we would have wisdom and sensitivity as we try to minister to both of our parents, and that we would find a way to bless and encourage them as we remember these past 25 years together.

Down to HUP again

2009-04-24T16:47:00.002-04:00

My dad is currently in the ER at HUP, waiting to get admitted. Early this afternoon my dad was having difficulty swallowing, and he started to choke and gag. In addition, he was experiencing some slight tremors. After my mom spoke with the nurse practitioner, it was decided that my dad needed to come to the ER at HUP to get admitted so that they can figure out what is causing this choking and gagging. The nurse practitioner told my mom that it is possible that the cancer is now affecting my dad's spine or spinal fluid, and nervous system. To determine if and what is affecting my dad's spine, they need to do an MRI and some other tests. The nurse practioner told my mom that this is not uncommon and that if the tests confirm that the cancer is affecting my dad's spine, they are able to treat the spot on the spine directly with chemo. In addition to the choking, gagging, and tremors, my dad has had some periods of disorientation as well.

Please pray that my dad would get admitted to a room soon, and that the doctors would be able to run these tests and be able to determine, with real clarity, what is causing the choking and gagging for my dad, and, how to to treat it. Please also pray for stamina and strength for my dad as he undergoes these various tests, and for faith for him and my mom, and our entire family, as we walk through this valley.

We also received the news on the biopsy of my dad's liver today. The results came back positive for cancer in my dad's liver. While this is hard news to hear, we are thankful that the test results are clear and we can go in a new direction to fight this cancer. Hopefully, my dad will qualify for a clinical trial of a new chemo, since the chemo he is on is no longer working against the cancer.

More later, as we receive news. Thanks for praying!

Still waiting...

2009-04-23T12:07:00.002-04:00

...for biopsy results. Today Dad went to the hospital to get his blood checked, and again his levels were high enough that he didn't need a transfusion, so that is something to be thankful for.

Dad continues to be very weak and deeply fatigued. Please pray that he would be able to eat and sleep, and that he would have energy to spend time with the family this weekend. Christine, Erin and I are in town to visit (Katherine and Rusty come Saturday), and we'll be celebrating Mom and Dad's 25th anniversary.

Wednesday April 15

2009-04-15T17:17:00.002-04:00

Today Dad got a transfusion because his red blood count went below a certain level. Also, the doctor feels that his fatigue, fever, and weakness are being caused by the cancer since his protein levels have risen. This means that the current chemo is no longer working. He will have a biopsy of his liver either tomorrow or Friday to determine the nature of the questionable spots. Mom is staying in the room on a cot and going back to the house when she can, to do laundry, shop for supplies and bring in the mail.

Please continue to uphold both Mom and Dad in your prayers.

newsblip

2009-04-15T11:33:00.002-04:00

The news as of yesterday afternoon was that Dr. Stadtmauer wanted the radiologist at Penn to look more closely at Dad's MRI results before scheduling any biopsy.

Down to HUP

2009-04-14T09:23:00.002-04:00

Just wanted to dash off an update this AM. Mom and Dad were transferred down to the hospital at Penn last night via ambulance. The decision was made to postpone any biopsy until Dr. Stadtmauer and his team had a look at all the test results and could compare them to past tests. Mom was hoping to be able to spend the night there with Dad to be able to be there to talk with the doctors first thing in the morning. Dad is extremely fatigued and seems to have just a raft of aches, pains, symptoms and side effects. Please pray for relief and healing for him, and for strength and courage for both of them. They have had some visitors, which has been a blessing, and Nana (Dad's mom) has been faithfully visiting during this and Dad's other hospitalizations. Today is Mom's birthday, by the way. Please continue to pray for insight for the doctors. More later.

Easter

2009-04-13T09:02:00.003-04:00

Dad spent the weekend at Abington hospital, where the doctors have been trying to figure out the source and type of this latest infection. There's been a lot of testing and waiting for results. Still no word on Dad's protein levels from a couple of weeks ago; he's had blood transfusions as well as blood taken to do cultures to identify the nature of the infection. MRI, X-ray, ultrasound, PETscan. The doctors are still uncertain of what has been causing the fevers, sweats and fatigue, as well as the acute pain in his jaw and ear.

The most urgent issue at this point is the discovery via MRI of some lesions on Dad's liver and kidneys. There is a biopsy scheduled for 4 PM today. Mom says that there were some lesions in the area previously, and she has urged the doctors at Abington to get in touch with Stadtmauer down at Penn. She asks that we pray for this situation, that the chemo would continue to work, that advance of the myeloma would be stopped, and that these lesions, whatever they are, would be healed. She also asks that we pray that the communication between the doctors at Abington and those at Penn would be productive and unhampered by ego, and that their diagnosis and prescriptions would be accurate and effective.

A New Round

2009-04-10T06:51:00.002-04:00

This is just a quick update before I head off to the hospital. Roger was hospitalized Thursday afternoon for what may be another infection. Please pray for the doctors as they work to determine the cause and find an effective treatment for whatever is going on. We'll send updates as they come. (There's still no report from the lab on Roger's protein level from the April 1st appointment.) Thanks so much for your prayers.

Waiting for the results

2009-04-08T21:15:00.002-04:00

On April first Roger and I headed down to HUP for Roger's regularly scheduled monthly appointment with Dr. Stadtmauer. The antibiotic Roger had taken for the blood infection he caught two weeks prior had apparently worked, and he gave Roger a clean bill of health in that regard. Dr. Stadtmauer said he was "guardedly optimistic" about the efficacy of the new chemo regimen Roger has been on, but we would need to await the new protein level readings before he could be sure.
Well, as of this date, April eighth, the labs have still not sent their results to HUP, so we all continue to be in the dark as to what those levels are. The nurse practitioner who works with Dr. Stadtmauer has promised to call me as soon as they come in, and when I get the news I will be sure to post it.
This past week I landed a nasty four-day cold--but, thank the Lord, Roger amazingly did NOT catch it. However, yesterday Roger did spend the day at Abington Hospital getting transfused with two pints of blood. Not the best way to start a new April.
But as always we are encouraged when we see the little crocuses and daffodils with their cheery faces telling us Spring is really here. And this week, Holy Week, points our hearts to the true and eternal Spring, a new birth and new life through the death and resurrection of our Lord Jesus Christ. Thanks be to God for His inestimable gift! He is our source of hope in every circumstance.

Day Seven

2009-03-26T14:00:00.002-04:00

It's day seven on the new antibiotics that Roger was prescribed in the hospital, and we're so encouraged to report that he is not battling the fevers any more. We are very thankful that the meds have worked against the infection, but unfortunately it has had to come with a price: more stomach and fatigue issues on top of those he already has from the chemo meds.
So we're standin' in the need of prayer, as the old hymn puts it, and we have three main prayer requests: (1) that these side effects would dimish and be able to be controlled; (2) that Roger's body would begin producing enough red blood cells to eradicate the anemia that dogs him and deepens his fatigue; (3) and--BIG ONE--that our April 1st appointment with Dr. Stadtmauer would show that the chemo is making major inroads on the cancer and even eradicating it.
The Lord ministers to us daily through so many means: just the right Bible verse for a particular moment of struggle; the steaming dinner brought to our door; the loving acts of our brothers and sisters in Christ; the cards and visits/calls from family and friends. A challenge for us in all of this is that while we so miss interacting with you, our dear friends, the window of suffcient energy in any given day can be very small or even nonexistent at times. So please know that we love you and even when we don't see you, are blessed to pray for you even as you pray for us.
And we trust that the Lord will, in His good time, give us all a green, grassy meadow by the still waters on which we can lie on our backs, gaze up at the sky, chew a long stalk of grass, and talk and talk and laugh and talk till those cows come home. Till then, may our Lord our Shepherd help us walk by faith and not by sight.

Not-so-update

2009-03-23T12:13:00.003-04:00

Well, I'm sure most of you know this now, and I'm sorry for not posting sooner, but Dad came home from the hospital Thursday night, with a new antibiotic prescription. The lab results had come in, pinpointing the bacteria responsible for his infection and enabling the doctors to prescribe something specific. Last I heard, he was still feeling low, but glad to be home.

Update as of Wednesday Night

2009-03-19T12:18:00.003-04:00

I'll have more for you tonight or tomorrow morning, but in the meantime, there's not a ton to report, just that Dad is still in the hospital, where they are keeping the fever down, administering antibiotics, and waiting for the labs that will help them pinpoint the infection. His red blood cell count was low yesterday, for which he received a transfusion. Mom said he just feels very tired. She spent the afternoon at the hospital with him yesterday, after getting home at 5 AM and sleeping just a few hours. She's been fighting some kind of bug herself. Please pray for both of them, body and spirit.

The return of the fevers

2009-03-18T12:21:00.002-04:00

They're baaaack! Yes, this past weekend Roger's temperature began to rise bit by bit and by Monday morning we knew we had to call the doctor. Roger had had chills and sweats during the night and his temp was up to 101.9 in the morning. So we went down to HUP and blood samples and cultures were taken. His white blood count was high enough, however, that he did not need to be admitted. We were sent home with a strong antibiotic and told that when the cultures matured if there was any indication of a serious infection, they would contact us.
Well, the call came Tuesday evening when we found out that the cultures showed that Roger had a blood infection and needed to be admitted to the hospital immediately so they could begin an antibiotic drip. So we headed down to the ER, which is a story in itself, which I do not have the time to recount. But the basic situation now is that Roger will remain in the hospital on IV antibiotics for at least 3-4 days while the lab examines the cultures and waits for them to fully mature. Once they can zero in on the particular bacterium causing the problems, Dr. Stadtmauer can better prescribe the exact anitbiotic to deal with it. He is not sure what may have caused this problem--it's pretty hard to be exact on these things at times--but some suspicion is falling on the PICC line that has sat in Roger's arm for many months, through which he receives transfusions and chemo and has blood drawn. Although we and the visiting nurses take great care with it, all it takes is one stray little bug.
So we wait and take hope in the knowledge that our great and loving Lord is in this with us and is mighty to save. We are learning deeper and deeper lessons in that "walking by faith and not by sight" dynamic. With a condition so continually in your face as cancer, as a Christian you are thrust into a daily/hourly/minute-ly deeper learning of what "putting off" fear and "putting on" faith looks like in each particular moment, in each particular situation. And our good and faithful God, who is closer than a brother, is there with His arm around us pointing us to Jesus and to hope.
Thank you so much for prayerfully walking alongside us through this learning experience.
Karen

Thanks for your prayers

2009-03-13T15:57:00.002-04:00

God can answer prayers pretty smack-dab quickly when He chooses, and that that is just what happened yesterday. Instead of watching Roger's temperature rise steadily through the day, we first saw it stabilize and then actually fall in the evening hours, right at the time that it would have typically climbed! Thank you so much for praying.
Today Roger feels much better and we are convinced that he must have picked up one of the viruses floating around over the weekend. At times it is very difficult to distinguish the side effects of the chemo from the symptoms of a virus, but his chemo treatments do not usually cause fevers, so when he gets a temperature we know that something extra is happening.
As always, we are blessed to know how much you care and pray for us--we feel surrounded by a veritable army of angels. May the Lord watch over you today and encourage your hearts, as He has done for us through you.

