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My sincere thanks to Marvin Olasky, editor, to Sophia Lee, journalist, and to Greg Schneider, photographer for a really nice story in World Magazine about my experience with cancer surgery and recovery. I hope it will encourage others who are dealing with physical and spiritual challenges, or both.  If you have access, you can read it online here: 
http://worldmag.com/2016/05/after_a_fiery_trial

Shortly afterward, the Discovery Institute posted a nice follow-up story here:
http://www.evolutionnews.org/2016/05/world_magazine102846.html

 
 
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I was reminded recently how precariously we stand on the edge of the precipice. Within minutes I went from carefree hiker to endangered species, then back again a few hours later. A freak incident could have ended my time on earth before I could even think about it. As I look back on this incident, I realize that I cannot assume that my neuroendocrine cancer will be the thing that takes me down eventually possibly ten to twenty years from now. Instead, some small, unknown threat could do it today. There’s no time to waste for any of us; we must live as if this day will be our last!

It was mid-afternoon on February 21, ten days ago as of this writing. As is my custom, I was taking an afternoon health walk. I was thinking about plans for the evening to teach a group of young people and visit my sister. My path took me above street level beside some flowering shrubs. Without any warning, wham! A flying insect stung me on my left ear lobe. I didn’t get a look at it—I don’t know if it was a honeybee, bumblebee or wasp—but it hit me like a sniper. Unpleasant as this was, I wasn’t worried too much about it, because I had been stung by bees before without anything more serious than local pain for a few minutes, but I decided I’d better head home.
I made my way to street level and started walking up the sidewalk. Within the first minute, I started noticing strange sensations. I felt prickly pains going down my neck and all over my back. My vision started get blurry. The farther I walked, the more tired I got, and breathing became labored. “I can make it home,” I thought, so I kept on. My feet suddenly felt burning hot. After about a half mile since the sting, I felt, “Man, I need to sit down.” Leaning on a post, I lost consciousness. 
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My next sensations are like snapshots of a dream: people leaning over me asking if I needed help. Men loading me into an ambulance on a stretcher. Hearing the siren as we raced down the street. Throwing up in the back of the ambulance. Being wheeled into the emergency room. 

Only yesterday did I find out just how close I came that afternoon to kicking the bucket. I found out who my rescuers were and was able to piece together the rest of the story. 

A man named Casey was driving along the street with his sister and young son, when he saw a man leaning on the post and then collapsing face-first. Thanks to his quick reactions, he found a spot to turn off the street beside me (the only spot available on this busy street) and told his sister to call 911. I had vomited, he said, and was having trouble breathing. We both remember that I said “bee sting”. Casey stayed with me till the firemen arrived. Fortunately, the nearest fire station was only blocks away.

Three firefighters raced over with the big engine and the smaller SUV-sized EMT vehicle, sirens blaring and horns honking. Joe was the first out, followed by John and David. Joe found me turning purple and brown in the face, gasping and aspirating in my own vomit. Quickly, he and the others cleared out my mouth and inserted a tube in my nose to help me breathe. My blood pressure was dangerously low. Joe got me onto my back. (I have a faint memory of looking up and seeing the sky.) They removed my shirt and prepared me for CPR, thinking I had suffered cardiac arrest, but Casey told them I had said “bee sting.” Two paramedics, Tom and Adam, arrived next. They put me on a stretcher and into an ambulance. Tom was able to get me to state my first and last name. He said, “We’re going to give you a shot, OK?” I was given epinephrine on the ride to the E.R. 
Once in the hospital I started recovering, but I must have faded in and out of consciousness, or slept, because I don’t remember much. I was awake enough at one point to give the nurse my sister’s phone number. When Judy heard I was in the hospital recovering from anaphylactic shock, she was horrified. No wonder I hadn’t shown up for the youth meeting!

After what seemed like just an hour or so, the nurse said I could be released. I noticed it was dark outside. To my surprise, almost five hours had passed. I found myself shirtless with adhesive pads on my chest and arms. When one of my nephews arrived to drive me home, the nurse provided a temporary paper shirt to wear. I was now fully conscious, but still tired; at home I slept some more. The next day everything was perfectly normal.
All that from one little insect sting. Who would have thought something so small could take a grown man to the edge of death in minutes?  In all my years of hiking, backpacking and camping, I had never experienced anything like this. I had never been allergic to anything in my life! Now I have to carry an Epi-Pen with me. I also take my Spot Device that can summon the nearest search and rescue team via satellite. Readers may want to think seriously about these safety measures, and get tested for susceptibility to insect allergies.
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I wanted to thank my rescuers, but had no idea how to find them. First stop was the hospital. I delivered a thank-you card to the doctor whose name was on the release papers. The receptionist told me that the EMTs were probably from one of two fire stations nearest my home, so I drove over to the nearest one and rang the bell. The captain, hearing the date of the incident, said that the C team had been on duty that day and would be back tomorrow. 
Returning the next day, I rang again. Captain Gabe, hearing my purpose for coming, was glad and said that yes, they guys were all here. He took me back to their break room and I met the whole squadron. Holding back tears, I told them all “Thank you; you guys saved my life.” 

Firefighters and rescue people rarely get closure on the lifesaving work they do on a daily basis. Needless to say, they were glad to see me looking strong and well. After some bear hugs and handshakes, they told me more about what had happened. One of them said it was one of the most severe cases of anaphylactic shock he had ever seen. I got details and names, promising to write the Fire Chief to commend them for their great work. I may also send the story to the local paper. As with anyone who protects the public, in the military, police, firefighters and paramedics, we owe them a sincere “thank you for your service.”

