Happy Encounters

Posted on August 11, 2022 by Margaret

Last week little Will’s grandpa got to meet his first grandchild, who is almost five months old.

When Ralph arrived from Germany, he also got to be reunited with his wife Astrid, his daughter Ann Sophie, and his son-in-law Nelson. It’s difficult to understand what’s happening in the little apartment in Rochester, Minnesota, from 4300 miles away in Europe.

But now Ralph has adjusted to the medically-oriented lives of his loved ones and how things work at the Mayo Clinic. Like the rest of us, he’s learning that by the process of elimination, doctors figure out what something isn’t, before they determine what it is. And this process can be frustrating for all of us.

Last week, Nelson’s vomiting and diarrhea had increased to epic proportions. Doctors thought it might be a response to trace remnants of the chemotherapy drugs mixing with the new immunotherapy drugs. Or it might have been Nelson’s reaction to the new immunotherapy as his system tried to switch from chemo to that.

They drew blood again (almost a daily occurrence) and finally discovered he had a bacterial infection of his digestive track, which was evidencing itself in the vomiting and diarrhea. Several days after he began antibiotics, though, the vomiting and diarrhea began decreasing—much to everyone’s relief, especially Nelson’s.

Throughout this time, he’s been taking the two pills daily that make up the targeted immunotherapy, and yesterday he spent time with the head oncologist on his case and another doctor. They were both pleased about where he is with the new therapy but will keep it at a half-dose for a while longer.

In meeting with pulmonology, they learned that about 150 milliliters of fluid are still “caught” in pockets at the bottom of his right lung. Though they tried to drain it out, the regular suction method failed. They may try to get it with a needle.

If they succeed, then they’ll also remove the catheter on that side and close up the wound. The left lung still needs draining daily, and Ann Sophie does that with excellence. It remains a mystery why the right lung had initially produced lots of fluid and now has dried up, while the left lung, which hadn’t produced much for many weeks, now has more.

But that’s the way it is in the world of medicine. One issue gets sorted, but then another one appears. But we have faith in the doctors we’ve worked with thus far and have seen their expertise and determination in action. Their goal is to resolve Nelson’s cancer symptoms and the side effects from drugs until the immunotherapy and his own immune system can overwhelm the cancer. And what a happy day that will be!

“My Child, never forget the things I (the Lord) have taught you. Store my commands in your heart. If you do this, you will live many years, and your life will be satisfying.” (Proverbs 3:1-2)

My Friend Nel

Posted on July 26, 2022 by Margaret

Growing up, I (Hans) viewed my eldest brother, Nel, as the biggest of my big brothers. We were nine years apart.

From my childlike vantage point he was an august and likable personality, though also somewhat distant and unpredictable. However, in time, I would go on to develop an enduring bond of friendship with Nel, a friendship that has proved to be one of the most formative relationships of my life.

It happened that, after I had graduated high-school, I moved down south to study at Belmont University, which is located in Nashville Tennessee, a place where Nel lived at the time. It didn’t take long before, in addition to my studies, I was employed in Nel’s lawncare business on the weekends to earn some extra cash.

(L. to R. Nels, Hans, Lars, Klaus)

It was in this context – living far from my childhood home for the first time – mowing grass, sharing meals, telling stories, mowing grass, drinking coffee, listening to and talking about music together, and mowing yet more grass, that my friendship with Nel was sealed. In addition to working well alongside one another, we went on boating adventures, road trips, we camped, and generally held court in all sorts of places together, animatedly discoursing about all sorts of subjects with mutual delight.

Nel and I have quite different personalities. He is naturally intrepid, practically minded, with an aptitude for logistics, and restless for motion. I am naturally more contemplative, a reader, cautious, imaginatively minded rather than pragmatic. However, we do share our family upbringing and a common Christian faith.

Also, we both were born with minds that just about never stop thinking and we process externally, having the habit of ‘test-driving’ our thoughts and feelings aloud in the process of working out what we believe and how we should live. Apparently, a measure of difference, mixed with some similarities and shared experience, is a sufficient chemistry for a good friendship.

On account of Nel, I was encouraged to make the move away from home and grow in independence as a man. Nel listened to me and showed me respect. Nel trusted me, as a 20-year old, to run his lawn care business for a month whilst he was travelling in India one summer. It was on the strength of Nel’s reputation that I got a job back up North after leaving college.

It was Nel who, through his travelling stories, encouraged me to look to the horizon and consider the big wide world out there, full of different people from other cultures with different customs and histories. It was Nel who told me about YWAM (Youth With A Mission) and encouraged me to seek God by giving it a try (I met my English wife in New Zealand doing a Discipleship Training School and we now live in England with our six wonderful children and have been happily married for fifteen years– thanks Nel!).

Nobody asks to be born. God determines it. We simply find ourselves, having been born, alive in a particular family embedded within a wider cultural context. Yet, the scriptural narrative is that God’s love abounds to all people and that he is reconciling the world to himself in Christ. Moreover, this amazing work of God is carried out amidst the familiar personalities and routines of our lives. I can attest that God worked graciously in my life through Nelson as a part of his story of redemption, and continues to do so.

“[God has] determined allotted periods and the boundaries of [peoples’] dwelling place[s], that they should seek God, and perhaps feel their way toward him and find him. Yet he is actually not far from each one of us.” (Acts 17:26-27)

Lock and Key

Posted on July 21, 2022 by Margaret

We were all thrilled when we learned, about a week ago, that the key had been found to unlock the mutation we’d all been hoping they would find, to treat Nelson’s cancer. This would mean that a targeted immunotherapy was possible—with a good chance to overwhelm cancer cells by teaching his own immune system to attack them.

Today, with Nelson out of the hospital, he and Ann Sophie (and Will) met with an oncologist who answered many of their questions and described what might be ahead.

First of all, Nelson will have to wait a week or more before anything new is started, since they want him to finish the course of antibiotics he began in the hospital a few days ago. After that, they may begin immunotherapy, depending on how he’s doing.

They’ll begin the new treatment slowly with low doses of two medications by mouth, watching to see how he tolerates the side effects. And of course they have to clear everything with their insurance, usually a 10 day process. The doctor assured them that if the side effects became too much, there were several other combinations of drugs they could try.

The BRAF mutation he has is super rare for lung cancer, only 1-2%. Half of all melanoma patients and 100% of all leukemia patients have it. That’s good, because they can try the specific immunotherapy for it, but negative because the prognosis is not as good long term for that mutation.

Two-thirds of patients do respond to these drugs. If Nelson doesn’t respond, he can always go back to chemotherapy, which does seem to be working… though it’s been hard on him. And that’s about all we know for now.

As always, we’re trying not to look too far down the road, because God has already gone there and will show us the way on a need-to-know basis.