The Latest, with an immediate prayer request

2009-03-12T13:06:00.003-04:00

Just got a call from Julie saying that Dad has a high fever. He's 1/10 of a degree away from the temperature at which the doctors say he needs to be admitted to the hospital (100.5). Please pray that the fever would abate and that his body would be able to fight off whatever likely infection he's picked up. (This sort of thing was anticipated by the doctors, given the effect of the chemo on one's immune system.)

Dad had an appointment at HUP last week. The good news was that there's been a slight drop in his protein levels, so the chemo has apparently begun to work. The bad news is that he was anemic and needed a blood transfusion, but again that was something the doctors anticipated, as a result of the chemo rather than of the cancer. In general, though, he's been feeling stronger and less worn out. This is most likely him coming out from under the radiation treatments, which were really wearing him down. Mom and Dad thank you all for holding them up in prayer. Please pray that the chemo would not only work but keep working against the myeloma. The tendency with the various chemotherapy concoctions is for them to work well for a while and eventually become ineffective. We're praying for as many months as we can get from this one!

Valentine's Day Pictures

2009-02-25T15:13:00.014-05:00

I thought I would add some pictures of our special Valentine's Day celebrations...

(Sorry Dad! This is the only picture I got of you, and you were blinking!)

Little Adrian crawled around, happy to be in the mix

Noah and Ellie play with their newest cousin

Ellie is the only kid who helped Katherine finish the job of making a fruit bouquet. The boys each did one and said adios!
We had a craft for the kids- making heart bags to hold their valentines. Even Kaelin and Juliana enjoyed the coloring

Since getting the family together becomes harder and harder, we finally had a chance to celebrate Sandy's birthday- 5 weeks late!

After a busy day, Kaelin was ready for her nap!

Mystery Sol-VED

2009-02-24T19:50:00.002-05:00

[Thanks to Bob and Claire Matthews for uncovering Mom's missing post, languishing in a new blog she inadvertently created while trying to post to this one. It seems the title was an old username or something that got typed into the wrong box...Anyway, usfolks thank you for your patience...]

Heading in to Valentine's Day weekend

On this Valentine's Day weekend, we send our love and appreciation to all of you who have supported us in love and prayers for so long. We thank God for you every day, but on the day of hearts and flowers, we want you to know how much you have encouraged and blessed our hearts.
Last year at this time, Roger was desperately ill, lying in one of the outpatient chemo rooms at HUP, receiving one of many 6-hour infusions of an experimental drug. This drug failed; ten days later he was admitted to the hospital and remained 22 days. Those were scary days, indeed.
Today, thank the Lord, Roger is taking his chemo at home instead of through IV drips at the hospital. Last year we were not sure he would see another February. Yesterday Roger insisted that we get into the car to go buy Valentine's flowers for me. When we arrived at our destination, he had no strength to actually go in to buy the flowers, so I did the deed. But how wonderful that we are together and we can still celebrate our love for each other on this earth. God is teaching us how to be truly grateful for every small thing--which is actually a very large thing.
Roger continues to be unsteady on his feet and quite weak and fatigued. Each day is different, and each day presents its own physical, emotional or spiritual challenges. But we can sense God's leading us, teaching us, challenging us, encouraging us--loving us--every single day. And we know that there is a purpose in every hardship He brings our way.
On Wednesday we saw Dr. Pinover, the radiation therapist. He was pleased to see that Roger is out of pain now, and we are continuing to reduce the amount of pain medication he is taking--it has to be done gradually. It seems that the radiation has done good work--Hallelujah! On Monday the 16th we head down to HUP to see Dr. Stadtmauer, who will weigh in on how he feels the chemo is working on the cancer. We do expect that Roger will be needing one or more transfusions soon--low blood counts are a part of this chemo's side effects.
We as a family are celebrating this weekend--our daugheter Julie, who lives in Texas with her husband and six children, is coming up to spend the weekend with her new baby (Adrian, 7 months old)! We have not seen her since last year at this time, so it will be wonderful to be together again and to meet our youngest grandchild. Unfortunately, Roger has not been well enough for us to make the trip down to Texas. Katherine and her family will be coming up from Virginia, so we will have five of the seven Clark children and their families with us, and that will be a treat.
We pray that you also will have a wonderful weekend with your loved ones. May God bless you greatly. Thank you again for your faithful prayers for us and our family.

2009-02-22T12:37:00.002-05:00

Dad went to see Dr. Stadtmauer on Monday, two weeks after starting on the new chemo. He had blood tests, for which we're still waiting for the results. The good news is that Dad's back pain has subsided, which seems to indicate that the radiation has shrunk the tumors there. This means that he can be weaned off the steroids and the oxycontin now, itself a good thing because the doctors believe Dad has developed some steroid toxicity, the probable cause of his muscle weakness and some of his difficulty in climbing stairs and the like. Dad continues to have the weakness in his foot, though, and to use a cane to help him get around. Dr. Pinover, the radiologist, believes that this may be a permanent problem, a result of damage done either by the radiation or by the tumors themselves.

Thanks as always to everyone for your prayers and sympathy. I will update you with the blood test results when I hear them. Mom spent an hour and a half last week writing up a blog post, which subsequently went MIA in the internet ether. Discouraging, but she promises to try again when she gets a chance. Toodles.

The New Game Plan

2009-02-03T12:16:00.003-05:00

Dr. Stadtmauer has started Dad on a new course of chemo. It's a combination of two new drugs, which, if they work, will start to show results in two or three months, and another, which Dad has taken before and which should start working sooner. The doctor chose this particular chemo cocktail from several options, any of which he feels has a 50-50 chance of being effective. At this stage, the options are fewer. There is still the possibility of a second stem-cell transplant; this would depend on whether or not the current chemo is effective, and whether Dad is healthy enough to withstand it.

There's been some further elevation in Dad's protein levels (.8), but still nowhere near the highly elevated numbers of last winter/spring, so it's not as bad as it's been before. One prominent side effect of this new chemo regimen is lowered blood counts, both red and white. This means that Dad will be weaker and subject to infection. Please pray that he will be protected from the many outside pathogens as these drugs fight the cancer. Please continue to pray that the radiation would show good results with the tumors in his back. Pray for Dad's energy and spirits, as he continues to deal with the weakness in his foot and and intense fatigue.

Both Mom and Dad are grateful for all your prayers and acts of kindness, even though they are unable to respond personally to every one of you, as they wish they could. Both say they feel upheld by the prayers of the saints, and that God has been close to them in yet a new and deeper way over the past couple of months. They continue to wrestle with the Lord to find and accept his will for them in this, and to find the right way to live through this passage, one way or another, honestly and faithfully.

2009-01-29T13:19:00.002-05:00

Mom and Dad meet with Dr. Stadtmauer today to determine what to do next. Tomorrow will be the last of the radiation treatments aimed at the large tumor around his spine. Dad is still dealing with pain, as well as the weakness/numbness in his foot. He's walking with the assistance of a cane, and basically just needs to be extra careful as he moves around. Our prayer now is that Stadtmauer and his team will have wisdom and insight in assessing Dad's situation and deciding on treatment. For the pray-ers among you, please pray too that the radiation would shrink the tumor, and that Dad would recover full functionality in his foot. Thanks to all of you for supporting Dad, Mom and the rest of us during this time.

2009-01-25T11:00:00.002-05:00

A quick note: I didn't get a chance to add this yesterday, but Dad came home from the hospital yesterday morning. The doctors determined from the MRI that there seemed to be no growth in the tumor causing any spinal cord compression. They're not sure what would have cause the lack of feeling and weakness in Dad's leg, but it may be a side effect of the steroids.
Dad will continue with the radiation this week, and see Stadtmauer Thursday to decide on the next course of action.
Sorry so rushed--
-A

2009-01-24T11:17:00.004-05:00

Dad was admitted to HUP yesterday evening. He and Mom initially went in to Abington because he was experiencing weakness and loss of sensation in his leg. They took an emergency MRI at Abington before the decision was made to transfer him down to HUP via ambulance. It does appear that this is the result of the tumor's pressure on the spine, though it could well have to do with the radiation on that area itself. We can only pray that the tumor will begin to respond the radiation by shrinking, and that any nerve damage would be temporary. Thanks to everyone for persevering with Dad in this. More later.

2009-01-22T10:46:00.002-05:00

Dear All,
This is Karen signing in, with an update on the past few days. First, Roger and I want to thank every one of you for your prayers, blog comments, e-mails and hugs. You are a very real part of God's blessing toward us during this time.
These last several months have been challenging, and, yes, difficult, on many levels, both medical and spiritual; but there has been a true "good"-ness to this time. It is difficult but deeply good to experience God's soul-searching, wrenching, purifying work in our hearts. Step by halting step we ask Him to help us to trust Him as He roots our faith and hope more fully in Him alone. We are thankful that our Lord does not settle for superficial faith in those He loves, but instead--holding tightly every hand-- leads with such care along the path that is "further up and further in."
As Andrew reported last week, Roger began radiation therapy immediately upon being discharged from HUP. He has received five treatments thus far, and will be finished by next Wednesday. We are encouraged that the pain in his back is lessening, and so far, side effects from the radiation have not been extreme. Of course, we are only half-way through and side effects are cumulative, so please continue to pray that the radiation will not adversely affect the spinal cord and that Roger will continue to tolerate the radiation well.
Next week is our appointment with Dr. Stadtmauer to decide on the next phase of systemic treatment of the cancer. We thank the Lord for this dedicated oncologist who for the past 6 1/2 years has used his skill and expertise to fight Roger's myeloma. We pray often for him, not just in relation to Roger's treatment, but also that God would bless his life in every way. As a matter of fact, through our experience and that of many others, many health professionals are daily lifted before God's throne in prayer--who knows what the Lord will do in their lives as a result?
May the Lord bless you and those you love greatly today. Thank you again for your prayers for us.