As I left to walk the final mile home, praying and almost choking up at how serious a situation I had been in, I felt a verbal thank you was too little. After some shopping, I returned to the fire station a few hours later with some stuff. Walking back into the station, I handed Joe two bags of “Lifesavers” candy; he shrugged and said, “Aw, you didn’t have to do that.” I said, “That’s just the appetizer. Come give me a hand.” Soon we were carrying two bags of chips and drinks and a big cake displaying, “To the Lifesavers of Station 150.” It was party time!
The guys welcomed me into their comradery for the next hour, giving me a tour of the station, swapping stories and (of course) enjoying hearty helpings of cake. One of the top experts in hazardous materials, an instructor at UCLA on the side, gave me a tour inside the big HazMat truck showing all the high-tech equipment that gives them readiness for chemical spills as well as chemical or biological weapons. Really impressive! I gave the team a copy of the Living Waters DVD that I had helped on, and also an autographed picture of Cassini from my JPL days that they happily added to their display case. 

As I left, I learned the names of the paramedics, and also obtained the phone number from the 911 roster that allowed me to reach Casey. He was glad to hear the rest of the story; he said he had been telling friends about it all week, but didn't know what happened after the ambulance left. I also stopped in at Station 107; Tom the paramedic was there. When I thanked him, his face lit up like the others, glad that his “routine” work had made a difference. I gave him a bear hug and encouraged him to keep saving lives.
All’s well that ends well, Shakespeare wrote. But this story could have turned out very badly for me and my loved ones. I had almost chosen a more remote route on my walk, where nobody would have found me. The EMTs said that without quick treatment, I could have died of asphyxiation, because the overactive immune system constricts the airways. How mysterious is it that a Good Samaritan like Casey would find me in the nick of time and stop to help? And what if the EMTs had been a few minutes late?

We often don’t realize how tenuous our grip is on life. Last month there were news stories circulating about a man struck and killed by a meteorite from space. We all know death is coming, of course; the news is filled every day with tragedies both natural and human-caused. Many of us, however, act as if we have plenty of time till our day comes. The Apostle James reminds us that our life is like a vapor that appears for a moment then vanishes away. We shouldn’t boast about our plans, but rather begin each day with, “If the Lord wills, we will live and also do this or that” (James 4:13-17).
Because I am following God's trail map, fear of death is removed by the cross and the empty tomb. But I do have some work I’d like to complete while still in the body, if the Lord wills. This incident reminded me that each breath, each heartbeat, is a gift not to be squandered on worthless pursuits, but on things that matter for eternity. As I write this, I hear an ambulance siren out on the street.

My dad was one-of-a-kind. He always put his heart and soul into everything he did. One of his hobbies was music and songwriting. The words to one of his songs came back into my mind after this incident; it expresses what drove him to work so hard for many years. I share it as an exhortation to each of us to invest each breath for the kingdom of God.  
No time to linger; life rushes on.

Make every moment count before it’s gone.

Each individual has work to do;

No substitution—there’s no other you.


 
 
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The Carcinoid Cancer Foundation's list of "10 Highlights of the Year 2015" is good news for those of us in the carcinoid and neuroendocrine tumor community. Here's the short version:
  1. Lutetium-177 PRRT was given fast-track designation by the FDA.
  2. Everolimus passed a Phase III trial.
  3. Those with untreatable carcinoid syndrome now have a new medicine.
  4. University of Iowa received a $10.7 million grant to study NETs.
  5. A global study of 2,000 NET patients was undertaken.
  6. NIH found a genetic link to gastrointestinal NETs
  7. The winner of the 2015 Warner Advocacy Award was announced.
  8. NET Cancer Awareness Day was the largest ever.
  9. A new app for NET patients was released.
  10. Various news items were collected into the #10 slot.

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In addition, City of Hope is doing some amazing research. On December 16, Giovanna Imbesi of LACNETS and I got to tour a research lab on campus where molecular biologist Dr. John Williams has recently found ways to literally "bolt on" custom molecules to antibodies. After finding that antibodies have a central cavity, he tested ways to insert a molecular "bolt" into the space where he can fasten on items like drugs or radioactive substances. This technology, called Meditopes, is a cutting-edge method for targeted therapy that may become very significant for cancer treatments in the future. It will allow physicians to precisely target tumors with therapeutic agents, producing minimal side effects. Watch the video and get encouraged!

These are exciting times, when a carcinoid cancer diagnosis is not necessarily a death sentence any longer, but a chronic illness that can not only be managed, but may be curable in the next decade or so if these trends continue. Stay encouraged, and meanwhile, do all you can to take care of yourself through diet, exercise, prayer and faith in God.
 
 
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When you have cancer, parts of your body lose function. Your oncologist may tell you not to make certain movements or eat certain foods.  You may have to give up some favorite activities. You may experience pain and fatigue. But until that day you “go under” (and who won’t sooner or later?) you have many body parts that are working just fine. Think about those: Do your eyes work? Does your mind work? Are you able to walk? Think of Stephen Hawking living in a wheelchair, using his fingertips to communicate complex mathematical equations.  If he can do so much in his condition, there are many things you can still do. Focus on what works, and resolve to use it to the fullest. 


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At the beginning of a new year, we often make resolutions. Cancer patients need to rejoice about their abilities, not groan about their infirmities. What can you do this year? Set a goal, and try to reach it. This will keep you in a positive frame of mind—something bound to improve your immune system and enhance your quality of life. I realize I’m one of the lucky ones, with a neuroendocrine cancer that is slow-growing and controllable with injections. Except for a liver filled with tumors, I have good health at this time. Since my doctors had told me after my surgery that walking was one of the best things I could do for myself, I resolved last January to walk 1,000 miles in 2015. 


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I realized this project would mean averaging over 2.7 miles a day on intentional, dedicated health walks. It would mean walking in cold, heat, and rain, and sometimes in the dark. I had walked about 870 miles the prior year, so this would mean averaging an additional half mile per day. That's a significant time commitment (about an hour per day). There are always some days you just can’t take the time, when you are traveling or in long meetings, or too sick to do anything; those will require longer walks to fill the gap. But it was something I thought I could do, so I set my sights on that new personal record.

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Most of my walks were outdoors. For the really bad weather days, I might use the elliptical, keeping track of “miles” on the counter, but I prefer outdoor walks. I mapped out various routes from my home that were two, three, four miles or more. I became a familiar sight to neighbors and commuters I’m sure; sometimes I would explain my goal to neighbors, and they would wish me luck.


