Book- Ch. 1

Chapter1

 Christmas carols hummed their way into my supper clatter, intertwining my thoughts with melodic strains and savory smells.  As I was trying to decide between peas or corn my 5:00 routine was brought to a grinding halt by the ringing of the phone.  It was our family doctor.

            "Marilyn, I'm afraid I've got some bad news.  Andrew's blood test shows that the cancer is back."

            Andrew was our 5 year old son who had been diagnosed with Acute Lymphocytic Leukemia at the age of 2.  Fortunately, 3 years of chemotherapy had put him into remission and we had promised Andrew that the pokes were over.  To prove it we had even thrown an 'End-of-Chemo' party.   Over forty friends and family members came to celebrate with us. 

            Five year old Andrew reveled in the exhilarating joy of having all his little friends and cousins together to play with at the same time.  Too young to remember when his cancer had first started he had been living with pokes and medications as an unpleasant, but unavoidable way of life.  To be told that he would now become a normal little boy with no more pills to swallow, no more baldness to cover, and no more I.V. needles to terrorize his damaged veins seemed unbelievable.  With a bursting heart he thanked the Lord in his bedtime prayers for making him well.  Pouring out his affection on us he hugged and kissed us many times a day as he joyfully began a new chapter in his life.

            How could I tell him that someone had turned back the pages and we were starting all over again.   Even as the contents of my stomach kept threatening to rise, I managed to take note of what Dr. Pauls was saying as he mapped out the steps that would be taken in

the next 24 hours.  I was even able to thank him as he expressed his deepest sympathy and, saying goodbye, I was once again alone in my kitchen with the Christmas

music playing on cheerily.  I waited for someone to turn it off, until my aloneness reminded me that I would have to somehow move my feet of lead into the next room and

find the ‘Off’ button myself.

            With the music off, silence reigned and began to wring out my heavy heart until it ached.  I tried calling my husband, Harry, on his cell phone but received no answer.  Feeling even more alone I knew that at that moment the burden would crush my very breath if I could not share it with someone.  And so I clumsily picked up the phone again and called the one person who had always been there for me from the first day of my life—my mother.  

            As soon as she answered the phone, I felt the lump in my throat dissolving into great heaving tears.  I barely cracked out, "Mom," before the flood of emotion rolled up and out from my broken heart.  

            "What's wrong, Marilyn?"  mom's persistent voice pulled me together.  

            "It's Andrew. His cancer's back," I sobbed.

            "Dad and I will come over as soon as we can.  We just have to attend a brief meeting where Dad has to give a short devotional.  We'll leave as soon as his talk is over," Mom said.

            "Okay, and please pray for us,"  I pleaded.

            "I already have been," Mom replied.

            "What do you mean?  You were praying before I called you?"  I questioned.

            "Yes.  You see Dr. Pauls was uncertain whether to call you himself tonight since he couldn't reach Andrew's pediatrician, or to wait till morning and let Dr. Traverse give you the news.  So he asked Auntie Betty for her opinion."

            Aunt Betty, one of my favorite aunts, was also my doctor's receptionist.  She suggested that they first contact my mother and get her advice.  Mom in turn urged them to call me immediately.  So it came to be that as I received my heartbreaking call my mother was already supporting me in prayer.

            Mom and I hung up and I resigned myself to finishing supper while waiting for Harry to come home.  Fortunately our three boys, Ryan, Andrew, and Ari, were still happily playing upstairs when Harry walked in the back door.

            "Honey, I've got some bad news," I said.  He set down the mail and his lunchbox quietly, with his eyes fixed on me.  

            "The blood test Andrew had done yesterday showed that the cancer is back," I said softly.  

            "Oh, no," he whispered, "Poor Andrew."  Our thoughts rode tandem as we silently visualized the renewed onslaught of chemotherapy and radiation on Andrew's body.

            "I don't think we should tell him yet," I said.  "Let's wait till we actually are preparing to go to the hospital."  Harry was in full agreement and so we called the boys down for supper   The boys chattered at the table without noticing our sober mood until with relief we finished the meal.

            Harry sank into his easy chair while I quickly tidied up the kitchen.  My churning thoughts were wearing me out and I desperately felt a need for release.  I wanted something to fill in the long evening ahead of us and my thoughts went immediately to our friends, Stan and Tilly, whose two boys would be great company for ours.

            "I'm going to call Stan and Tilly, and ask them to come down,"  I blurted out to Harry.  "I don't want Andrew to notice how down we are.  If the boys have someone to play with the evening will be easier, don't you think?"  Harry shrugged apathetically, and then shook his head.