2009-01-16T09:41:00.004-05:00

Dad was home from the hospital last night. The decision was made to send him back for another round of radiation with Dr. Pinover, 10 visits, aimed at the new tumor. Though this area was radiated awhile back, the doctors believe it can take more. It seems there's really no alternative, since they believe that--on account of previous radiation--the tissues in this area wouldn't be able to heal were they to perform surgery to remove the tumor. In the meantime, the fear is that Dad could sustain neurological damage on account of the tumor's location on Dad's spine. During the hospital stay, the doctors were frequently coming around to test Dad's reflexes from head to toe; the good news is that he's been spared any paralysis or other loss of function due to this growth thus far. And while further radiation carries a small risk, ironically, of nerve damage, the risk of leaving this tumor to grow unchecked is obviously far greater.

So: Dad starts radiation at Abington right away, today, and in two weeks will go back to Penn to see Stadtmauer, who has two different possible chemo regimens in mind for him. If the tumors respond to the radiation, the hope is that chemo can then once again slow or halt the attack of the myeloma.

Mom and Dad thank all of you for your prayers and encouragement, and are sorry not to be able to communicate with each of you individually. Dad said that during this hospital visit he felt sustained by the many prayers being sent up on his behalf. Please continue to pray that both he and Mom would have the physical and emotional resources to keep on keeping on through what has become a grueling phase in this battle. Pray that the one-two combination of radiation and chemo will knock the cancer back before it reaches that truly critical phase when the protein levels shoot up and the blood levels--hemoglobin, platelet, red and white blood cell counts--start to really drop. Pray that Dad would be clear-eyed and courageous, as well as sensitive and open to the good that God has for him in this.

I was thinking about all this this morning, and remembered this passage from Philippians. Paul's chains are not only literal: to live at all on earth is to be chained, to be manacled to a body that inevitably suffers and decays. To know Christ is to be subject to a complicated double longing: one is the desire to endure chains, to live, for the benefit of others and so that "in every way...Christ is preached"; the other is to have the chains loosed, to be free of the body and be with Jesus, which is "better by far."

"Yes, and I will continue to rejoice, for I know that through your prayers and the help given by the Spirit of Jesus Christ, what has happened to me will turn out for my deliverance. I eagerly expect and hope that I will in no way be ashamed, but will have sufficient courage so that now as always Christ will be exalted in my body, whether by life or by death. For to me, to live is Christ and to die is gain. If I am to go on living in the body, this will mean fruitful labor for me. Yet what shall I choose? I do not know! I am torn between the two: I desire to depart and be with Christ, which is better by far; but it is more necessary for you that I remain in the body. Convinced of this, I know that I will remain, and I will continue with all of you for your progress and joy in the faith, so that through my being with you again your joy in Christ Jesus will overflow on account of me."

I know that so much of what is keeping Dad here, enchained to a dying body, is his love for Mom, and his mother, brothers, sister, children and grandchildren. But of course the timing isn't his to determine, and our prayer is that he will be ready and joyful when the time comes, ready to relinquish the one love, and its labors, and to embrace the other, better by far.

MRI results

2009-01-15T11:40:00.004-05:00

Just wanted to let you all know that Dad got the MRI, and it revealed that there is a new, large tumor growing around his spine. This is more or less confirmation of what Dad and the doctors suspected, given the new and different pain he's been having. They meet with Stadtmauer today to decide on a course of action.

Dad has asked for prayer for faith in the face of this discouraging news, that he and Mom would be able to trust God and find his will in all of this. Please pray, too, for the continuing pain, which has been difficult for the doctors to control.

Sorry so little; you'll know more when I do.

2009-01-13T17:10:00.003-05:00

Turns out they couldn't fit Dad in for an MRI last night, which means he may have to wait until tomorrow. He expects to spend at least another night in the hospital. Our prayer is that the MRI would provide the doctors with a clear indication of where this new pain is coming from, and of what the status of the old tumors is. It's apparently too soon to see the full effect of the radiation, which Dad completed last week, but hopefully the old tumors have begun to shrink. We still hope that the doctors will be able to formulate a new chemo strategy for Dad in light of the recent setbacks. On the upside, last week's blood tests indicated that Dad's white and red blood cell numbers are at good levels, so at least his body is still functioning there.

2009-01-12T23:05:00.003-05:00

Dad was admitted to HUP today. Last night he was up with intense pain in a new area of his back, and the doctors recommended he come in. They took an EKG, as well as a chest X-ray, to see if his heart and lungs have been affected. He's scheduled for an MRI. We'll know more tomorrow, but for now the pain is under control.

Dad is spending the night at the hospital. I will post more after I talk with my parents in the morning. Thanks for checking in.

New Year News

2009-01-07T21:13:00.004-05:00

Dad has his three final radiation treatments this week, and a new dose of steroids. He is still dealing with a lot of pain and discomfort in his trunk and lower back, and has been feeling increased fatigue. He's starting to have difficulty with the stairs in the house again, which means his blood counts may be dropping. Those numbers also come in this week. Mom and Dad will be meeting with Dr. Stadtmauer mid-January to assess his situation and to formulate a new treatment strategy. Thanks for checking in, and for praying. Please pray especially that the radiation will significantly reduce the size of the tumors, and that the doctors will be able to find the right combination of measures to beat back the cancer once again. Pray that Dad will be able to sleep regularly at night and have relief from the pain that he's been facing for over a month now. Pray that he would be encouraged and that both he and Mom would be able to experience joy in and through this suffering.

In fact, the Christmas holiday at the Clarks was one of much joy and general goofiness, with many little grandchildren keeping things lively, and Mom and Dad and Erin and their helpers cooking up numerous culinary storms. It was so great to be home, and Dad was very much present throughout the week, and was in fact able to participate in the family festivities far more than last year, when his situation was becoming so dire. After such a difficult and uncertain year for Dad, this Christmas was a precious gift to all of us.

Radiation therapy begins this week

2008-12-21T19:45:00.003-05:00

On Wednesday, Dec. 17th, Roger and I met with Dr. Pinover and the radiation team. They "tattooed" Roger with marks on his trunk which will guide them in their precision radiation. On Monday, Tuesday and Wednesday this coming week he will be receiving the radiation and we hope his severe back pain will soon be relieved. They will be targeting the tumor on his lumbar spine as well as several lesions on his sacrum that showed up on that second set of MRIs taken 1 1/2 weeks ago. This treatment is extremely delicate and potentially dangerous to Roger's spine and spinal cord. We continue to ask for your prayers for the Lord's protection against the harmful side effects and that He would enable the radiation to indeed fully zap the tumor and lesions. After Christmas the radiation will continue; we don't know the schedule just yet.
We are in the midst of all of the craziness that this time of year brings, preparing to celebrate Christmas with five of our seven children and their families. Two groups are traveling in from out of state: Andrew and Erin arrived from Chicago yesterday and Katherine and Rusty and their two children will travel from Virginia on Christmas day. Our children have been wonderful encouragers, supporters and prayer partners through the years of Roger's myeloma; it is a precious gift to be able to celebrate another Christmas surrounded by our large family, whether we are physically together or not.
This week we all lost a family member with has been with us for 18 1/2 years: our ancient little cat Shadow (known affectionately as Foop). This has been hardest for Roger, Cara and me, since we are the three who have been closest to her in recent years. Her going reminds us once again of the brevity of life and the ache of losing a loved one (and it's amazing how much you can love one of the furry variety).
It again brings us to remember that this life is but a brief prelude to the next, everlasting one. So thank the Lord for the joy of Christmas--the Hope of redemption from this fallen world through our dear Saviour, Jesus Christ. Roger and I and our family cling more tightly each year to the promise of our eternal home with the God who loves us and will take us to be with Him forever. (And I, along with Roger and C.S. Lewis--good company--are convinced that the Lord will spread His arms to include our animal friends there as well.)
Thank you for your prayers for Roger this coming week.
We pray for you for a Christmas full of joy.

A full week

2008-12-13T11:47:00.002-05:00

Well, it's Saturday and we have just finished a full week. Every day but Monday saw us at some type of medical appointment. After seeing Dr. Pinover on Tuesday, we drove down to HUP for our appointment with Dr. Stadtmauer. He confirmed that Roger would have to begin a different chemo regimen since the other has stopped working. He also began him on another four-day course of steroids for an immediate shrinking of the tumor (and lessening of pain), but that is a stop-gap until the radiation treatment will begin. The presence of tumors shows that the cancer is not contained; the protein level reading--which should be available early next week--will tell us how much the cancer has advanced from its low point while the chemo was working. If the number is at an "acceptable" level, and everything appears stable for the next six weeks, Dr. Stadtmauer will see us in January to begin the new chemo treatment.
On Thursday night an MRI was taken of Roger's sacrum, which Dr. Pinover will review for tumors before he begins the radiation. On Friday Roger's orthopedist checked out his shoulder (where he has had pain for several months), and declared that the PT regimen he's following seems to be doing some good. Our next doctor's appointment is with Dr. Pinover on Wednesday, when Roger will get a CT scan and be prepped for the two-week course of radiation, which we hope will begin in the next couple of days.
So it has been a full week, a bit tiring for us, but full of reminders from the Lord of His closeness and His loving care. We enjoyed a wonderful pastoral visit on Thursday by Terry Traylor and Marc Davis from New Life Glenside; the messages we have received from you via e-mail, cards and phone calls have truly encouraged us. Thank you so much for your love and prayers.
We do ask for prayer that the radiation would totally eradicate ALL vestiges of the tumor and that it would not injure the spinal cord, which could result in very serious complications, including paralysis. It is an extremely delicate procedure, especially since Roger has been radiated in this area before. We even dare to ask for prayer that the cancer would not progress quickly and Roger could have several months off the chemo (even full remission)! God tells us to pray big prayers. But we know that God's will is perfect even when we do not understand it, so our prayer is always that we will fully receive all that He gives us with trusting hearts.
May the Lord bless you all this week of the Advent season as we meditate on the coming of our Saviour.

Meeting with the radiologist

2008-12-09T21:26:00.003-05:00

Today we had our long-awaited appointment with Dr. Pinover, our radiologist. As he examined Roger, the location of Roger's pain had him a bit puzzled: it was lower than he would have expected from the location of the tumors on the MRI. So before he initiates any radiation, he wants to have an MRI done of the sacrum, (the lowest part of the backbone) to make sure that there are no tumors there which might be causing this pain. This of course delays the start of any radiation, so it's a bit discouraging, but we really appreciate the fact that this underscores Dr. Pinover's measured thoroughness. The good news is that he fit in a CT simulation for Wednesday (17th), which is the workup ncessary for the radiation.
Tomorrow we wend our way down to HUP to see Dr. Stadtmauer, and discuss with him all of the happenings since our last visit in October--and there have been plenty. The blood tests taken will show if Roger's protein levels have changed, as sure sign that the cancer is progressing, but we will not get those results immediately. The question on our minds is just what Dr. Stadtmauer will decide to do about the chemo regimen Roger has been on since June.
Please pray for much wisdom for him, for faith and trust for us, and for Roger right now, who is experiencing more pain and will probably have to go onto the steroids again tomorrow morning.
Thank you, Jesus, that you are with us through every changed schedule and bend in the road.