Photo: Here I am on Fresno Dome in the Sierra Nevada mountains.


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On a few occasions, when traveling or vacationing, I took walks in national parks, deserts or wilderness areas. My longest walk in one day was 18.5 miles in Yellowstone’s back country, keeping a sharp eye out for grizzly bears. Wherever I was, I kept at it, rarely missing a day. It became a routine part of my life.

Photo left: Overlooking Paria Canyon in Utah.

Photo below right: Deep in the Yellowstone backcountry.

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Preparation can make walking more enjoyable. On a typical warm day in southern California, I take a trekking pole, a water bottle in a belt holster, some dog biscuits for the neighborhood dogs, a hat, my keys and a SPOT device for emergencies. Other than that, I travel light, wearing shorts and going shirtless whenever the weather permits, avoiding the sunburn hours.  I use a smartphone app called Runtastic that monitors distance, speed and elevation gain. Recently, a friend gave me a Fitbit; this, I have found, shows that I usually walk 50% more per day than what Runtastic records on my dedicated walks, due to incidental walking around the house or when out on errands.

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To pass the time, you can listen to favorite music, podcasts or radio shows through headphones. This really helps take one’s mind off the repetitive footsteps. Sometimes I'll pray for those on my cancer prayer list. Sometimes I'll try to estimate how far the next landmark is. Another thing that helps is multitasking errands. If I need something at the grocery store, or need to go to the bank, I'll walk there instead of drive. Sometimes I’ll snap a selfie of my walk in a location that might interest my Facebook friends. One I took in the rain (see above), another on a Sierra dome, and one at a Yellowstone lake.
Photo: At a Sierra Nevada waterfall.


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Each day I record my progress in a spreadsheet. I also record my blood pressure, weight, and any other exercise like weight training done that day. A spreadsheet allows you to quickly add up the miles and the elevation gain. Knowing that you are making progress toward your goal helps keep you motivated, and lets you know the pace needed to reach the target on time. You don’t want to get 50 miles behind schedule!  I try to stay ahead of schedule to build in some margin for the unexpected.

Photo: I'm fortunate to live near some hills and valleys for some of my favorite walking routes that begin right from my house.

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I’m happy to report that on Christmas Eve I met my goal. I knelt at my 1,000th mile mark and thanked the Lord for the health and strength to reach it. Total elevation gain was over 160,000 feet—that’s over 30 vertical miles that my muscles hoisted my body weight up against gravity. My total for the year was 1,020 miles, about the distance from Los Angeles to the Canadian border.

Photo: Shortly after reaching Mile 1000. My usual walking pace is 3.4 mph.


It’s really astonishing to think of what a human body can do. Imagine engineers building a robot that can walk a thousand miles over all kinds of terrain and automatically repair itself from its fuel! From Fitbit data, I figure that amount of walking entails well over 2 million steps involving multiple complex systems: muscles, nerves, sense organs and more. Similar wonders exist in every body system: eyes, ears, hands, brain—everything. With bodies this amazing, it would be a shame for any of us not to use them to the fullest, even if they are partly afflicted with cancer.

Walking may be out of the question for you. I only tell my story to share how satisfying it was to set a challenging goal and achieve it. As I have posted before, diet and exercise are key things you can do to get involved in your fight against cancer. You owe it to yourself to strengthen what remains and keep using what still works. Can you lift a weight while sitting or lying down? Can you take deep breaths and do isotonic muscle exercises? Can you use your mind to write, compose music or carry on a ministry such as calling others regularly to pray for them? Before my older sister died of cancer, she and her husband continued their habit of calling friends to wish them a happy birthday, even as she and her husband were both declining physically. It required keeping a list of birth dates and phone numbers for dozens of people, and making the effort to call them and cheer them up on their special day. In addition, she and her husband would regularly pray for others and take gifts to them when then were suffering. It’s no wonder that 300 people showed up at her funeral, so touched by her thoughtfulness!

The best New Year resolution is to serve God and others. Sometimes this entails taking care of your own health as best you can. This is the time of year to set a goal and make plans to achieve it. Go for it!
 
 
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Here is a response to a friend who sent me links to watch some videos called "The Truth About Cancer" by Ty Bollinger. In this letter I share some principles that guide my thinking about alternative therapies.

Hi [name],
Thanks for the links. I watched the first & second videos, but find them to be a mixed bag. I certainly empathize with Mr. Bollinger's motivation to question things after the loss of his parents to cancer, but I don't think that qualifies him to be an objective spokesperson for "the truth" about cancer. I agree with the need for nutrition and exercise, but many of his statements and those of his expert witnesses don't provide a complete or accurate portrayal of the situation with cancer care, according to my experience.  (Hiram's Law: If you consult enough experts, you can confirm any opinion.)

A lot has changed in cancer therapy over the last 5-10 years. It's not all systemic chemo and radiation now. There are targeted therapies and immunotherapies that are almost miraculous, with more discoveries every week. Any time I hear about "the cancer industry," I cringe. It's so unfair. We may as well talk about the "cavity industry" as if there is a conspiracy between dentists and toothpaste manufacturers, who are determined to keep us in dental chairs to make money for themselves. The doctors I know would be thrilled to see a cure for cancer. My surgeons are ecstatic that I am doing so well. Any researcher who found a cure for cancer would get a Nobel Prize. The conspiracy idea is unfair to many thousands of doctors and researchers who have devoted their lives to the elimination of this scourge. If cancer were cured, the cancer centers and hospitals would have plenty of other ailments to work on. City of Hope, for instance, used to be primarily a tuberculosis treatment center.

One problem is that cancer is complex. You can't put all cancers in one category; they're all different, and patients are all different.  The causes, too, are different: everything from genes to carcinogen exposure to radon gas. That's what makes it so hard to understand and treat. It's simplistic to think that one treatment modality will work for everyone. Every week I read about new insights into cancer from research labs all over the world. Amazing discoveries are coming from understanding the immune system. Science Magazine called immunotherapy the "breakthrough of the year" at the end of 2013, and more discoveries are coming apace. Some patients with advanced melanoma went into complete remission with immunotherapy--but others in the same trial did not. Figuring out the reasons for the difference is a hot area of research right now. It may require personalized medicine to help people. One size does not fit all.