            "I don't want to see anyone," he said despondently.

            "But think how well distracted the boys will be, and we both could use the support of our friends," I pleaded.   Harry shrugged again resignedly and I picked up the phone.  

            Tilly was shocked to hear the news, and immediately agreed to spend the evening with us.  Hearing her comforting voice so boosted my flagging spirits that I impulsively decided to phone another friend.  Two hours later ten of our closest friends were sitting in our family room ready and willing to carry our burden with us.  As we talked and shared Scripture, and prayed together I felt the weight lift a little.

            The next morning we wondered when Andrew's pediatrician would call to confirm the lab results that we had already been informed about the night before.  By 8:15 a.m. I could wait no longer and dialed the pediatrician's home number.  He was speechless at my news and promised to call me as soon as he had studied the lab results of Andrew's blood work himself.  Forty-five minutes later he phoned from the Hospital laboratory to say that he could not spot any cancer cells in the specimen slides but wanted me to meet him at his office where the pathology report would be waiting for him.

            My heart lightened with this reprieve and I entertained the possibility that we had become disheartened prematurely.  I made arrangements to leave Ryan and Aaron at my mom's and took Andrew with me to meet Harry at Dr. Traverse's office.  We left Andrew in the lobby while we conferred with the doctor.  He greeted us with a grave face and held out the documents from the pathology lab.

            Because the blood specimens were somewhat nebulous, our local pathologist had sent them to another hospital 40 miles away where two other pathologists had studied them and concurred that indeed, blast cells were present.  One more step could be taken to confirm that the cancer had relapsed and that was to do a bone marrow test on Andrew.  As we waited, Dr. Traverse called our oncologist in Vancouver and set up an appointment for the following day.

            With heavy hearts we drove away.  Andrew seemed not to suspect anything and wanted to play "I Spy".  Forcing a smile I suggested he start the game.  

            "I spy something that begins with J," he shouted.  Harry and I began guessing.  

            Jeep?

            No.

            Jalopy?

            No.

            We scoured the passing scenery but had to admit we were stumped.  The answer?

            "Jesus!" he gleefully responded.  The game continued with Andrew happily taking turn after turn. The next letter was "G" for "God", and then "A" for "Angel".  We mused over the unusual turn this age-old game had taken and felt inexplicably comforted.  In our darkest moment our young son had turned our eyes to Jesus.

            As we packed in preparation for a lengthy hospital stay we chose not to say anything to the boys.  We wanted to prolong Andrew's carefree thoughts for as long as possible, even if only for one more night.  Furthermore, we weren't sure how to prepare him for the next few days, as we ourselves didn't yet know what lay ahead.  The only definite river to cross was the Bone Marrow test which I knew would throw Andrew into a panic.  

            The last bone marrow test had been six months before and we had promised him that it was the last one.  Andrew did not hold broken promises lightly, and I was already imagining his hurt and dismay when he discovered that he had been betrayed.

            We decided to drive into Vancouver that evening and spend the night with Harry's parents, whom the children called "Oma" and "Opa".  They greeted us warmly, hugging Andrew tenderly.  Oma had already prepared the bedroom for the boys where they liked to 'camp' on the floor, and as I tucked the children into their cozy blankets,  Andrew asked hesitantly, "Mom, am I getting my bone 'n arrow shot tomorrow?"

            I caught my breath.  How had he known?  Why did it have to come out now—just before bedtime when his melancholy nature would so quickly weep and worry.  Inwardly I breathed a prayer, "Give me the right words, dear God."

            Out loud I said, "Yes, Andrew, you're having a bone marrow test."

            "I wish I didn't have to have any more pokes,"  he sighed.

            "So do I," I agreed wholeheartedly.

            "What kind will it be?"  he asked next.

            "One poke in your hand.  That's the only one you'll feel.  You won't feel anything else."

            "Don't forget to put Emmla cream on," he reminded me.  I gladly promised him that,  and after his bedtime prayer and a goodnight kiss he fell soundly asleep.  I thanked the Lord that there had been no tears.

            Realizing that God had been preparing the way for us throughout the last 24 hours, I suddenly hungered for His Word.  Opening my One Year Bible I found that the reading for that day was Jonah 1-4.  With a growing sense of awe I read the prayer of Jonah in the belly of the whale:

            "In my distress I called to the Lord and he answered me.  From the depths of the grave I called for help and you listened to my cry."  Although I had not yet verbalized my feelings to the Lord, my spirit resonated with these words of Jonah.

             "You hurled me into the deep, into the very heart of the sea, and the currents swirled about me, all your waves and breakers swept over me."