Pursuing radiation

2008-12-04T10:21:00.002-05:00

Last Thursday the family celebrated a large (27 people) and meaningful Thanksgiving Day. We are so thankful to God for our family and for His leading and care for us all, as He guides us through this maze that is the cancer experience.
Through fits and starts, on Monday we were able to get Roger's MRI's to Dr. Pinover at Abington Hospital for him to review in order to see if radiation is possible on the tumors on Roger's backbone. Dr. Pinover is the oncologic radiologist who radiated Roger's tumors in 2004, so he is the one who can tell if he has radiated these exact spots before. Standard protocol is that if the spot has received radiation,already, that's it; too much incurs damage to the structure you're trying to save/protect.
Dr. Pinover was finally able to do his review yesterday (Wednesday), and called us from his home last night to give us his analysis. One of the tumors IS in the same spot as before. Not good. However, he said that he feels he can figure out a way to do the radiation anyway. Good! Because myeloma tumors require less actual radiation to treat them--they are filled with blood and are not the "solid" tumors of other cancers--he believes that the amount he used the first time and the amount he will use this time will allow him to go ahead with the procedure. Thank the Lord!!! This is a direct answer to all of our prayers.
We do have another hurdle, which we ask you to pray for. Dr. Pinover said that the radiation schedule is so filled up that his scheduling secretary is sure to put Roger in for January. This is just too long to wait, which he acknowledged. I spoke with the secretary this morning and she said she would speak with the doctor about what to do and when. Please pray that all of the preliminary procedures and the actual radiation can be done in December.
Roger is again experiencing pain from the tumors, which began this time right after the second round of steroids finished, so we know the cancer is becoming more aggressive. He is also quite weak and easily fatigued. This is discouraging. But I must say that when we get to a place where we are beyond our own strength, the Lord provides a Bible passage, a phone call or card, a visit, or just the direct prompting of His Holy Spirit to encourage us and remind us of His love and care--and that whatever happens, He has it all under His control. Thank you for praying with us and for us. Your prayers continue to be deep and real blessings through which God is working in our lives.
May you have a blessed week as you prepare for Christmas.

2008-11-25T12:23:00.005-05:00

The MRI results came in at the end of last week, and did show that there are two tumors growing in Dad's lower back. The plan is, basically, to continue the steroids in an effort to shrink them, and to continue with the chemo. The nurse practitioner said that these new growths did not appear to be in quite the same places as the tumors Dad has had in the area before, which would mean that they might be able to use radiation on them if necessary (since radiation of this type and in this area is so destructive to the surrounding tissue as to be a one-time fix).

Hopefully Mom and Dad will be able to talk with Dr. Stadtmauer about what the growth of these tumors means, given that the chemo had been keeping the protein levels so low. The NP said something to indicate that the chemo Dad is on does not specifically combat the growth of tumors. So at this point we're trying figure out where that leaves us: does this mean that at this point the cancer remains stronger than we thought? What does the tumor growth tell us about the cancer's status that the protein levels do not? Apparently the thanksgiving week is not a good one for getting questions answered at the hospital, but we hope to know more soon.

So, a setback. A reminder that this fight is an ongoing one. Thanks for checking in.

2008-11-15T12:31:00.002-05:00

...Dad started on the steroids yesterday morning and by the end of the day was already reporting a great reduction in the pain. The MRI's scheduled for Monday night. Please play that he will be able to sleep. He's exhausted, but the 'roids have him all hopped up.

Update:

2008-11-14T09:23:00.004-05:00

Mom and Dad did speak to the folks at HUP on Wednesday, and the decision was made to put Dad on a five-day course of steroids. These have shown some success with shrinking Dad's tumors in the past, and the hope is that they will go to work on whatever lesions might be growing in his back, until the MRI can be be done on Monday. Thanks to the responsiveness of Dad's nurse practitioners and doctors, we can now be confident that something is being done about this new develoment while we wait for the chemo to be completed. Dad continues to take the oxycondone for the pain. Thanks to all of you for your emails and comments, and for your renewed prayers. More when I know more...

2008-11-11T21:23:00.004-05:00

Hard to believe it's been another two months since our last post. I'm on here tonight to ask for your prayers about a recent development in Dad's situation. Dad has moved to a six-week chemo cycle, and is on the drip this week. His protein levels are still low (up a tiny bit from .1 to .2, but the doctor is unconcerned by this relatively small variance) and all signs are that the chemo has continued to be effective.

For the past few days, though, Dad has been experiencing gradually increasing pain in his lower back, pain reminiscent of that which, in the past, first indicated the growth of tumors along his spine. Yesterday the pain was particularly intense, and still worse today. He and Mom spoke to the nurse practitioner at Penn in the hopes of scheduling an MRI, but were told that since chemotherapy and MRIs can't be mixed, and the chemo is being administered this week, the earliest he could have the scan done would be Monday. She prescribed some oxycondone for the pain, which has helped but not solved the problem.

At this point Mom and Dad intend to call Penn again tomorrow and see if the MRI can't be moved up, and the chemo suspended if necessary, because Dad isn't sure he can push through until Monday. And if the tumors are back, then a few days' jump on any new treatment strategy might be beneficial. Please pray that the staff at HUP would be sensitive to Dad's situation and discern the wisest way to proceed. Pray for relief from the pain, and that the growth of any tumors would be halted. You may remember that Dad had some tumor growth this past winter, including along his ribs around his lungs. He was on steroids, in part to shrink the tumors, and this spring the doctors suggested that the lower protein levels and improved blood numbers, thanks to the chemo, were an indicator that the tumors also had subsided. The question now is whether the protein levels could be failing to register new tumor growth and the associated activity of the cancer, and whether the chemo is no longer working effectively against this particular manifestation of the disease.

...But that's really just anxious speculation from the non-professionals. Please pray for courage and faith for Dad and Mom, and for insight and inspiration for the doctors. Thanks as always for checking in. Mom and Dad and all of us have been grateful for these past few relatively good months and trust that God will continue to provide in every way for those to come.

Also Tuesday, September 9, 2008

2008-09-09T12:53:00.002-04:00

Well, Andrew has--with great patience and perseverance--just finished his instruction to a very tech-unsavvy mom. Thanks to his dogged determination to get me to this spot, here I--Karen-- am, actually onstage and ready to communicate! Thanks again, son. And we do have new news to communicate to all of you, our dear friends and family, who have been praying so faithfully for us for all of these months (and years).
Roger's latest visit to Dr. Stadtmauer's office was this past Wednesday, September 3. We returned from that visit at 7:00 p.m., just in time to attend the viewing of our dear friend, Nancy Macha, who had died of breast cancer five days before. Very sobering, indeed. In so many ways the Lord has shown us that it is He who ultimately determines our first breath and our last--and that truth has been our great comfort, as well.
A few minutes ago we spoke with Dr. Stadtmauer's office and received the report from the blood tests taken on Wednesday. The results show that Roger's protein levels are at a very low 0.1! This is actually the lowest level since his diagnosis six years ago, so this news is really encouraging and a cause for celebration--we are so very grateful.
The flip side to all of this is that the chemo and the additional meds Roger must take every day have very strong side effects, as Andrew indicates on his posting just below. Dr. Stadtmauer hopes to mitigate some of them by the tweaking of chemo schedules and meds over the next weeks/months. Please pray for the Lord's leading on this process.
Thank you again for your faithful prayers and love--you are a continual blessing to us.

September Update

2008-09-09T09:12:00.003-04:00

Thanks for being patient as these postings become fewer and further between. As you've probably deduced, this is a good sign. The cancer has been quiet, if not on retreat, and daily dispatches from the front would have been less than enthralling, the "front" having become more Korean DMZ than Omaha Beach.

Dad has been on a four-week cycle of the at-home chemo. While Erin and I were at 225 N. last week he was first hitting the bottom, then coming out, of the low phase following the chemo the previous week. He was extremely fatigued, struggling with the effects of the chemo and of the inevitable host of other meds, but over the course of our visit the color returned to his face, and he was able to participate a little more in the goings on. Dad and I built some shelving in the basement together, which was like old times.

This particular treatment has been more unpredictable and more taxing than Mom and Dad had expected, and Dad has had to bear up under many side effects, including intestinal unpleasantness, fevers, "chemo brain," and a deep, soul-penetrating weariness. On top of this, it has been very hard for him, and Mom, to see many friends and acquaintances also falling ill, often with other forms of cancer, with several dying in recent months. Last week Mom and Dad attended Nancy Macha's funeral, which was a moving experience for them, to state the obvious. (The Clarks are praying for you, Machas, as you grieve.) It is a paradoxical, profoundly "double" experience, facing suffering and death as a Christian. The pain and loss is real, all too real, but so is the promise.

All of which is to preface the good news, of which there are two parts: Dad's counts and levels are all in good places, with the proteins still at .2, which is a great number for a myeloma patient. This means the cancer is at bay, for now, and the chemo will be continued in an effort to keep it on its heels. The second positive development, given the difficulty of the current treatment, is that Dr. Stadtmauer decided last week, in response to Dad and Mom's hope, that it would be safe to extend Dad's cycle from four to six weeks, giving him two more weeks "off" after each dose, more time to recover and, hopefully, to enjoy some normalcy. Please pray that this regimen would be as effective against the myeloma while giving Dad and Mom more "quality" down time.

Thank you for praying. Mom and I are scheduled to have a blogging tutorial, so you should be hearing from her on here soon...but let's not count our chickens. Like the Boeing 787 and the full-service robot butler, this debut has oft been heralded, promised and hoped for, but, as yet...only...(*crickets*).

Taking Stock

2008-06-18T10:47:00.003-04:00

Very encouraging news from Dr. Stadtmauer on Monday. Dad's protein levels have dropped further (more so than after the previous stage of the chemo), down to .2, compared with the high of 3.8 about six months ago. Given that the protein levels are the most reliable indicator of the myeloma's activity, this is a great sign. Dad's platelets are also much improved, up to two hundred, which actually puts Dad in the "normal" range. To put this number in perspective: back in February and March Dad was struggling with single-digit platelet counts, with transfusions required just to get him up to the twenties.

So all of the lab numbers are heartening. The plan is still to go ahead with the Cytoxan (cyclophosphamide) treatment, starting this week or next, for 4 days every month, barring new developments. This chemo drug is one of the four he has been taking for the past months (the "C" in "CVAD"), and has shown good results as a "maintenance dose" chemo for myeloma patients. Dad is thankful to be spared the hospital routine with this treatment, as he can now be doped and monitored in the comfort of his own home.