As for the insinuation that the "cancer industry" is opposed to nutrition or alternative medicine, look at what City of Hope is doing:
http://www.cityofhope.org/natural-therapies#Overview
City of Hope and other cancer centers have specialists in nutrition who advise patients on what to eat. That was true in my case. They didn't want me back! They wanted me to stay healthy and successful.

I'm sure there are cases where drug companies are blameworthy; after all, they are businesses, and have to watch their bottom line for their shareholders. But they are also highly regulated by the FDA (perhaps over-regulated); it's a huge debate about how much regulation is appropriate. New therapies in Europe often become available years before the US catches up; I know people who have flown to Sweden or Germany to get treatments still unapproved in America. Clinical trials are often dreadfully slow.  I would be more critical of government regulators than drug companies. If a company could extract a compound from a plant and market it as a cancer cure or preventative, they could make a fortune. In fact, that is what they do; many top drugs are plant derivatives. The injection I get each month is made to mimic a natural hormone inhibitor; it works with no side effects, going right to the tumors. It's like a miracle drug. There's a new compound that was just FDA-approved that does even better.  No side effects! I keep my hair. No nausea. This is terrific.

"Chemotherapy" is way too broad a term. Each drug has its benefits and side effects. Most are targeted now; except in extreme cases, systemic chemo that damages healthy cells is on the downward trend. Radiation therapy has also come a long way. There are many different types and methods now. For my kind of cancer, there are microspheres that can go direct to the tumors and blast them with short-range radiation, leaving healthy liver tissue untouched. Proton beam therapy is coming into prominence now.  It's misleading to lump these treatments into general terms like "chemo and radiation" to scare people.

I agree strongly about the importance of nutrition. That's why I eat a lot of fruits and vegetables that have known cancer-fighting properties. It's also why I exercise every day. It's definitely helping, but it's not a cure; each MRI, those liver tumors are still there. I know people who did everything right and still got cancer, and others who live into old age with bad habits. It's inaccurate to suggest that tumors are just symptoms of bad diet, or that lifestyle changes will attack the root of the cause. Good lifestyle habits are important, but are no guarantee.

I also cringe at the suggestion that people should avoid standard-of-care treatments and go for alternatives only. I know of cases where people died doing that. Steve Jobs, in fact, had my kind of cancer, and died years before his time by going after empty promises about herbal remedies. There are quacks making a living off phony cures (talk about a conspiracy!). An MD in Texas, for instance, has evaded FDA shutdown for many years through legal loopholes, offering a phony cure based on a phony theory that no other  doctor or scientist accepts. I've had well-meaning and intelligent people come to me and offer me books or pamphlets about this-or-that herbal remedy or product, but when you look at the evidence, it's often woefully inadequate... usually based on testimonials. Isolated success stories do not prove effectiveness. Spontaneous remission can occur. It takes controlled trials with large numbers of people to obtain reliable evidence--evidence that overcomes the biases to which we humans are prone. 

My red flags about cancer claims: 1. The" cancer industry" doesn't want you to know this. 2. So-and-so took this and was miraculously cured. 3. Buy my product.

Carcinoid patients who follow the standard of care are often living for decades now, and the numbers continue to improve. It doesn't have to be either-or. I follow the standard of care, but I also eat right and exercise. I urge you to look beyond these videos and follow reputable sources that provide evidence-based information. We each have the responsibility to weigh everything carefully, and hold fast to what is good. In the final analysis, our days are in God's hands. I am convinced that prayer was the main thing that got me through my ordeal.

Thanks again, and blessings to you and [your husband]. Stay healthy!

 
 
PictureOn one of my daily walking routes
As I write about exercise, I realize I'm one of the lucky ones.  I regained my strength after my surgery, and my outlook is good for some years unless my tumors act up again.  Many reading this may not be so fortunate.  All I can say is, you owe it to yourself to strengthen what remains.  Martin Luther King gave memorable advice about perseverance: "If you can't fly then run, if you can't run then walk, if you can't walk then crawl, but whatever you do you have to keep moving forward."  To do less is to quit and die.  Don't quit!  Give it your best shot.

We have remarkably resilient bodies.  The parts of your body that are not cancerous are probably working just fine.  When we strengthen those parts, they share their strength with the afflicted parts.  A diligent program of exercise (whatever you are able to do), helps your immune system get stronger, and your immune system is your best internal cancer fighter.  Exercise is not a cure, but it sure beats quitting!

Numerous scientific studies affirm the value of exercise for cancer patients (recent example).  Exercise does wonders not only to your body, but to your mental attitude as well.  Supported by a healthy diet, you might add precious months or years to your life – perhaps long enough for cutting-edge research to find a cure.  Whether or not that happens, you will have enjoyed those precious days, months, and years much better than if you had quit. Exercise feels good!

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It Starts with Determination

As I lay recovering in the hospital bed, the doctors and nurses told me one of the best things I could do for my recovery was to walk.  I took that to heart.  I couldn't even eat solid food yet or pass gas through my newly shortened intestines, but I didn't wait for them to come and make me walk; I asked them to come and walk me!  It was painful at first, and for the first couple of days they had to pull the IV rack alongside me, but I was determined to walk, walk, and walk some more.  Soon I was pulling the IV rack myself as I walked.  When the surgeons allowed them to remove my IV and drainage tubes, I surprised the nurses by walking unassisted up and down the aisles, even before I could blow the plastic ball in the breathing toy up to the normal level.  By the end of the week, I was walking the entire floor four times in a row at a pretty fast clip.  The amazed nurses cheered me on!

PictureExhilaration!
Make it a Project

When I first got home, I could hardly stand up straight.  I was told I couldn't lift anything, and needed lots of rest.  But I could walk: and so I did.  The first day, I walked up the sidewalk the distance of two houses, then I turned around and walked back.  That was all I could do for the whole day.  The next day, I walked up 3 houses.  The next day 4, then 5, then 6.  I made it a project to add another house each day.  Pretty soon I was adding two at a time, then more.  Gradually I could stand up straighter despite the scar, and my lungs improved.  It took weeks, but I could finally blow the plastic ball up to the top of the tube.  I was feeling much better!