            I could fully relate to deep waters and swirling currents as my emotions and thoughts consistently threatened to overwhelm me.  I was fearful about what lay ahead but I knew that God would be with us.

            In the morning I asked the Lord to give me good news that day.  I did not expect a happy diagnosis, but I was hoping for another reassuring sign of God's presence.

            After a pancake breakfast with Oma and Opa, we made our familiar trek to the B.C. Children's Hospital.  It  was a long hallway to the Oncology Clinic and Andrew held my hand tightly.  I glanced down at his hands which sported large Emmla patches over his much-used veins.  The Emmla was a topical freezing medication that slightly dulled the pain of the I.V. needles.  Soberly we opened the heavy door with its warning sign:

"Do not enter this clinic if you have an infectious disease or have been exposed to one."

We were well aware of the dangers that infection posed for the children inside.  Their immune systems were being suppressed by rigorous medical treatments and an infectious disease could be life-threatening.  Andrew had been one of those children for three years and now, after an all-too-short reprieve, he was back.

            I checked off his name on the big chalkboard and looked around.  We were one of the first patients of the day, so hopefully our wait would not be long.

            Andrew had just sat down at the play table when a nurse called him away to take his height and weight measurements.  Quietly he pulled off his shoes and backed up against the meter stick.  The nurse tried to make conversation but he remained unresponsive.  Next, his weight was recorded and then it was time for the big needle.  Harry joined us in the tiny treatment room and we watched in silence as the nurse laid out her sterile tray.  Andrew wanted to sit on my lap as he customarily did, and after a quick hug he held out his hand for her.

            "I'll count to three," she said.

            "Please don't count," we interrupted.  Experience had taught us that distracting Andrew with a book worked better than letting him focus on the needle.  Harry held up a Where's Waldo book, and as Andrew looked for Waldo, the needle found its mark.  A few measured breaths helped Andrew over the initial pain and then the needle and hand were bandaged up together and connected to an I.V. pole.

            Back to the play table we went where others waited for their turn to be 'hooked up'.  Immeasurably  sad to me were the little bald heads around the table that day.  Most of them were under the age of five.  Their usual childish curiosity was replaced by wary looks.  I could understand their perplexity at being in a place made for children with its abundance of color and toys and at the same time designed for torture.  The occasional loud cries and screams were unsettling, but even more heartbreaking were the pathetic little sobs of the children who tried to be brave.

            Andrew had always been a brave one.  Even when he had been first diagnosed at the age of two, he had never needed any restraining during the pokes.  It was as though he feared causing more pain by  accidentally moving the hand or foot that was being accessed.  On two occasions the chemotherapy drugs had leaked into surrounding tissues causing burns under the skin.  Even then he made little fuss, only whimpering softly.    Near the end of the three years of chemotherapy his veins had become more and more difficult to enter due to the tremendous amount of scarring, not to mention the complete destruction of the two veins that were chemically burned.  I tried not to imagine the anxiety we would experience in the next few days but gained hope from the fact that today's poke had gone smoothly.

            Then it was time for the bone marrow test.  This was done in a large room where Andrew lay on his side while a nurse helped curl him into a tight ball so that his spine and hip was properly exposed to the doctor on the other side of the bed.  Beside the doctor stood a sterile metal cart with the various instruments used in the procedure.  At the bottom of the bed stood two technicians who would immediately prepare microscopic slides of the extracted  bone  marrow which would  be studied later in the Lab.    

            Harry and I stood at the head of the bed where we held his hand and kept up a steady stream of stories.  Before starting the procedure, the nurse wrapped a tiny Velcro device around Andrew's thumb which would monitor his blood pressure on a nearby machine.

            Next she injected a mild sedative into his I.V. tube.  Within two minutes Andrew started smiling lopsidedly.  His eyes drooped as he got downright giggly.  We were used to this reaction to the sedative and ironically, I loved that moment because it was usually the only time we would see Andrew smile all day.  After waiting a full five minutes, the Doctor injected a local anesthetic into his lower back.  Once that took effect, it was time to carefully insert a long, thin, stainless steel tube into his hip bone.   

            The nurse supporting Andrew on one side of the bed had to brace herself as the doctor on the other side used all his strength to drive the tube into his hip.  A small moan came from Andrew as he struggled to escape the pressure. The nurse only held him tighter.  The bone marrow was drawn into the tube with a corkscrew contraption and then removed from his body.  Both a

chip of bone as well as the pulpy bone marrow juice were aspirated and sent to the lab.

