About To Go In

It's 5:30 am and I'm waiting to go into my last surgery. Because of its location, it will also be the most serious one. The mass they will remove today is in my chest cavity along my right lung and behind the heart. They will go in between my ribs in a couple of locations, collapse my right lung, then remove the mass.

Taking out the mass is easy...it's just hard to get there.

Pray that everything goes well and there are no complications. Check for updates on Facebook from my family. I'm sure they will be on there before me.

Surgery

It's been a while since my last post. Many of you already know how the surgery went, but I know that not everyone does. First of all, I want to thank everyone for their prayers and especially thank all the friends and family who came to the hospital during and after my surgery. 

If you read about the surgery you know that it was an extensive one. Well, it was even a little more extensive than we previously thought. We later learned that this type of surgery is hardly done anymore due to the low survival rate: 30%. Instead of lasting 5-7 hours, it ended up lasting 11.5 hours. Yeah, I was in surgery for nearly 12 hours. It's something I wouldn't really recommend. My family received calls every hour or so updating them on my status and the overall progress of the surgery. It was 5 hours until they received the call that the surgeons finally reached the mass they went in for. To make matters worse, part of the mass was bordering a kidney. We were blessed with a truly great surgeon, however. The other surgeons working with the main surgeon later told my parents that most surgeons would have just taken the kidney too; my surgeon simply slowed down, took his time and cut out the mass without taking my kidney. 

It was then time to remove it and slice it up to run pathology on the mass. If you remember, the main concern was that there was a chance that the mass contained teratoma. Teratoma is a benign mass that is undetectable and at some point turns into a malignancy that is untreatable by any type of chemotherapy or radiation. Not only was there teratoma, there was quite a lot of it. Out of everything they removed, over 60% of it was teratoma. Surgery proved to be a prudent decision. 

Because of the fact that teratoma was present, they then had to go back in and remove all of the lymph nodes in my abdomen. Then they were able to put all of the organs they had previously taken out of my body to get to the mass back inside of my body and staple me up. For those of you who are wondering, the scar is pretty nice. It's about 14 inches long and they cut around my belly-button forming a small detour in an otherwise straight path from the base of my sternum to the top of my pelvis. There were 40 staples that were a little less than 1cm apart. 

I haven't had too many complications after the surgery. They expected me to be in ICU with a ventilator for at least 24 hours. I did stay in ICU for a while, but I was off the ventilator in a little less than 2 hours after the surgery. Really, that's a miracle in itself. They told me that I would be in the hospital for up to a week, and was out in 4 days. I had a lot of pain to begin with and it wasn't all great. The week after my surgery, I had some sort of stomach bug. And, if you can imagine, throwing up that close to a major abdominal surgery isn't pleasant. In fact, it is probably some of the worst pain I've ever had to experience. It literally felt like my abdomen was ripping apart. I got through that day, started doing better and then I got the stomach but again the next week. It wasn't fun, but it was considerably easier than the previous week. 

Since then, everything has gotten progressively better. I've been able to go back to work and even started to jog slowly last week. I'm doing my best to not rush things but sometimes that gets difficult. You begin to feel better and you just want to get back into life. But, I have to remember that I'm still recovering from not only a major surgery, but nearly 9 months of a life-threatening disease filled with surgeries and grueling chemotherapy treatments. If I'm honest, I'm really worn-out. I'm not even close to where I used to be physically, and emotionally it's been just as hard. Yes, I've handled everything well. Yes, I've been able to get through everything better than most. Yes, I have so much to be thankful for. But, it has still taken its toll on me. 

Unfortunately, I'm not quite finished yet. One more. I have one more surgery that is scheduled for August 14th. This one is to remove the small mass that has been in my chest the whole time. The mass is 2cm; it hasn't grown and it hasn't gotten any smaller through all of the treatments. This surgery won't be as extensive as the last, but it's still another surgery. They will go in through my right side, in-between my ribs. They will begin with a small incision and a scope and will do everything they can to remove the mass in that manner. Please pray that's all that has to happen. If they can't remove it with a scope they'll have to make a much larger incision on my side and then spread my ribs apart and remove it that way. I'm like anyone else, and would much rather have a smaller incision and not have to   have my ribs spread apart. 