There was hardly a day when I didn't walk.  I kept records of my progress on a spreadsheet.  By March 18, just two weeks after returning home from the hospital, I walked my first mile.  Ten days later I walked 2 miles.  The very next day, I made 3 miles!  Two days later, 4 miles!  It was working.  I could feel my body getting stronger.  I decided that I would walk 2 to 4 miles every day, and I have kept that commitment ever since.  By the end of 2013, I had walked a total of 700 miles, the distance from Los Angeles to Denver!  This year in 5 months I've done 370 miles already.  At this pace, I may break 900 miles in 2014, and if I were to push it, a thousand-mile year is possible, just walking for about an hour a day.

PictureSkydiver Leap, about 55'
What Exercise Can Do

My walking program was so successful, in fact, that less than 4 months out of the hospital, I went backpacking!  I carried my own 45 lb pack 10 miles into the Grand Canyon and back out.  The photo shows me jumping off "Skydiver Leap," about 55 ft high, into a deep pool.  I had not attempted that jump in 11 years, and here I was, now a cancer survivor, well enough to do it at age 62.  My surgeon's eyes widened as I showed him this; "That's insane!" he exclaimed, sharing the astonishment of a phenomenal recovery.

Just two months later, I backpacked again deep into the Sierras, hiking about 20 miles with some non-trivial elevation gain.  I was able to keep up with young adults half my age.  Before my surgery, I worried I would have to give up these strenuous activities.  The benefits of daily exercise, along with my doctors' ongoing care, had given me a new lease on life.

Between these major outings, there were numerous day hikes, some strenuous.  One nearby trail rises 2000' in 2.3 miles.  I made it to the top and back, not too shy of my personal best, within 2 months of returning home.  (In this part of the country, I do have to watch out for rattlesnakes.  I've seen half a dozen on my walks since surgery.)

PictureOne of my 4-mile routes
Make it Varied

To keep my walks from getting monotonous, I mapped out several routes from my home.  Using Google Earth, I measured routes that are 1 mile, 2 miles, 3, 4, 5, and 6.  The picture shows one of my more challenging 4-mile routes.  You can see the trail stretching off into the distance, all the way to the freeway far, far away at right.  I get 700 ft of elevation gain as I go up and down from the hilltops by the powerlines down into the valleys and back up.  Hills are the best exercise for walks.  They give the lungs and muscles a workout.

Other routes take me up sidewalks in the neighborhood.  One benefit is that I have met many neighbors I never knew before!  A one-mile route takes me by all the homes in my housing tract, and I have enjoyed getting to know people.  I carry dog biscuits in my pocket to make friends with their dogs.  When Max and Bailey see me coming, they run to me so fast for their treats that they pull their owners running behind them on the leash!  Nasty barkers are now my friends.  The neighbors have been encouraging when I tell them the reason for my walks.  They smile and cheer me on.

Other routes take me by a shopping mall.  I can walk to a sandwich shop, buy lunch, and walk back in 2 or 3 miles.  Sometimes I drive to nature trails.  Variety helps keep it a fun project, not a boring routine.

PictureIn my preferred attire (less laundry)
Exercise Your Ears, Too

These days, you can take the edge off exercise with a smartphone and headphones.  I listen to music and the radio, and before I know it, my walk is over.  With my water bottle strapped on my belt, a hat, walking poles and my headphones, with a few dog biscuits in my pocket and sometimes an apple or granola bar, I'm off.  On most days my walk takes less than an hour.

I like to go when the sun is low to avoid that southern California sunburn.  When it's warm, and I hike out on nature trails away from people, I prefer going shirtless.  There's fewer sweaty T-shirts to wash, and it feels so good and free with the breeze on the skin.  At first I was self-conscious about that 12" scar on my abdomen, but now I wear it like a badge of honor.  It's my reminder of God's goodness to me to He has let me regain my health so well, so soon after being near death's door.  You appreciate your body so much more when you don't take it for granted!

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Use It or Lose It: Add Some Weight Training

Before the surgery, I had lost a lot of muscle mass.  My arms and chest were skinny and embarrassing.  So with the principle of "strengthen what remains," as soon as I was able to lift things again, I added weight training to my exercise regimen.  Every other day I do bicep curls, and alternate with dumbbell flys.  This shot was taken 7 months ago, and I'm continuing to get bigger each month.  That's another benefit of exercise in "thriving with cancer" -- if you can do it, it improves your sense of well-being, because you're not as embarrassed to look in the mirror as before.  You feel like you're making progress, not wasting away.  Most people have no idea what I'm dealing with unless I tell them.  That's one weird thing about carcinoid cancer.  The title of a new book about carcinoid patients is, "But you look so good!"  Yes, but...

Picture7 months out of surgery
Our Bodies Are Made to Be Strong

The Bible speaks metaphorically of God's "strong right arm" with which He comes to the aid of His people. Strength is honored in the Bible, not as the highest good, but as a good nonetheless.  "Therefore strengthen your feeble arms and weak knees, and make level paths for your feet," Hebrews 12:12-13 says, "so that the lame may not be disabled, but rather healed."  The Great Physician did His part in making you.  Now do your part in strengthening what remains.

PictureA wise man is strong, and a man of understanding increases strength -- Solomon
The Bottom Line

Can you tell I'm an advocate of exercise for cancer patients?  I'm not alone.  Like I said, there are numerous studies backing this up.  It's one of the best things you can do for yourself.

Even so, I realize it's not a cure, and it's not for everyone. A friend in my cancer support group has been an avid bicyclist all her life, but now is in advanced stages of carcinoid cancer.  Her bones are brittle and she is in constant pain.  Exercise is not an option for her.  Others are bedridden, dealing with severe side effects from chemotherapy or radiation.  My heart goes out to them.  There are a dozen people with cancer on my prayer list in various stages.  Even though I encourage them to exercise, I know I don't walk in their shoes.  I can only tell you my story that has worked for me up to this point.  I realize that I'm in a kind of "Indian summer" before the storms of winter hit me, too.  I've got time bombs in my liver that could become active any time. 