Mom and Dad had a very nice, if hectic, Father's Day weekend with the family, and anticipate numerous visits from out-of-town family and friends this summer. Please pray for wisdom for them as they try to pace themselves and keep Dad healthy. Pray that Dad's immune system would maintain this new strength and not be overly compromised by the continued chemo. Pray that Dad would be protected from the short- and long-term side-effects of these drugs. And thank God for his mercies and grace over the past few months, as we thank him for all of you and for your many acts of love towards Dad, Mom and the whole family.

What's Next

2008-06-06T19:49:00.004-04:00

Hello all. Dad reports that he's recovering well from the latest chemo, still tired but feeling better than last week. He's been able to spend some time working in the garden with Mom, and he was talkative and chipper over the phone, too, all of which is encouraging.

At their visit earlier this week, Dr. Stadtmauer indicated that he wants to go in a new direction with Dad's treatment. While Dad and Mom had understood that he would start on a milder, oral chemo at this point, Dr. Stadtmauer has decided instead to proceed with one of the drugs from the CVAD regime Dad's been on, administered intravenously from a device worn around his waist--from the sound of it, sort of like one of those portable insulin pumps for diabetics. Kind of a chemo fanny pack. While you struggle actually to picture this, just note that it'll be a more aggressive chemo than the oral forms, but not requiring a hospital stay, for which we're grateful.

Please pray that Dad's newly won health will be preserved by these measures, and continue to thank God for the remarkable improvements in his condition over the past few months. We will keep you updated. We might ask you to pray as well for Nancy Macha, who, if you didn't know, is an old New Life friend also battling cancer. She and her husband Dan found out a couple of weeks ago that the cancer had metastasized to her liver. The situation is grave, and she is now on a very intense chemo regimen.

2008-05-26T13:43:00.004-04:00

Dad is scheduled to be discharged today. The latest lab reports are in, and his protein levels have continued to decline, though at a slower rate. Dr. Stadtmauer plans to see Dad again in three weeks, with the expectation that he'll be starting him on a less aggressive oral chemotherapy regimen, basically as maintenance dose to try and preserve the gains Dad's made.

Dad has been coping with various side effects for the past couple of days, but we're grateful that he's been spared some of the worst effects associated with this hardcore chemo, i.e. mouth sores, vomiting, and the like. Nurses from Penn will be visiting him at home this week to take blood and administer transfusions if necessary. His blood cell counts too have been much better than during the initial rounds of this chemo.

Thank you all for persevering in prayer for Dad. We thank God for answering those prayers so mercifully over the past few months.

Begin the Beguine

2008-05-22T12:36:00.003-04:00

We're just about dancing. Dad finally got a room at 7 last night, but unfortunately the doctor who would have ordered the chemo had gone home by then, so no drugs until today. The chemo recipe was sent to the lab by Dr Tsai at about 10:30 this morn, so hopefully the stuff'll be hooked up and dripping by mid-afternoon.

Dad has been feeling better the last couple of days--his birthday, by the way, was Monday--so perhaps the delay was for the best, allowing his condition to improve a little before he would be subject to more chemo. Thanks for your continued prayers and concern.

2008-05-21T10:26:00.002-04:00

Heard from Mom last night. Dad was scheduled to start the last round of this course of chemo yesterday, but he was told not to come in until he got a call from Penn informing him that they had a bed for him. The call never came, except, late in the day, to tell them that there was no room in the inn. Yet to hear the word for today, but please pray that Dad would get a bed. We'll keep you updated.

The Latest

2008-05-14T19:50:00.003-04:00

Please continue to pray for Dad as he prepares to go in for the last dose of this chemo next week. He has been feeling good overall, but is noticing the cumulative effect of all these chemicals on his body. His skin in particular has been painfully sensitive, and he's been subject to those chills again.

Mom and Dad got the word from Dr. Stadtmauer last week that he wants to proceed with another chemo course immediately following this one. This was somewhat discouraging for them, because they had been hoping that Dad would have a break from treatment, given how well this one has gone. But S-mauer said that because the cancer is now evidently at an advanced, aggressive stage, it is best to keep it back on its heels with continued chemo.

More updates to come. I'm still holding out hope that the old dinosaurs will get up on this thing and give you a firsthand report, so stay tuned. Maybe you can pray for that miracle, too.

A brief update:

2008-04-28T13:55:00.002-04:00

Dad returned home on Saturday, as planned. He's exhausted, but hasn't suffered any serious side-effects this time around. The most encouraging news is that the latest labs showed still lower protein levels, indicating that the chemo has been increasingly effective in fighting the cancer. These numbers are actually the lowest they've been in years, comparable to the protein levels following the stem cell transplant four (?) years ago.

Due to room renovations, Dad ended up in another one of those "luxury suites" for the latter part of the week. Marble sinks, walnut molding, the works. Everything but a Louis XV armoire and a bowling alley in the basement.

One more round to go, scheduled to begin three weeks from tomorrow.

Round 3

2008-04-24T14:12:00.005-04:00

Dad is back in the hospital this week for the latest chemo dose. His overall condition has continued to improve over the past three weeks--higher blood counts, lower protein levels--and he has had more energy and less discomfort.

Dad will likely be in the hospital until this Saturday night. He's been placed in a two-bed room this time around, which means that there is no space for Mom to stay overnight. But it's also a good sign, as it's because Dad's immune system is stronger that he's able to share a room.

The overall prayer request continues to be that the chemo would be effective in destroying the cancer cells without doing too much damage to Dad's organs and immune system. Mom has also asked for prayer for their interactions with Dad's roommate, that they would be able to be "light and life" to him.

As those of you who have been able to see or talk with Dad recently know, the difference between four months ago and now is like night and day. He is in every way stronger, more spirited, and simply more himself. We thank the Lord. This is more than we could have hoped for.

Prior to this latest hospital stay, Dad had been spending so much time in the garden that Mom had to struggle to keep him from over-exerting himself. But it has been such a pleasure for them to be able to enjoy the weather and the garden in springtime, especially a spring that Dad has said he didn't expect to see.

Thanks as ever for the prayers and support. More later.

2008-04-09T19:07:00.004-04:00

Dad reports that he's been feeling pretty good since leaving the hospital where he received the second round of chemotherapy. He has had to get a platelet transfusion, but in general he's been able to function better than he has in months. Mom and Dad's small group came over to the house Sunday morning, and they had a little home-church, Acts-style. This is the first time that Mom and Dad have been able to get together with this group since December, so it was a real blessing.

Thank you all for your continued prayers. Pray that this chemo would be effective in fighting back the myeloma. Thank God that Dad has been feeling better, that his "counts" are generally good, and that he has had less pain and discomfort. We are so grateful.

A more thorough report is, theoretically anyway, forthcoming.

2008-03-29T09:10:00.005-04:00

The lab report on Dad's protein levels is in, and the news is very encouraging. When Dad was admitted to the hospital in February, they were at 3.73; thanks to the chemo, they have dropped to .91. (Apparently, when a myeloma patient hits 1, doctors start treatment. So while this new count is not completely normal, it represents a huge improvement for Dad.)

Mom and Dad are back in their quasi-domestic routine at the hospital. Dad has decided to brave the hospital food (should you find yourself admitted to HUP, our man on the inside says take a pass on the collard greens). Dad sounds good, like his old self--really a world of difference from a month ago when he could hardly muster the energy to talk. He has started to feel the intestinal effects of the chemo, but nothing too extreme, and his spirits are good.

Even the climate has been home-y: the hospital room has been quite like 225 N Easton in winter (i.e., arctic). Now, Mom and Dad are not completely literal-minded about re-creating their home environment: they'd been turning the thermostat up, but to no avail. The heating vents were blowing super-chilled air, despite the thermostat reading 85 degrees. Dad had to wear a knit cap, ski goggles, and mittens (well, not mittens). Yesterday the maintenance guy came and said that, obviously, in order to get the thermostat to function, you have to turn the heat side down and turn the air conditioner side up to the desired temperature. Reason aside, the room has since become much more comfortable.

The plan is still to release Dad on Sunday. Thanks for checking in and praying. God hears.

another go 'round

2008-03-26T10:42:00.003-04:00

Dad left a characteristically to-the-point message on my phone last night: They're in the hospital and will be there until Sunday.

This is the second round of the CVAD chemotherapy, administered intravenously and accompanied by numerous other pharmaceutical cocktails and supplements. Please pray that this course of drugs will build on the gains that have been made over the last month. Pray that Dad's various blood counts, especially that of his white blood cells, will be at safe levels. Pray that he'll be safe from infection, and that he and Mom would have the strength to persevere, in faith, through another hospitalization.

Let me renew our thanks to everyone for your myriad expressions of love and support for Dad, Mom and the whole family. What a moving thing to know how well and widely Dad is loved!

Easter time with Dad

2008-03-23T21:08:00.007-04:00

It was a special treat to spend some brief but meaningful moments with Dad this Easter weekend. Here are a couple of photos:

Dad with Uncle Bill (visiting from France)

Mom & Dad joining us at the Marsh Easter gathering

Wednesday's Appointment, and a New Plan

2008-03-21T09:03:00.006-04:00

The report from the visit with Dr. Stadtmauer at Penn was good. He feels that the chemotherapy is working effectively against the myeloma. Dad's platelets have climbed up into the 80s, indicating that he really is producing his own. They've decided that Dad can stop his trips to Abington for transfusions, unless the blood drawn by the nurse who comes to the house indicates another drop. His hemoglobin (red blood cell) counts are also up, though his white blood cell count has stayed at the recently reduced level; the report on the protein levels is not yet out.

The new plan is for Dad to return to Penn on Tuesday for the next round of chemo. This is earlier than expected, so Mom and Dad will get less of a break, but the doc feels that it's best to get while the gettin's good--to capitalize on Dad's gains now.

Thank you for persevering in prayer for Dad. Please continue to pray that his white blood cell count would improve, and that he would be protected from infections over the next few days. Pray that Dad and Mom would have the endurance they need for this chemo marathon.

2008-03-18T09:38:00.006-04:00

Dad and Mom are so glad to be home. Thanks to all those who are bringing meals; Mom reports that it has been such a relief not to have to worry about dinner every night. Dad has been feeling pretty good for the last few days. Not exactly 100%, of course, but then compared to last time he was home, he feels like a million bucks. He has been to Abington for one transfusion so far, and will return today for another. Blood tests have shown an improvement in his red blood cell count, as well as--wonder of wonders--his platelet count. For the whole time he was in the hospital Dad needed daily, sometimes twice-daily transfusions just to keep his platelet numbers hovering, weakly, in the 20s (i.e. twenty-some thousand per tiny unit of blood). Two days ago it was 60, and while "normal" would be between 150 and 400, this represents a significant improvement for Dad, especially since for a while there his body was unable to maintain even those lower levels on its own. Thank the Lord: this is a specific answer to specific prayer.