            They also did a spinal tap which meant inserting a long hollow needle into the spinal area from which several vials of cerebral fluid were extracted.  It was not a pleasant sight to see the needle sticking out of his back and watching the fluid slowly drip from the needle into the vials that were held by the doctor just beneath the opening of the needle.   This test would indicate whether the cancer had spread into the spine which then automatically raised the prognosis of the patient to "high risk".  

            Finally all needles were withdrawn and Andrew was allowed to rest.  Today he seemed unusually passive.   As a rule he would be trying to get off the bed in spite of his sedated condition.  In the early days we had once allowed him his determination to 'get up—go home' only to have him drunkenly weaving his way through the hospital hallway until he finally crumpled into my arms.  

            Today he was content to stay on the bed while Harry read on.  I followed the nurse to her station where we booked a return appointment for the next day.  At that time we would receive the test results and a course of treatment would begin.  Thankful to have one more night away from the Hospital, we returned to Oma and Opa's house.  

            My heart still felt burdened, but it was a comfort to hold Andrew and cuddle him.  It was a comfort also to have my two other boys.   I loved to feast my eyes on their boyish enthusiasm and their expressive, rosy faces.  I clung to the fact that I had two healthy children who would hopefully never have to experience Andrew's suffering.  It also assuaged my guilt that this invasion of cancer in our family was not my fault.  Before I fell asleep that night I again prayed for good news the next day.

            Grey clouds blanketed the morning sky, but my heart was already looking for the silver lining.  I was sure that the day would hold a blessing for us somewhere.  We had a relaxed breakfast with Oma and Opa who did their best to cheer us but their strained faces belied their outward calm.  

            Knowing from experience how quickly Andrew could be admitted to the Hospital, I decided to take along a suitcase for him and myself.  Harry felt my precautions were premature but I had spent enough unexpected nights at the Hospital without a toothbrush and extra clothes. 

            At 1:00 we were ready to leave for the hospital and kissed Ryan and Ari goodbye.  Ari refused to be left behind and so, sensing that his sunny nature would perhaps be of benefit to us we let him hop in the car next to Andrew.  True to form, Ari immediately began chattering about the passing scenery while Andrew listened half-heartedly.   At the clinic the boys sat down to watch a movie, while we were called into a consultation office to meet with our doctor.  With a heavy sense of foreboding we took stock of the

medical staff crowded into the tiny room.  There was our oncologist, Dr. Ron Anderson, who was still very new to us and seemed far too young to be a cancer specialist.  Next to him was a doctor who was training to become a specialist, and an oncology nurse.  Dr. Anderson greeted us with a warm handshake, introduced us to the other two and then picked up Andrew's medical file.  

            "I'm so sorry," he said sympathetically, "But the bone marrow test shows that Andrew has relapsed.  His bone marrow is already 80% full of cancer cells."  We looked at him numbly.

            "Now we have a choice of two types of treatment.  Either we try chemotherapy again for another two years, or we try a bone marrow transplant.  You don't have to decide right away, but we will need to admit Andrew today and begin chemotherapy immediately to put him back into remission."  

            "What if we chose chemotherapy again?" Harry asked. "How effective would that be seeing as how it didn't prevent Andrew from relapsing?"  Dr. Anderson nodded understandingly.  

            "The chemotherapy we would use this time would be much stronger, however, you're right—there would be no guarantee.   You should also realize that in either case Andrew would definitely require radiation to his testicles since the cancer recurred there as well."  

            "Can you explain to us what a bone marrow transplant would involve?"  I asked.

            "It would mean he would have to undergo radiation to kill off all his blood cells and then receive the bone marrow cells of a healthy person.  These cells would take root in his bone marrow and start manufacturing normal healthy cells," the doctor replied.  "Do you know if any of you match his bone marrow?"

            I shook my head.  "Three of us were tested when Andrew was first diagnosed with leukemia, but our youngest son, Ari, was born later and has never been blood-typed so we don't know if he matches or not."

            "There's a slim chance that he might," the doctor said.  "We'll have to check that out before we make any decisions.  Andrew's case will also be reviewed by the entire team of oncologists here at the hospital and they will submit a proposal for treatment as well."

            We talked for about an hour trying to fully grasp the pro's and con's of the options that lay before us.  We were beginning to feel overwhelmed with all the information when Dr. Anderson wisely drew the consultation to a close.  As the medical staff rose to go he asked our permission to begin chemotherapy that day.  On the verge of tears I nodded but couldn't speak.  Harry nodded as well.  Dr. Anderson ushered the others out

and then quietly closed the door, leaving us alone.  Like a lost child I went into Harry's arms, and together we wept.

            Then Harry pulled a chair over, and sitting down with me in his lap he told me of the promise he had received from God's Word that day.  