But isn't that true for everyone?  No man knows his time.  We're all afflicted with an incurable disease--mortality--that is going to get us eventually.  You could be hit by a bus before the cancer gets you.  Why not make the most of each day?  Your life is like a box; some boxes are bigger, some smaller.  Your box may be small, but you can choose to fill up and fill out the box God put you in.  By doing so, you may get more out of your life than someone in a big box who huddles in the corner.  So don't just sit there and bemoan your fate.  If you can squeeze your hand, exercise your forearm.  If you can breathe, do breathing exercises.  Do whatever your doctors don't forbid in the way of exercise.  You might just surprise them!

 
 
PictureWith my sister after returning home
A year ago today, I was released from the hospital.  Being appreciative for the doctors, nurses, family members and praying friends who helped me through my ordeal, I resolved to do all I could on my part to take care of my health.  This would be something I could do to give them a reason for rejoicing, to show that their care was not in vain. One of the things health professionals agree on is that stress is to be avoided.  Here are a few things I have found helpful to keep a healthy attitude.

Gratefulness
Many surveys have shown that grateful people have better health.  It should be intuitively obvious, but it bears up in evidence.  Stress cannot be good for a body trying to recover from cancer.  One sure stress reliever is gratitude.  An old Sunday School chorus advises, "Count your blessings, name them one by one; count your many blessings, see what God has done."  To be genuine, gratefulness must be unselfish and sincere.  You can't say, "I'll try to act thankful so that my health improves."  That's not gratitude; that's selfishness.  

Have you noticed how easy it is to murmur and complain?  Gratitude requires effort.  There's something about human nature that finds perverse pleasure in complaining.  We identify the bad things in a situation before the good.  We need rain but complain about it when it comes.  We need government but rake the politicians over the coals.  Watch out for that in others and in your own habits.  We cancer patients naturally worry about the tumors that remain in our bodies, but how often are we grateful for the body parts that remain healthy?  Make a list of all your body parts that are still working just fine— taste buds, your limbs, your eyes, your heart, your brain—you'll be surprised at how much you can be thankful for.  

My mother is slowly wasting away from dementia.  When I visit, I know that one thing that can open her eyes and bring a smile out of her usual sleepy posture is a dish of ice cream.  We have little parties together, with ice cream followed by prayer time.  I'm happy when she smiles, and her expression shows she is happy her taste buds still work.  If we could all focus on the good parts of our lives, we would relax more – and improve our health.

Unselfishness
Getting cancer has raised my awareness of others in the same battle.  I've made a point of praying specifically for cancer patients the Lord brings along my path. As a leading cause of death worldwide, cancer is near to the minds of many, many people.  Bring up the subject and you immediately start a conversation about a loved one they lost, or ones they know who have it.  I'm one of the lucky ones with a slow-growing kind that can be treated.  Some in my support group with carcinoid cancer have much more advanced cases, and have been through far worse ordeals – multiple surgeries, treatments with bad side effects, and symptoms that affect their quality of life.  

Praying for others and helping them in tangible ways, or with a simple word of encouragement, helps them and helps you.  Once again, you can't fake sincerity!  We need to cultivate the habit of unselfishness by taking time to pray, comfort, and help those in need.  To reduce stress, though, you can't lapse into worry about things you cannot control.  That's why having confidence in God—who is in control and cares about His creatures—is vital.  With faith in God, and knowledge of His promises, you can calmly act as His angel of comfort, and leave the outcome to Him.

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Sharing
One of the ways you can help others is to share helpful resources.  See if there is a support group in your area for people with your kind of cancer.  It's a great way to not only find emotional support, but to get practical information on treatment options.  In a good support group, you can give and receive help.

One of the unique resources I have to share is my sister's book, Hope for Those Who Hurt.  Jeanne Tomlinson and her husband Howard went on a roller-coaster ride of emotions for a decade as they dealt with his brain tumors.  The lessons they learned are preserved in this short book that not only tells their story, but can be read as a daily devotional filled with helpful attitudes for anyone dealing with medical trials.

Another helpful resource specifically for cancer patients is Larry Burkett's short book, Nothing to Fear: The Key to Cancer Survival.  The late financial adviser was given 2-3 years to live with kidney cancer, but lasted 8 years – and he didn't succumb to cancer, but rather to an unrelated medical condition. In his semi-autobiographical text, Burkett shares what worked for him.  He gives practical, reasonable tips for managing cancer, controlling diet, exploring treatment options, and especially, building a confident faith that can provide hope and relieve stress.

There's no substitute, though, for being there with the hurting person.  Spend time talking with others.  Let them express their worries and doubts.  Can you be their shoulder to lean on?  Can you provide helpful guidance?  Can you research answers they need?  If you can be a stepping stone, not a stumbling block, you will help yourself as well as helping them.  There's an inexpressible satisfaction when someone is blessed by what you provided.

Knowledge
"Knowledge is power," Francis Bacon famously said.  Understanding your cancer can help you deal with it rationally.  Like diet and exercise, it's one of the things that can make you feel empowered as you face this formidable enemy – provided you don't dwell on the negatives.  Instead, learn all you can about the treatments available.  Larry Burkett reminds us that we are in control of our health care decisions.  It's defeatist to just flop on your oncologists.  They are essential, requiring our trust, but they don't know everything, and some have mixed motives.  Not all doctors are created equal!  Find the ones that really understand your cancer and have a good track record.  It's best to have a team of specialists working together.

Be sure your knowledge is sound.  One of the things you find as a cancer patient is that friends are all too eager to help you with advice about diets, miracle cures, and quick fixes.  Some of the advice I've encountered is pure quackery.  Don't put your hope in weird, unconventional cures, especially if someone has a product to sell or claims that the medical establishment ("the cancer industry") is a giant conspiracy trying to suppress their miracle cure.  This is not to say that medical "evidence based research" with clinical trials and all is infallible, but it's the best we have, with the best track record.  Cancer survival is much higher now than it was 30 years ago.
  