Please continue to pray that these numbers would climb. An area of concern is Dad's white blood cell count, which had fallen as of that last blood check. Dad is going down to Penn tomorrow to see Dr. Stadtmauer and get a read on his protein levels, which, as many of you know, are a key indicator of the myeloma's activity. They will decide when to begin the next round of chemo. Stadtmauer will be away until the beginning of April, so Dad will be "off" at least until then.

Thanks for checking in. We'll keep you updated. I'm even going to try to get the Aged P's up on this thing (provided they have the energy), so stay tuned.

Home Again, Home Again, Jiggety Jig

2008-03-14T19:51:00.002-04:00

I talked to Mom this evening and she said that they were VERY happy to be home. She also said that Dad spent a couple of hours downstairs once they arrived, and ate dinner before going upstairs to collapse. She wanted to thank whoever left a meal tonight, it was such a blessing to have a dinner waiting for them when they walked through the door. She said they have been overwhelmed with thankfulness to everyone who has helped out, provided meals, sent cards and prayed for them.

Dad was discharged today after receiving two bags of platelets. A home nurse will be coming by this weekend to check up on him, and then on Monday he will go to Abington to receive his next transfusion. Their prayer requests for this weekend is for Dad's platelet levels to remain stable, and that there will be no episodes of bleeding.

Home again 2.0

2008-03-14T08:39:00.005-04:00

The present plan is to send Dad home this afternoon. He received a bag of platelets yesterday, and they're going to double-bag him today and hope that holds through the weekend. Whether or not his platelet production is going to recover is uncertain, but the doctors feel they can adequately monitor Dad's situation at home and bring him in for necessary transfusions as an outpatient.

Dad has been feeling pretty good, for the past couple of days going on walks around the ward, trying to get his strength back. Besides this platelet business, please pray that Dad and Mom will be able to enjoy their time at home, and be rejuvenated before they have to come back again in a couple of weeks for the next round of chemo.

2008-03-12T21:56:00.008-04:00

According to Dad's blood tests today, the transfusion he got yesterday made no real difference in his platelet count. It seems apparent that he is still not producing his own platelets. Dad, Mom and their doctors have decided to postpone his homegoing at least until tomorrow, but probably for longer. (The strategy today was to skip the transfusion to see if his numbers will actually drop.) Mom and Dad are disappointed, of course, but prefer to stay put until Dad is no longer dependent on daily blood refills. Please continue to pray that Dad's body would recover that platelet-producing function.

Incidentally, all of this blood comes from the Red Cross, where platelets in particular are often scarce. This is because they have a shorter shelf life than other blood components and are a small proportion of any given donation, so that one transfusion of platelets typically includes cells from 5 or more donors. If anyone is interested in in a direct, "tangible" way to help Dad and patients like him, you might consider donating blood. You can find a blood drive or donation center here.

Going Home (we think...)

2008-03-12T10:06:00.002-04:00

If all goes according to plan, Dad will be going home this afternoon. Monday night was fever-free again, though Dad had some difficulty sleeping. His white blood cell counts are continuing to recover, and the adjusted mix of antibiotics appears to be working against the staph infection without any further side effects. The platelets remain an issue of concern. It's still unclear whether Dad's body is producing its own in any significant number, since Dad has continued to receive daily transfusions, and when they tried holding off on the transfusion to see if the numbers would stay put or rise on their own, they just dropped further. But the doctors at this point believe that Dad can go home and return to the hospital for tranfusions two or three days a week, if necessary. The plan is for a nurse to come out to the house twice a week to draw blood for lab tests, and to schedule the transfusions accordingly. Of course, the more times a week Mom and Dad have to make the trek down to HUP for what often amounts to an 8 or 10 hour day, the less sense it makes for him to be home at all. There is some possibility that he will be able to recieve the transfusions at Abington Hospital; our prayer is that that would work and that the two hospitals will be able to cooperate in a timely and efficient manner.

Thank you all for the hundreds of prayers and other words and acts of love and concern for Dad during this hospitalization. By every measure, Dad is doing considerably better now than he was when he was admitted two and a half weeks ago. Given the extent of the myeloma's advance, as indicated by Dad's pre-chemo blood counts and the bone marrow biopsy, Dr. Stadtmauer has indicated that Dad will need to come back for another round of chemo at the end of the month. So we might pray now that Dad's recent gains will be preserved and increased by the next round.

2008-03-10T23:14:00.006-04:00

Last night was Dad's best night in a long time, since even before he was hospitalized. Every night for a couple of months now he has endured chills and sweats--he typically soaks through his pajamas, sheets, and the towels placed under him. But last night he slept through the night without any serious issues, and he was basically fever-free today. Add to this his slowly rising white blood cells counts, and tentative reports that his platelet count may be stabilizing, and you have a pretty good day for Dad. Mom reports that all the nurses have been commenting on how good Dad looks. Both Mom and Dad sound really upbeat, which is a great sign, too. They were actually able to relax--not merely to "rest," but to enjoy themselves, to have a bit of normalcy, a space to breathe, the wonderful sensation that they need not, right now, defend this particular inch of ground against the cancer. Dad did a few sudoku, Mom did some crossword puzzles. Dad was not hooked up to a single machine this afternoon. No, we're not out of the woods, but this was a kind of sunlit clearing. We are thankful to God that the fevers have, for now, left Dad, and his "vital signs" are good.

Yesterday evening before bed one of the nurses whom Mom and Dad have gotten to know came into the room and broke out into a gospel song for their benefit, and when she left Mom and Dad found themselves looking at each other in delight and gratitude.

Our hope now is that this progress will hold, and will be the pattern for the future. Our prayer continues to be that the chemo would be effective against the myeloma, and that Dad's blood counts would rise. The platelet numbers continue to be the most immediate concern; they seem to have stabilized but the prognosis remains uncertain. The doctors have suggested that, if the platelet situation proves stable, making the risk of more bleeding low enough, Dad could be released from the hospital in two or three days.

Mom and Dad wanted me to thank all of you, their brothers and sisters, and to tell you that the Lord is listening to your prayers.

Sunday

2008-03-09T20:56:00.005-04:00

Cara and I visited this afternoon, and not surprisingly were treated very hospitably by Mom despite her fatigue after another long night. Thankfully, her cold has greatly improved and, while Dad rested, Mom shared several tangible ways she saw the Lord’s sustaining grace carrying her throughout the morning. As always, her steadfast faith and encouraging spirit in the midst of this suffering really ministered to us.

In terms of Dad’s health, the good news is that his white blood cell count is starting to rise. He is, however, still experiencing chills and fevers several times a day and through the night.

Please pray:
1. that all of the blood counts (white, red & platelets) would rise. The platelet levels continue to be at the lowest level among the three.
2. that the doctors can identify all of the specific bacteria that are implicated in Dad’s fevers. They have pinpointed one and are tailoring the antibiotics accordingly. There is another bacteria that has not been fully identified.
3. for ongoing faith, perseverance and good rest for both Mom & Dad.

Thank you again for all of your support expressed in your blog postings, cards, practical help and prayer. Mom & Dad feel so loved and blessed by you all.

Saturday Afternoon

2008-03-08T19:40:00.003-05:00

Mom wanted me to pass along the word that Dad's latest fever has broken. This afternoon he had been struggling with chills, sleeping fitfully. At one point he woke up and said he wanted to go for a walk. They took his temp and it was down to 98, and he and Mom walked around the floor while the nurse changed his sweat-soaked sheets. This was a small moment of reprieve for Dad and Mom, an answer to prayer.

Saturday Midday

2008-03-08T15:08:00.003-05:00

Last night and today Dad has had a 103-degree fever. Thankfully a chest MRI they took last night came out more or less clear. The fever is consistent with the chemo, so nothing too out of the ordinary, but please pray that it would be brought under control and that Mom and Dad would continue to be sustained and encouraged.

Sat Morn

2008-03-08T08:37:00.006-05:00

Dad has clearly entered that 7-10-day-after-chemo period where he feels, and is, the most wiped-out. For the past couple of days Dad has continued to struggle with a fever and its effects, especially chills and sweats. The fever seems to be due both to the sinus infection and to the daily transfusions he's been getting, to which his body often reacts as a foreign substance. One "bag" of platelets may have blood cells from five different donors, some of which will be less closely matched to Dad than others. It is the classic cancer scenario, isn't it? Battling the host of baby or pseudo- "cancers" caused not by the actual cancer but, precisely, by our best efforts against it. Medicines levied against medicines, the side-effects shuffle. That which we hope will cure us may yet kill us.

Dad has continued to struggle with headaches from the sinusitis, and his nights have been difficult, while he sleeps through most of the day. I spoke with him briefly last night and he sounded, to be frank, utterly low and exhausted. But his characteristic pragmatism, and courage, remained. Not a trace of complaint. In fact, Mom has said that it is sometimes hard for her and the nurses to know what Dad needs, because he doesn't complain. At its best, suffering is this sort of refining fire, in which the incidental and inessential are burned off, and the essentials of character emerge hardened, clarified, and in relief.

2008-03-07T21:56:00.005-05:00

I was talking with Mom yesterday and she shared a story with me of God's faithfulness, and special care for her. On Wednesday, when things were so uncertain and the outlook so grim Mom was feeling especially vulnerable and alone. Dad was going to be going in to see the ENT specialist, and if he required emergency surgery, she would have no one by her side to pray with her as she waited. She just prayed to the Lord for his presence.
The orderly who came to wheel Dad down to the clinic immediately started a conversation with Mom and Dad. Within a couple of sentences it became clear that he too was a Christian. For the 10 minutes that it took to walk down he quoted scripture to them and just encouraged them in such a way that they felt the arms of God were wrapped around them. And then of course, the result of the examination was that the infection wasn't fungal, so my mom ended up not having to sit alone through the surgery.
My mom said that this was just one example of the way God has provided people each day they have been there who have either been Christians, or who have taken special interest in Dad. They have expressed repeated thankfulness that Susie is on the nursing team, and it is such a blessing for them to see her, and also the way her family has shown their love to Dad and Mom in this time. Even today Mom had to be away from the hospital for a period of time to go home and replenish supplies. It is hard for Dad when she is gone, but he had a special nurse who was very kind and attentive to his needs, and was able to care for him while Mom was away. These are just a couple of specific ways that they have been encouraged through this trial, and I know that each and every comment they get here is a blessing to them, and a way that you too, are God's arms of love around them.