Even though I have to have a surgery, I'm at the end of it all. For this I'm glad. So, as far as prayer requests go:

• Pray that I continue to recover well and there are no more complications
• Pray that I can be patient and allow my body to rest and begin to build itself back up to get prepared for this next surgery
• Pray that the next surgery goes well and that nothing major has to be done. Agree with us that it can be done quickly and just with the scope. 

Update: Surgery

As many of you already know, life since my last post has been...well, normal for me. It has been truly great. Catherine and I have been able to enjoy life together as a married couple like you are supposed to be able to do as a newly-wed couple. I have been able to work full-time and I believe that I've actually accomplished a lot in the past few weeks (although I suppose that statement is highly relative seeing as how the previous few months I was only able to work in scattered doses between treatments). I've been able to run, actually run. It has been amazing to me how quickly running is coming back. I was out for months, almost on my death bed literally. When I started running at the beginning of the month I could barely make it 20 min and at a pace at which I used to warm-up and cool-down. Now, although it's still not where I was, I'm able to go run 4-7 miles at 6:40-7:00 mile pace pretty comfortably.

It is great to get back to normalcy. For so long it seemed as a mere illusion. I was caught in-between what seemed like a distant memory and a dream for the future, just to get to the point in which I am now in regards to feeling 'normal' again. And perhaps that is the very reason why this next part is so hard. We found out at the end of last week that I am going to have to undergo the surgery previously mentioned to remove what remains of the masses in my abdominal cavity. It is scheduled for next week.

I won't go into detail, but if you want to know what the surgery will be like...I believe the post before this describes it. They will cut me open, take out my 'guts' and put them aside to be able to get to the mass. Then they will remove the mass that started out over 12.5 cm and is now 4 cm. They will also remove any of the other smaller masses. Basically, anything that is not supposed to be there, they will remove (might as well...since they have me open right?).

After everything that needs to be removed is cut out, they will slice the removed masses to obtain sections to perform biopsies on them. If they are simply scar tissue (which we are believing they are) then they will be done. They can put me back together and sew me up. However, if they find any teratoma or perhaps some other form of cancer that went undetected, they will have to go back in and remove all the lymphatic tissue in my abdominal cavity.

THIS IS NOT GOOD.

To make a long story short if this happens then it would jeopardize Catherine and my ability to have children.

So please...continue in prayer. Pray that there are no complications in what will be an invasive surgery. Pray that all they find is scar tissue (or even that they open me up and find nothing at all! That would be pretty cool huh?!). Pray for a quick recovery. Pray for no infections. Pray for Catherine and my family.

Thank you all for your support through this entire journey. Although it isn't completely over yet, and surgery isn't the most exciting news...it is nice to be at the end of the journey.

I AM

I've known my entire life (or at least for as long as I can remember) that God is the " Great I Am". He is everything that we need him to be, when we need him to be. He never changes. Today, my dad sent me this from Joseph Prince ministries, and it spoke to me. Read it and I know you will too receive from it:

"Whatever your challenge is today, whether it is physical, emotional, financial or marital, the great I Am declares to you: “I am to you what you need Me to be.”

Do you need healing? He says, “I am the Lord who heals you. (Exodus 15:26) And as you believe Me, you will see your healing manifest thirtyfold, sixtyfold and a hundredfold.”

Are you groping in the dark, not knowing what to do? He says, “I am the light of the world. (John 8:12) When you walk in Me, you will not walk in darkness, but will have the light of life.”

Are you looking for a way out of a bad situation? He says, “I am your deliverer. I will reach down from on high, take hold of your hand and draw you out of the deep waters.” (Psalm 18:2, 16)

Are you wondering if there is more to life than merely existing from day to day? He says, “I am the resurrection and the life. (John 11:25) I came to give you life. And where there is life, there cannot be death. You will have life and life more abundantly.” (John 10:10)

Are you fearful of what is ahead of you? He says, “I am the good shepherd (John 10:11), who leads you to pastures of tender, green grass and waters of rest. You will not suffer lack.” (Psalm 23:1–3)

Are you confused by the opinions and reports of man? He says, “I am the Alpha and the Omega, the First and the Last. (Revelation 1:11) I have the final word in your life. The doctors do not have the final word. The experts do not have the final word. I have the first word and the last word in your situation.”

My friend, do not be fearful of the problems you face. The great I Am declares to you, “Fear not! For I am to you what you need Me to be!”