What I suggest is to study up on your cancer when you are in the mood to do it – when you can be rational and clinical in your mind.  Maybe a spouse or other family member can assist.  Once you know all you need to know (or all you are prepared to deal with at the time), make the best decisions you can, then let it go.  Don't dwell on it.  Don't visualize the tumors.  Don't fear what might happen (it hasn't happened, yet).  Avoid those traps by finding worthwhile things to do.


PictureIn a better world with my headphones
Creativity
Another stress reliever is spending time doing creative work you enjoy.  Whether quilting, playing an instrument, painting, or practicing a sport, we all have special activities that give us fulfillment.  My problem is too many hobbies!  I love to write music, take pictures and video, lead hikes... my list is long.  I just wrote a composition for concert band, with all the parts--clarinets, trumpets, drums, the whole shebang!  I performed it in my home studio with my electronic musical instruments, and now I can listen to it with headphones on my walks.  Wow!  Sure, I'd be happy if others liked it, but whether or not anyone else ever hears it, it's a big emotional lift for me, and cancer is the farthest thing from my mind when I'm engaged.

Another carcinoid patient I know is a pianist who produced a beautiful album she shares with people.  She said it's what got her through her ordeal.  Pity the person who has nothing to do but flop on the couch with the remote.  If you don't have a creative interest, find one—it will do your body and soul good.

Mountain LakeWhere I'd rather be, away from troubles
Beauty
I like to think of the world as a 360-degree, surround-sound, audio-visual resource.  Do you have opportunity to view the beauty of nature?  Try it: it's health-giving.  The song of birds, the color of a rose, the glory of a sunset – there's no end of natural wonders that can refresh your soul.  

Even if you are bedridden, you might be able to watch beauty on a TV screen.  I assist a film documentary company that makes outstanding nature videos and inspirational films.  We just finished an inspirational film called "King of Creation" (see trailer at this link) featuring Scriptures, hymns and awe-inspiring scenes of nature.  I'm going to get a lot of copies to share, and will be watching it over and over myself to relax. Scientific studies have shown that beautiful scenes of nature help hospital patients heal faster.

Music, too, can be a tremendous healer.  I recommend classical music.  Cancer patients don't need the incessant hard beat of rock that assaults the eardrums.  Maybe you can tolerate it; I can only speak for myself.  But the soothing sounds of strings and oboes and horns is always in style.  Many great works can lift you out of the pains of this life and take you temporarily to a kind of heaven.  You can tell a good piece of music, because it bears listening to over and over, but you always find something new.  Maybe your taste is jazz, country, or something else, but consider music as one of your most practical stress relievers.

Other audiovisual aids, like books and movies, can also take your mind off your cares for a time and lift your spirits.  I purposely avoid high-stress movies unless there is some redeeming value; I don't need more stress, I need less of it!  Why put your emotions through the wringer with someone else's troubles, real or imagined?  Sometimes it's justified, but aim for things that will relieve stress in your life.  That goes for a lot of things.  Remove yourself from the presence of stressors.


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Priorities
If you have quality time, use it wisely.  None of us knows if we are going to be cured, or how much time we have.  "Which of you by worrying," Jesus said, "can add a single day to your life span?"  With apologies for an old cliche, remember that each day is a gift: that's why it's called the present.

What were the things you always wanted to do before you die?  Hopefully they are good things.  I know I've had to reconsider what things are worthwhile and what things can lapse.  I'd really like to have a well-organized garage, but there are other things far more important now.  Maybe I'll get to that some day.  If I don't, no matter.  What is important to you?  Make a list of things you don't want to leave undone.  Cancer patients are keenly aware of the preciousness of life, but even if we didn't have that reality, we all know we are going to die sometime.  It could be soon (a car crash, a heart attack, a crime).  So we cancer patients are there with all mankind: everyone is in the same boat, facing the inevitable.  If something in your life is important, don't put it off.

Certainly one of the most important things on your list will be to tell your spouse, children, or best friends that you love them.  If you've been taking them for granted, it's about time to write it into your "list of things to do today" to express what they mean to you.  Maybe your list will include asking forgiveness for a past wrong, or clarifying a misunderstanding.  Maybe it will be planning for the needs of family members, writing or updating a living trust including an advance healthcare directive.  Maybe it will be taking a trip to somewhere you always hoped to see, or giving a special person a gift.  Why has that important priority been on the back burner so long?  Cancer is a wake-up call to stop procrastinating.

There is no greater priority in life than to know your Maker and be in a right relationship with Him. On this website, I provided a map to summarize the way shown in the Bible, God's Word.  Let that be a start, but don't just read the map: get on the trail—the straight and narrow path that leads to eternal life.  How long since you opened a Bible and read it?  How long since you talked to your Creator?  If you are a Christ follower already, no doubt you have friends or family members you have wanted to talk to about the Lord.  Don't put it off any longer.

What could be better than to end this life like Paul, saying, "I have fought the good fight, I have finished the race, I have kept the faith. Henceforth there is laid up for me the crown of righteousness, which the Lord, the righteous judge, will award to me on that Day, and not only to me but also to all who have loved his appearing" (II Timothy 4:7-8).  To be safe in the Lord's hands, to look forward to hearing Him say, "Well done, thou good and faithful servant," to have confidence of life with no more tears or sorrow – that is the ultimate stress relief.  It makes our temporary afflictions down here endurable.

I hope you will be cured of cancer, or live a long life in spite of it.  Most of all, I hope I will see you in heaven.  If so, we will have new bodies that never get old, never get sick, and are filled with vitality, with which to worship the Lord of all creation (see I Corinthians 15).  Until then, we can choose to use our time wisely: "Therefore, my beloved brothers, be steadfast, immovable, always abounding in the work of the Lord, knowing that in the Lord your labor is not in vain" (v. 58).

If you were helped with this blog entry, I'd like to hear from you.  Feel free to leave a comment.  Thanks for dropping by.  Best wishes for many more days of stress-free, healthful, joyful life!
Dave C.