Friday Morning

2008-03-07T10:19:00.004-05:00

It turns out that Dad's infection is a staph infection, which is a bit more serious than previously thought, and will require a stiffer antibiotic regimen. Please pray that Dad will be able to hold up under both the illness and the cure here--which is of course our general petition in all this: that Dad's cancer would be defeated, and that the he would be able to endure the treatment.

His blood counts are still sliding. The platelets continue to be a big concern, and he received yet another transfusion yesterday. His white blood cell numbers are also extremely low--he is in fact just about neutropenic. The prayer is for protection against other infections now that his immune system is essentially non-existent.

The plan is for Roger and Karen to remain at the hospital through the weekend, so that the doctors can continue to monitor this infection and Dad's blood situation. Mom has full-blown cold now; the hope is that she will recover quickly and not pass it along to Dad. Both of them are obviously exhausted at this point. Pray for the deepest possible rest and for a special grace to uplift them.

Let me renew our thanks to all of you for your prayers, help and love. My parents have been sustained and heartened by it.

Briefly,

2008-03-06T11:44:00.002-05:00

Dad had a test for the flu yesterday, which, thankfully, came out negative.

Mom has been fighting a cold. Please pray that she would kick it, and that Dad wouldn't get it.

Our main prayer continues to be that the chemo would effectively destroy the myeloma cells and that Dad would recover the ability to produce his own blood cells. Pray also that the antibiotics would effectively combat the sinus infection.

More tonight...

Good News!

2008-03-05T17:14:00.002-05:00

Mom & Dad just returned from their visit to the ear, nose, and throat doctor at HuP. When they cleared out Dad's nasal cavities, they found no evidence of a fungal infection. His sinuses are inflamed & swollen, but fortunately can be treated with antibiotics, a far more desirable option than emergency surgery!

Dad is now resting, and he also went for a stretch of time today at a lower, more stable body temperature (he's had periods where he runs at a higher level).

Praise the Lord; Mom wanted us to convey her thanks and encourage you to keep the prayer support coming!

Some pictures to share...

2008-03-05T13:16:00.007-05:00

Here are a couple pictures I thought you might enjoy of my parents and some of our family, this past October, at my cousin Megan's wedding reception. The reception was at Normandy Farms in Blue Bell. It was great to see both of my parents so relaxed and happy and my dad had enough energy to last through most of the night, with some energy to spare for dancing!!

2008-03-05T13:12:00.002-05:00

I forgot to mention a couple things that we can be thankful for:

1. My dad is now free from his excruciating back pain due to the various painkillers he is on that are able to properly target the pain.

2. The doctors thought to do a catscan which found the sinusitis, so now they can determine how to treat it, once they figure out what kind of sinusitis it is.

3. The support and love of our many friends and extended family during this time. It really does mean a lot.

THANKS!

2008-03-04T22:51:00.006-05:00

Today was a hard day for my dad. He had a high fever during the day and his platelet count was still very low, so he received two bags of platelets. Due to my dad's repeated battles with fevers, the doctor decided to do a catscan to determine what might be causing the fevers.

The catscan came back positive for sinusitis. The "good" news is that one kind of sinusitis is a lot less serious than the other. Bacterial sinusitis is the less serious kind of sinusitis and may only require antibiotics. The "bad" news is that the other kind of sinusitis, Fungal sinusitis, is more serious than Bacterial sinusitis, and could require surgery. The doctor told my mom that if my dad has Fungal sinusitis, it is an emergency situation. At this time, we still do not know what kind of sinusitis my dad has.

So, the ear nose and throat doctor came to my dad's room tonight to see if he could determine what kind of sinusitis my dad has. He stuck a probe up my dad's nose, but because my dad has had repeated nosebleeds and the nose pack [technical term?] was in his nose before they did the probe, there was "crusting"in his sinuses and the doctor could not determine anything. Consequently, he decided to have my dad sleep in a vaporizing mist tent overnight to try and loosen up the dry patches, so that, come morning, he might be able to determine what kind of sinusitis my dad has.

Also, several patients in the cancer ward on the same floor that my dad is on, have the flu and because my mom has been spending virtually all of her time in the hospital, they are concerned about her contracting it and passing it on to dad. So, she is wearing a hospital gown and mask to prevent any kind of possible infection.

So, I guess you know how to pray - 1. that the vaporizing tent would loosen up the dried patches of blood so that the doctor can determine the kind of sinusitis, 2. that the sinusitis would be bacterial and not fungal, 3. that neither my mom or dad would contract the flu, 4. that if my dad does have fungal sinusitis, that the surgery would be successful and my dad would be sustained during it, and 5. that my parents would have a constant sense of peace from God as they anticipate this next cancer hurdle, and that we would know how to support and care for them in the best way, that would really be a blessing to them. Thanks for your support.

2008-03-03T18:49:00.003-05:00

Mom and Dad found out today that the doctors now want to keep them in the hospital at least until Wednesday (that's a de facto "them," as Mom has been living and sleeping there for the past 9 days). The doctors' most immediate concern continues to be Dad's low blood counts, especially the platelet numbers. Because of the recurring and persistent bleeding due to the low platelets, they are considering giving him a blood coagulant, but this would carry with it a risk of life-threatening blood clots. As it is, Dad has required daily, sometimes twice daily, transfusions, and it is hard to see the value in sending him home only to endure trips down to Penn every day, plus the risk of more nosebleeds that won't stop. So Mom and Dad are actually happy to stay put for the time being. Too, Dad's energy level is so low that a long trip home through the cold hardly sounds tempting.

The doctors are also concerned with the state of Dad's immune system as the cumulative effect of the chemo becomes increasingly manifest. (As I understand it, the expectation is that Dad's system will be at its weakest--and he'll feel the worst--about 7 days after the end(?) of the chemo--i.e. this weekend.) Dad has struggled with a low-grade fever for the past few days, and had another rough night last night with chills and sweats. A test for a urinary tract infection came out negative, thankfully; we are waiting for the results of a chest X-ray to check for signs of pneumonia, a particular danger for myeloma patients on chemo. Dad is already on a course of antibiotics as a preventative measure.

So. Please pray for wisdom for the doctors in deciding how to handle the platelet deficiency. Pray that Dad would be safe from blood clots if they decide to go ahead with the blood coagulant; regardless, pray that Dad's platelet count would stabilize and begin to climb. In general, our prayer is that all of Dad's blood counts--red blood cell, platelet, white blood cell--would rise--that is that Dad's body would again begin to make its own blood cells. Pray that Dad would be protected from infection on account of his weakened immune system.

Thanks for checking in.

Pictures

2008-03-03T09:53:00.006-05:00

Here are some pictures to supplement Julie's entry.

Dad with Mom

...and Nana

....and Julie

...and Katherine

Clark Cafe- "Can I offer you some more coffee? How about some scones? Wait! I have some donuts here, or maybe a muffin?"

Visiting from Texas

2008-03-02T21:42:00.014-05:00

First of all I want to thank God for making my visit to Philadelphia happen so quickly and smoothly. I was able to fly up on the red eye Friday. I visited with Dad and Karen a couple of hours then. I was also able to come back Saturday with my sister, Katherine, and Dad's Mom in the morning. Then I visited later in the evening by myself to say bye. After that, I caught my early flight home on Sunday.

My visit was very short but productive. I was able to see Dad at his best this week. At the beginning of the week he had been very sleepy. When I got in, he was already on 4 chemos and steroids. One of the perks of the steroids was that he was awake when I visited. I was blessed to spend such quality time with Karen and Dad. They were in good spirits in spite of the seriousness of his condition. They are taking his illness day by day. We were able to visit, talk and eat together. Daisy was right that room is truly very welcoming in spite of it being in the hospital. I felt like I was in the kitchen at home.

I was also so blessed to see the overwhelming amount of support our parents have received from friends and family. They are so thankful for and are so blessed with the prayers, cards, calls, snack, work details etc... Thanks for your continuous support.

I was truly glad to see Dad on those good days. By the time I left Saturday, the first round of Chemo was done. The doctor was trying to regulate his platelet levels in order to prevent future nose bleeds. His white blood cells were down. Karen wasn't sure at that point when or if he would be going home soon. However, we all felt that he was in the right place for the time being. The days ahead are going to be very hard. Next week is going to be a very tough week for him since he will be experiencing the effects of the chemo. Please pray that the chemo will work. Pray that his body will be strong enough to handle the chemo and replenish itself. Please pray for Karen as she cares constantly for him. Pray for her to have strength and endurance.

We love you Dad and are proud of you. You may be physically weak, but we know you are spiritually strong. Hang in there. Karen we love you too. We are so thankful for your love and devotion to Dad. We know he is well taken care of.

The Weekend Edition

2008-03-02T21:09:00.004-05:00

Thanks for your patience, folks. I know you're all eager for more information on Dad's condition. I've been experiencing some technical difficulties on my end, but am miraculously back online for the moment.

Dad suffered another nosebleed on Saturday morning. Thankfully they were able to stop the bleeding more quickly this time, but his platelets were obviously low again, so the doctors gave another two "bags" of 'em. The blood levels initially responded, but were flagging again at last count; his white blood cells are also showing reduced numbers.

All of this is clearly due to the activity of the myeloma in Dad's bone marrow, preventing the proper production of blood cells. The results of the bone marrow biopsy confirmed this, indicating (as Mom explained to me) that 95% or more of the cells in Dad's bone marrow are tumor cells.

In light of this sobering news--the gist of which Dad, Mom and the doctors had already more or less grasped, but the hard data confirmation is still difficult to hear--our prayer is that Dad's bone marrow would recover the ability to produce healthy blood cells, especially, at this point, platelets. The hope is that the chemo would destroy the cancer cells while preserving the bone marrow's capacity to regenerate and begin to function properly. Please pray for this, and as always for peace and strength for Roger and Karen. Pray that their perspective would be that of eternity, and that their confidence would be not in drugs, doctors, bodies or antibodies, but in the person and promises of Jesus.

I talked with Julie, who was back home in Texas tonight, and she said that her visits with Dad this weekend were a real blessing. She, Nana (Dad's mom) and Katherine were able to be with Dad during times when he had the energy to talk, look at pictures, and crack a few jokes.

Thank you again to everyone who has called, emailed, sent cards, snacks and gifts, shovelled snow, given rides, fixed meals, prayed, and otherwise demonstrated love and concern for Dad and the rest of us, especially over the past week. We are all deeply grateful for every such act, even if we haven't been able to acknowledge your kindness personally and individually. We'll do our best to keep the news reported; y'all keep them prayers comin'.

2008-02-29T20:17:00.003-05:00

The chemo officially stops dripping tomorrow, but the doctors have decided to keep Dad in the hospital at least until Monday. They want to be sure his condition is stable, and to run some additional labs.