More Chemo??!!??

Ok, let me try and relay this information as clearly as I can. Yes, I'm getting more chemotherapy. No, the doctors don't believe that there is any cancer left. So, why more chemo? That is the question that we had to patiently seek out an answer to last week. I'm still not entirely sure I can even clearly articulate exactly why I'm here again but I will do my best.

For starters, I will try to explain what is going on with the mass in my abdomen. On my last post, I wrote about how the large tumor (12+ cm) that I had to begin with had shrunk to 2cm and that they were recommending a surgery to remove it even though there were no obvious signs of cancer. Actually, up until last Thursday that was still the same information that anyone of us had been told. On Thursday, March 29th, I met with the urologist that would be a part of the surgery so he could discuss what the surgery would entail. However, when Catherine and I arrived we received some rather surprising news.

We learned that the mass in my abdomen was not 2 cm, but actually around 4.5 cm. I know, huh? Shocking news right?!? This was the first shock. Yes, there's more. The urologist then went on to say that he was actually recommending one more cycle of chemotherapy before he would recommend the surgery.

Now, I will try to decipher the conundrum that we were faced with when we learned this news last week.

Basically, we learned that nothing had really changed. We were able to meet with a counselor who was a great mediator and communicator that did a really great job of describing to us the different vantage points of urology and oncology, and how different their reports can be. In a nutshell, it boils down to what each department is looking for. Let me explain. Hopefully I can do as well as the guy we met with.

Oncology (cancer doctor) is very specific at what they look for in a scan. They will see a mass and then try to look closer and determine points within the mass that might contain specific types of tissue. The urologist is the surgeon that would remove the mass. He simply looks at the big picture. He analyzes the scan and looks for things that shouldn't be there. He sees a mass and knows that he will have to remove the entirety of the mass, regardless of what type of tissue it contains.

So, my oncologist sees the 4.5+ cm mass but focuses on a 2 cm portion of the mass that he is worried about. There was 2 cm of something that he saw within the mass that he suspected to be tissue to be concerned about. There are still no signs of cancer. The tumor markers are 0. There is not a high mitosis rate (which would indicate cancer because it replicates and spreads at a high rate). The oncologist believes that the majority of the mass is scar tissue, all but about 2 cm of the mass. The 2 cm could be a couple of different types of tissue. Both are non cancerous. One of the types of tissue it could be is something I described in my last post: teratoma.

Teratoma, in my understanding, is actually a little more frightening than cancer in the sense of its predictability. There is none. It is benign, however will become malignant at some point. The point in time in which malignancy occurs is completely unpredictable and undetectable. Teratoma produces no tumor markers in the blood. It doesn't digest sugar at any rate comparable to cancer cells therefore can't be detected in PET scans. Quite literally, it goes from a simple non cancerous mass to a cancerous mass that is untreatable by chemotherapy or radiation at the drop of a hat. I don't understand how that can happen but I suppose if I did then I would probably not be here typing on this blog.

So, this is the type of tissue that both oncology and urology is worried about. I have a 4.5 cm mass in my abdomen. Both doctors believe that there is more than likely more scar tissue than anything because of the fact that is began as a large 12.5-14 cm mass. However, there is a possibility that there could be some teratoma (more than likely within the 2cm portion of the mass). The only way of knowing what is in the mass is actually taking the mass out and testing it, thus the surgery.

Why more chemo? That's a valid question. It's one that I don't completely understand. I'll do my best to tell you what I know.

The surgery, no matter when it might happen, would be an intense surgery. About 5 hours and at least two surgeons worth of intensity. Why so intense? It all has to do with the location of the mass. It is located behind my intestines between my spine and aorta. So, if you can imagine something fairly large lodged between your spine and your aorta and you can clearly see why I was in such immense pain in the beginning of this process. Anyways, there is no easy way to get to that location. They would have to perform what is known as a zipper surgery and I would receive a huge battle scar from it. It would consist of them cutting me open from the bottom of my sternum to the top of my pelvic bone, then taking out my intestines and laying them on top of my chest. This is just to get to where the mass is. Then, they would have to cut the mass out and while I was still under anesthesia they would slice it into pieces to run pathology reports on it.