            "Whatever you ask in my name I will give it to you."  (John 14:13, 14)  With firm hope in his voice he insisted that the same phrase had come up over and over again in his reading.  He was convinced that God would grant us healing if we asked for it.  Comforted, but not wholly convinced, I dried my tears.  As we prayed, huddled together, I felt the familiar shadow loom over us again.  It hurt to think that we were being forced once again to enter the 'Valley of the Shadow of Death'.  Even as I mentally cringed at the thought something made me catch my breath.  A warm peace came over me as I realized that I had been wrong in thinking that the shadow of death loomed over us.  It was not death at all, but rather a pair of Almighty Wings that were overshadowing us.  We were as safe as any sparrow could ever be!

            I was glad for that peace when it came time to tell Andrew what was happening.  With as few words as possible we told him that he was going to have to stay in the hospital for some more pokes.

            "Why?"  he cried.

            "Well, Andrew, your cancer has come back and the doctors need to make it go away again," Harry tried to explain.  

            "Why did it come back?"  he asked.   "I thought you said it was gone, and I would not have to have anymore pokes."  

            "We don't know why it came back, Honey," I began.

            "I thought I was healed," he interrupted.   

            "We thought so too.  But God can heal you again," I pleaded with him.

            He was devastated and refused to be comforted.  He cried all the way from the clinic to the cancer ward on the third floor of the hospital.  Fortunately we were given one of the few private rooms, and tried to distract Andrew with T.V.  He eventually stopped crying and gathered together his courage for a new I.V. needle to be inserted.   Chemotherapy was administered as well as anti-nausea drugs.  

Once the pokes and pills were over we cuddled together on the bed enjoying the view of the helicopter landing pad from our room.  

            Andrew perked up a bit when company arrived in the form of both sets of grandparents plus my brother, Ed, and his family.    Harry had gone for supper too, and returned shortly with both boys.  It was like a family reunion with everyone wanting to talk at once while the children spilled out into the hallway with their romping.  Harry finally took the children to the playroom while I updated the adults on Andrew's prognosis. 

            After discussing his medical situation we wondered how the relapse was affecting him emotionally.   I don't think he's coping very well with the relapse,"  I said,  "But its going to get a whole lot worse when he finds out he's spending his birthday in the hospital."   His 6th birthday was just two days away and I was at a loss how to remedy the situation.

            "Couldn't you have the party at the hospital?"  my sister-in-law, Linda asked.

            "How would I get all his friends here from Abbotsford?"  I wondered.

            "I don't mind bringing a van full,"  Linda replied.    And so we made plans to throw a surprise party at the Hospital.

            Later when everyone was gone and Andrew had been tucked in for the night, I sat down on my hospital cot and opened my One Year Bible.  Two passages leaped out at me from that day's scripture.  Psalm 136 issued the phrase "His love endures forever" twenty-six times.  The convincing repetitiousness was hard to ignore.  Nahum 1:7 read, "The Lord is good, a refuge in times of trouble."  This reminder to take refuge under the Almighty wings was so appropriate for a day when death had once again beckoned us.

            Just then Andrew sat up and whimpered.  By the time I realized what he wanted and was scrambling for a vomit tray, he was heaving violently.  Forceful explosions rocketed up from his stomach, splattering the walls, the bedding, and himself.  My heart so at peace the moment before, instantly plummeted.  Visions of other sick children I had seen flashed through my mind.  It was routine to see cancer children throwing up, but Andrew had not once vomited in all his years of chemotherapy.   This seemed like an ominous foreboding of the new chapter he was beginning in his life.

            After ten minutes of ongoing eruptions, an exhausted Andrew had finally emptied the entire contents of his stomach and it was safe to begin cleaning up.  How I blessed the capable hospital laundry that would wash up my son's bedding without a complaint.  All I had to do was strip off the sheets and throw them in the hall hamper.  Bathing Andrew with a connected I.V. pole was a little more challenging, but a helpful nurse showed me her trick of pulling off pajamas without unhooking the tubes.  Once he was clean again a fresh pair of p.j.'s without buttons were put on and then it was back into bed for Andrew.

            Tired and strained I slipped into my cot shortly thereafter hoping to fall asleep quickly.  Every movement by Andrew startled me, and I worried whether this would be a busy night for both of us.  Then the words of a kind nurse came back to me, "You're going to go through your own, unique story with Andrew, so don't worry that the stories you hear from other patients will necessarily happen to Andrew."  

            At midnight Andrew was given one more dose of anti-nausea pills, after which we both went to sleep and slept soundly until morning..