Thank you all for your prayers and comments, emails and calls. It has been a moving experience for Mom and Dad--and for us kids as well--to see how our family and community have rallied in support of Dad during this time.

More details tomorrow. Today was a better day for Dad, largely because the pain meds had been increased. But Dad's main physician, Dr. Stadtmauer stopped by and said that Dad was looking better than he has in a week, and suggested that it may well be that the chemo is doing something good. Peace.

Thursday Night Prayer Requests

2008-02-28T21:04:00.003-05:00

Today was a bit rougher for Dad. He was feeling still more pain in his back and was running a fever. The doctors have upped the dosage of the painkillers, both oxycontin and oxycondone. Both Dad and the doctors at this point believe that the pain is due to the growth of tumors in his back.

Please pray

that the tumors' advance would be halted by the chemo, and that the doctors would have wisdom in treating this latest activity of the myeloma.
that Mom would be able to keep Dad hydrated. He has been so drowsy and weak that she has had a hard time keeping him drinking.
that his glucose levels would normalize.
for Dad's spirits, that the Lord would give him peace and courage.

Today Mom and Dad received a card from Connie Stonehouse (Susie's mom) who said that the hymn "How Firm a Foundation" has been especially meaningful to her during difficult times. Mom quoted from this song during our call:

How firm a foundation, ye saints of the Lord,
Is laid for your faith in His excellent word!
What more can He say than to you He hath said—
To you who for refuge to Jesus have fled?

Fear not, I am with thee, oh, be not dismayed,
For I am thy God, and will still give thee aid;
I’ll strengthen thee, help thee, and cause thee to stand,
Upheld by My gracious, omnipotent hand.

When through the deep waters I call thee to go,
The rivers of sorrow shall not overflow;
For I will be with thee thy trouble to bless,
And sanctify to thee thy deepest distress.

When through fiery trials thy pathway shall lie,
My grace, all-sufficient, shall be thy supply;
The flame shall not harm thee; I only design
Thy dross to consume and thy gold to refine.

The soul that on Jesus doth lean for repose,
I will not, I will not, desert to his foes;
That soul, though all hell should endeavor to shake,
I’ll never, no never, no never forsake.

October 4, 2008 ~ Multiple Myeloma Race for Research

2008-02-28T15:52:00.002-05:00

Roger's Racers will be gathering on October 4, 2008 in Philadelphia, PA. Whether you love to run, walk, or even ride in a stroller you are welcome to join our family in the Multiple Myeloma 5K (3.1 miles) Race for Research. Save the date!

More about MM

2008-02-28T13:25:00.004-05:00

For those who are interested in getting a basic grasp of Dad's condition, or for a refresher course, here is a link to the Muliple Myeloma Research Foundation, which provides a primer on the disease, as well as a ton of other relevant info elsewhere on the site. Of course, there is also some good stuff Wikiward. And no, I do not hold stock in Wikipedia.

Visiting

2008-02-28T12:33:00.003-05:00

I entered the room, and after being warmly welcomed with a hug and kiss, I was immediately ushered into a chair and offered some horsd'oeuvres, a bowl of baby cut carrots, ranch dip, cheese cubes and crackers. Where was I? Why, at that downtown establishment, Clark Bed and Cafe! Well, techinically, there is only one bed, and it is occupied, but there are plenty of snacks for all.

Even being stationed in a hospital room, surrounded by blips of machines, the drip of chemo and the unmistakable smell of "hospital", Mom has managed to create a homey and welcoming environment. There is a small refrigerator stuffed (and only those who have seen Mom and Dad's refrigerator at home can fully picture this) with healthy juices and food. Over the sink is a shelf, where silverware, plates, and bowls are neatly stacked, as well as containers of healthy snacks. Under the window is another box of individual bags of crackers, kindly provided by a church friend, as well as a plate of homemade treats. On the wall is a bulletin board decorated with cheerful pictures from grandchildren, as well as kind cards from friends. Overall, it created an environment of love, and even normalcy, in a place that can be devoid of those home touches.

I spent about an hour with Mom and Dad as they ate dinner. Mom has been purchasing frozen, ready made items from Whole Foods and Trader Joe's to bring to the hospital for their meals. She said that she was planning on eating the hospital food, and giving Dad the "good stuff", but she couldn't stomach it. She asked, "How do they mess up EGGS? I mean, how can they make eggs taste bad?" So she is making sure that Dad has healthy food as long as he can handle eating, before the chemo makes him too nauseous.

Another blessing is that they were transferred to a nurse practitioner team for Dad's care. This transfer was facilitated by my good friend Susie, who has known Dad ever since we were kids, and who is a nurse on the team. They are glad to see a friendly and familiar face throughout the day as Susie comes in to check on Dad (he is not actually "her" patient to spare them both any embarrassing or awkward situations if he needed to be examined).

All and all, it was a very nice visit, and I was thankful to see that Dad was looking better. Mom also seemed to be in good spirits, and it was really good to spend time with them both.

Latest as of Wednesday Night

2008-02-28T12:27:00.002-05:00

Some positive news last night. They were indeed able to unpack Dad's nose--to remove his "tusk," as he called it--thanks to the stabilized platelet count. Thank the Lord that Dad's transfusions seem to be working now--his red blood cell (hemoglobin) count has also improved.

We also found out that the new doctor/nurse practitioner team would include Susie (Stonehouse) Lee, who apparently made a special request to be on it. Hers has been a welcome familiar face, and her presence has been an encouragement to Mom/Karen and Dad/Roger both now and in past visits to Penn. For those of you who don't know, Susie was an elementary/high-school classmate of Daisy's, and the Stonehouses are a way-back New Life & Phil/Mont connection. (I will henceforth go easy on the virgules; that last one was both gratuitous and incorrect, I know.)

Mom said last night night that Dad was looking good, as good as he's looked in the past two weeks.

Dad's current chemo is a CVAD, a fairly traditional chemotherapy blend, administered through a PICC line, which delivers the stuff directly to a large vein near his heart. The acronym indicates the chemo drugs included, which are cyclophosphamide, vincristine, adriamycin and dexamethasone.

I promised info on the scans and biopsy results. There was some expectation of a CATscan floating around; turns out the CATscan was not performed. They did do a MUGAscan to check the health of Dad's heart before the chemo, and everything there looked OK. As for the biopsy, the results are expected to come through Friday.

Daisy visited yesterday, and Mom ran into Sandy at the house, where she has been helping out with the cleaning while Joe keeps an eye on the kids at their place. Cara and Ed had also been in to visit recently, along with Nana and Aunt Sue (Rogerdad's mom and sister). Karenmom also reports good visits with Marc Davis and Steve Young from New Life.

Trying not to overload y'all with info here, so I'll just finish with Mom and Dad's prayer requests. They ask for continued prayer simply that the chemo would be effective. Also, Dad's glucose levels are elevated, which may or may not be an effect of the chemo. He is on insulin to help his body process the extra glucose.

CVAD, PICC, CATMUGAhemoglobinsulinoxycondexamycyclosaline and so on "may or may not" be/do/account for this that or the other thing. Plenty of uncertainty here, which only reminds us that we are not in control, that the workings of Dad's body, like our own, are finally a mystery to all but one doctor. Please continue to persevere in prayer, as Mom and Dad persevere, in faith, through this treatment.

Teeny Update Blurb

2008-02-27T15:42:00.007-05:00

More later, but I just spoke with Dad briefly. We had to get off the phone when the doctor came in to see him. The latest is that Dad's platelet counts appear to have stabilized thanks to the more or less daily transfusions he's been getting since he was admitted to the hospital Friday. This means that they'll be able to unplug his nose, which has been artificially corked to hold back the bleeding that's been plaguing him for the past week or so. Apparently the platelet deficiency not only prevents the blood from clotting, but predisposes Dad to bleeding in the first place.

I forgot to mention last night that Dad is also on Oxycontin (20 mg twice daily as of yesterday) for the pain. This has meant that he's drowsy, and sleeping most of the day, though the effect of the steroids he's now getting seem to have altered that pattern somewhat.

Mom was home this afternoon to buy more food and other supplies, and to take care of some housekeeping business. In order to spare Dad the hospital food, she's been buying organic foods (pre-prepared meals, whole grains, smoothie supplies, etc) at Whole Foods, storing them in the hospital room fridge, and doing what she can to prepare them there. Dad hasn't had much of an appetite, but she's been doing her best to encourage him to eat.

Talked to Julie last night. She's flying in from Texas for the weekend to see Dad and help out however she can. Julie has taken the initiative to keep many of us out-of-towners updated by phone over the past week.

Daisy will now be contributing here--in addition to her twelve other blogs--so Dad will be benefiting from some real blogspertise. I, meanwhile, was excited just to have added those embedded links up there. What's a link, you ask? (OK, I'll try to refer you to sites other than Wikipedia in the future. Baby steps.) We should be hearing from more sibs/kids in the future as well.

I'll give more news this evening, hopefully some word on the biopsy and scans.

Getting Situated

2008-02-26T22:17:00.000-05:00

As most of you probably know thanks to Daisy's email, Dad finally started the latest round of chemo today. The drug is administered intravenously, and he is also on a steroid and anti-nausea medication to help him cope with the chemo's side effects. When I talked to Mom at about 4:00 EST today they were still readying the stuff, "mixing it up downstairs," as she put it; when I spoke to her again at 7 the brew was flowing and Dad was having a negative reaction to it, once again enduring "the sweats"; by about 10 he was doing better and seemed to be in good spirits. Mom said he got into the chair to eat around 5 this evening, and was still in it at 9--apparently all jazzed up on the 'roids. Mom thanks everyone for all their prayers and messages, including those she has yet to reply to. Please pray that Dad--and Mom--will be able to rest, and of course that the chemo will do its thing (without causing too much collateral damage to Dad's already weakened system).

This is Andrew, by the way. Despite my relative youth, I am not all that technoliterate, so I ask for your patience as we get this blog thing up off the ground. Mom's idea was to find a way that she could keep friends and family up-to-date on Dad's condition and treatment without her having to spend the time and energy to compose regular emails and/or call everyone. The plan for now is for her to given Erin and me the latest by phone, daily or so, and for us to post it here. Our hope is to set the page up for multiple authors, so that at least Mom and the sisters--and interested brothers/sons-in-law--can also originate posts and not be confined to the comments section and its lame fonts. Please contact me through the site with any suggestions or questions. I have set up an email for the purpose as well: ajclark55@gmail.com. ("ajclarkZOING!!" was taken.)

The look and structure of this site is likely to change a lot in the near future. Mom and Dad are ruminating on a title and Cara is supposed to supply a photo for the header. And if you're here, hopefully that means that the initial invitation email worked. More to come, tomorrow.

Courage, Dad. We're all praying.