This is where the different types of tissue comes into play. They would run the pathology reports and look at what the mass contains. If there was no reports of a certain type of tissue then they would put me all back together and I would be good to go. However, if they found some they would go back in and remove all the lymphatic tissue in my lower abdomen, on both sides.

To make a longer story somewhat shorter, this is why the surgeon recommended yet another round of chemotherapy. Both doctors are believing that I'll still have to have this surgery. The surgeon simply wanted me to go through another cycle for two reasons. The main reason was that it would lessen the chance of having to remove all of the lymphatic tissue in my abdomen. I'll explain why briefly.

The mass in on the left side of my body. The same side that the initial surgery I had to remove the cancerous testicle. Because of the location of the mass, there will be nerve damage to the autonomic nervous system. This is the part of our bodies that controls all of the functions of our body that we don't think about. More specifically, it controls all of the reproductive functions. Because of the fact that there isn't anything south of the mass on the left side (if you know what I mean), the surgeon isn't worried about damaging the nerves on that side. However, if they have to go back in and remove the lymphatic tissue on both sides it would damage the nerves on my right side (the good side) and yield infertility.

That's the major concern. The surgeon wants to increase the chance of the mass not containing the tissue that would require them to go in and remove all of the lymphatic tissue in my abdomen. Also, he simply wants to shrink the mass as much as possible. This would further define the mass and thus give him more confidence in removing all of it successfully.

Also, there is the initial size of the mass to begin with. We learned that about 95% of patients with this type of testicular cancer only have masses up to about 3 - 4 cm in size. The nature of this cancer usually produces smaller tumors that spread very rapidly through the body and into other major organs. So, for a mass to grow to a size of well over 12 cm is extremely rare for this type of cancer.

My initial treatment schedule (4 cycles) is the typical treatment schedule for advanced testicular cancer. However, I'm not the typical testicular cancer patient seeing as how the tumor I had was 3 to 4 times the size of what most patients have. With this in mind, it is only logical to assume that the normal amount of treatments wouldn't be enough.

Alright, I think that about explains why I am here. I know, it's a long confusing story and I am sure you are about as clear as mud as to why I'm back receiving chemotherapy. That is about as clear as I am, in my own understanding that is.

I'll tell you why I BELIEVE I'm back getting more chemo. Catherine and I, along with our families were basically decided on the fact that I was going to have the surgery. It was the doctors recommendation and although it was going to be a long, intense surgery we decided it was probably the best thing to do.

I believe that I'm back getting chemotherapy to allow God more time to operate my healing. This cycle of chemo will end on April 16th. At that point, we will wait four weeks and then have another scan (May 14th). That gives us about 6 weeks from today to pray. I will tell you EXACTLY what to pray for. I need this mass to be gone. Right now. I believe that God has already begun a great work and will complete it. The doctors don't even think that this cycle of chemo will do much. And it may not. BUT MY GOD IS GREATER THAN CHEMOTHERAPY. I believe that we will get to the scan in 6 weeks and there will be no mass, only a small memory of where it once was. I'm believing that the doctors will have no explanation of why there is no mass. There will only be one explanation: God is my healer, Jehovah Rapha, the great physician, as described in Exodus 15.

Agree with me, and my family. We believe that there will be no need for a surgery and that this round of chemo is simply evidence of God stepping in and giving us a little bit more time to unleash the power of prayer. So please, be apart of a miracle and spread this blog. There is power in prayer and power in numbers. Get on facebook, twitter, email, the phone, whatever. Spread the word. Commit to spending time in the next 6 weeks to continue a directed effort straight to this "mass" in my abdomen. I see it as gone. I see myself as complete, whole, and lacking nothing that would keep me from a clean bill of health.

And, as usual, in these weeks of chemo pray that the chemo would only affect the mass and nothing else in my body. Pray that there would be no temporary or long-term side effects resulting from more chemotherapy. Above all else, pray that the name of Jesus would be magnified and glorified through all of this.

-Kirby

Cancer Free!!

So, many of you may have already heard the news. I had a follow up appointment today to get the results of the PET scan I had last week. The results were great: no signs of cancer!

However, there was some slightly disappointing news. The mass that started out at 14 cm before treatments is not totally gone. There is still about 2 cm left. The scan showed no signs of it being cancerous which is good, but the recommendation was to have a surgery to remove it anyways.

I asked my oncologist what the chances were that the remaining 2 cm is just scar tissue and he said that in his opinion he believes that is the case. However, there is no way to determine exactly what it is unless they do the surgery. There is a chance that there could be a type of benign tumor known as teratoma left within the 2 cm mass. Like I said earlier, it isn't cancerous but if there is any teratoma then there's a possibility that it could develop into cancer later in life. This is ultimately the reason why surgery is recommended: to completely eliminate every possibility of cancer.

So, we will meet with the urologist that would perform the surgery to discuss everything. We can either get the surgery and then go back for scans every six months for a while, or opt out of the surgery and go in for scans every three months for a long time.

Continue to be in prayer for us. I'm healed and ecstatic, but we still need wisdom on what steps to take regarding surgery. I obviously don't want another surgery; however, I also don't want to go in for scans forever.

God is amazing and He gave me the strength to get through all of this crap. I'm completely confident that if I do end up having another surgery that I'll get through that just as seamlessly, and that it will just give more glory to God and bring even more people closer to Him.

The Finish Line

Today was my last treatment! I finally crossed the finish line of the hardest, longest race of my life. I'd like to say it has been fun, but it hasn't really. It's a little strange to be here. I'm not sure I even realize that the finish line is actually here. That may sound strange, but it's the truth. When your life is immersed in a daily battle like cancer, it seems as if the end will never come. Now that it is finally here, it seems false. It's like walking through the desert, longing for even a drip of water. Your body is shutting down. You feel like you're about to dry out, literally. Then you see a life source. A solution to your thirst. You see water. Or is it a mirage? Today, as I crossed the finish line it's as if my mind is telling me it's only a mirage. Stay focused. It's not reality. Yet it is. I know it is in my heart. As Jesus said, "It is Finished."

I've had a similar occurrence in my life, and it was in my racing. I finally won a National Championship my senior year of college. It was something I had dreamed about and worked toward for years. It was something that had alluded me. It was something that I knew I was capable of, but didn't know for sure if I would ever actually achieve. It was my focus. It was my goal. Then, in a matter of a couple of minutes and 1000 meters, it was there. I crossed the finish line before any one else.

It definitely wasn't the first time I had placed first in a race. I have a drawer full of t-shirts proving that fact (most collegiate track meets hand out a t shirt to the winner of an event rather than a medal or plaque). I just had never won a race of that magnitude.

As soon as I crossed the line I knew I had won, but it took me a while to realize it. I had another race less than an hour after my championship effort, so there wasn't time to realize that I had just won a national championship. I had to get focused and prepared for the relay that was to come. I felt as if there was much more riding on the relay race than on the race I had just won. There was. In the 1000m race I has just won, it was just me. Sure, my points helped the team but I was the only winner of that race. As soon as I finished I began to think about the three teammates that would take the baton after me in the relay. I began to think about the entire team that was depending on our relay for hopes of a team championship. That I had won a national championship hadn't really crossed my mind yet.

I wish I could tell you that our relay won, and it propelled our team to another indoor national championship for the school. But that didn't happen. I ran well, but not fast enough. Not as fast as needed. I ran a 3:00 for 1200 meters and handed the baton off in first place but by too slim of a margin. I needed to be a couple of seconds faster to set our relay up for the win. The cards didn't fall right for the rest of the relay and we ended up in a disappointing 4th place finish, allowing our team to finish in 2nd in the overall point standings.

You would think that after the track meet that I would have finally realized the championship, but you would be wrong. There was still more to focus on. That race was during the indoor track season, so as soon as it was over the outdoor season began. It was time to focus on the next goal, a team outdoor national championship. And, to make a long story short, we achieved that goal. I didn't win another race on my own. I placed 2nd in the 800m, and anchored our 4x800m relay to a 2nd place finish. Nobody was disappointed though, because as a team we battled over three days to win the first men's outdoor national championship in school history. It wasn't until this that I was finally able to understand the reality of the race I had won almost three months prior.

I pray that I realize this victory sooner. You can join with me in this. Pray that my body recovers quickly. Pray that I can get back to my typical daily routine quickly. Pray that all my hair grows back quickly! Pray that the next scan shows that I truly have victory and no more cancer. That I am healthy, whole, complete, and lacking nothing. Pray that the facts line up with the truth. I know I'm healed. Most of you know I'm healed. Now it's time for the doctors to know I'm healed.