 
 
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6.5 months after surgery
In spite of stage 3 neuroendocrine cancer, with a liver riddled with tumors, I'm flying high in my post-surgical recovery, feeling great. Praise God!  It's all due to God's mercy, answers to the prayers of many friends, and the great doctors and surgeons whose expertise and compassion gave me a new lease on life.  As an expression of my gratitude, I decided to do all within my power to aim for healing.  I'll share what I'm learning in a few posts on "thriving with cancer." 

To thrive means I have to form better healthy habits including diet, exercise, and stress avoidance.  In this post I will describe what I'm doing to eat better, knowing that our Creator provided us with amazing compounds for health if we will just put them in our mouths, chew them and swallow them.

I speak not as a health food nut.  I always looked askance at those people.  Me?  For decades, I was a burger, fries and coke kind of guy!  With my busy schedule, I usually only had time for drive-through fast food and prepared meals.  That cancer diagnosis in January, though, was a serious wake-up call.  I knew things had to change.  My doctors and nurses, and a registered dietitian at City of Hope, confirmed what I was learning from my own reading of scientific studies: eating healthy food is one of the best things a cancer patient can do.  

[Important note: your situation may differ depending on type of cancer, surgical history, prognosis, and treatments, so seek the guidance of your oncologist or a registered dietitian familiar with your case. I can only speak for what is working for my situation.  I hope it helps others.]

It's usually impossible to pinpoint the cause of one's cancer.  We all face a multitude of carcinogens throughout life.  Even healthy eaters are exposed to radon from the earth, cosmic rays from space, atmospheric pollutants and other things beyond our control, including the genes we inherited.  Cancer cells form every day in our bodies but – and this is the key – our immune systems are usually effective at stopping them.  Immunotherapy is one of the hottest topics in cancer treatment now.  I heard on the news about a Phase 3 trial underway that trains a patient's own immune cells to fight the cancer. It looks very promising.  But there are also things we can do right now to help our immune systems with the foods we eat.  Why not arm the troops in your body that are defending you?
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MY SUPERFOOD SALAD
Information on the cancer-fighting "superfoods" (blueberries, onions, tomatoes etc.) is readily available on reliable internet websites or from your doctor or a registered dietitian.  (Note: don't trust someone who calls him/herself a "nutritionist" especially if they want to sell you their products.  Registered dietitians have to complete medical training.)  The key is to add a variety of raw, unprocessed fruits and vegetables to your diet.  "Eat the rainbow" of veggies: the reds, purples, yellows, oranges and greens are indicative of cancer-fighting phytochemicals (plant molecules) that promote the immune system and overall good health.  Don't get it processed; go for the real food, raw and natural the way God created it.

You may dislike raw vegetables because they taste bland or take a long time to chew. Here's what I do to keep it simple and enjoyable.  I bought an inexpensive KitchenAid food chopper (about $32).  I bought a box of Debbie Meyer Green Bags that keep produce fresh.  In the grocery store, I scour the produce department for a variety of multi-colored vegetables and greens, the more the better (see recipe below).  Look especially for the cruciferous vegetables like red cabbage, broccoli, and brussels sprouts; onions, tomatoes and mushrooms are also good superfoods.  I bring them home, bag them, and start chopping, preparing enough for about 3 days.  Mix them all in a bowl, add a few raisins and dried fruits before serving to sweeten the mix, and presto!  You have an easy-to-eat, ready-to-use superfood salad.  It actually tastes great as a snack or meal, even without any dressing.  You can add spoonfuls of the mix to a breakfast burrito with turkey and egg, to sandwiches, tuna, chopped chicken, and to many other meals.  Often, though, I just shovel it in while working at the computer or stopping to eat a snack.  It requires less chewing and is quite delicious.  [Note: I've heard that some chewing helps activate the healthy molecules.]

Fruits don't work as well in a chopper, so I eat them raw: pears, apples, bananas, blueberries (in yogurt), nectarines, strawberries, blackberries, grapes, watermelon, canteloupe, and more.  I juice fruits and vegetables sometimes, but it's usually better to eat them raw  I also eat mashed potatoes or yams with the skins included.  You can get frozen vegetables now in packages that steam-cook them in the microwave, keeping more nutrients in.  However you do it, include more fruits and vegetables in your diet.  If you like nuts, they are great, especially walnuts and almonds.  Crushed walnuts can be a topping for a small dish of ice cream.  Unsalted nutty trail mix with raisins is a good snack.  Tomatoes don't chop well, but you can cut pieces of them into your mix, or add tomatoes to sandwiches with leafy greens.  I didn't realize how good they taste on nut butter sandwiches.  Use whole wheat bread or sprout bread, and try almond butter or sunflower seed butter in addition to peanut butter.  For snacks, almonds and raisins coated with dark chocolate are OK in moderation.  Instead of white sugar, try stevia or honey.

It takes about 3 weeks to get accustomed to a dietary change.  A lot of it is attitude and commitment.  My dad used to say, "Happiness comes from liking the right things."  Train your mind by thinking of all the benefits you will enjoy, make it a commitment, and start.  You'll be surprised at how soon the old desires will fall off, and you will like the good stuff.  I feel I have more energy since I started eating better.  My weight is also stable, and my blood pressure is good.

I'm not advocating a total vegan diet--just adding more to your day.  It's OK to occasionally indulge your favorite comfort foods.  A little ice cream, chocolate, or a cookie will not hurt, so don't let guilt defeat your commitment.  I eat unprocessed chicken, fish and eggs (I've sworn off of red meat, even if a little won't hurt).  You can still eat other things, but I encourage you to make the good food the priority and learn to enjoy what will fight your cancer (or prevent it).  I also doubt the value of supplements unless prescribed by your oncologist.  That's another story; people have strong opinions about them, but beware of anyone seeking to sell you cures for cancer with a pill or special herbal mix.  Even if you believe in those things, they are no substitute for eating right.  One spice that seems to have solid science behind it is turmeric.  I sprinkle it on chicken, mashed potatoes and other things whenever I can.

Who knows if my superfood suggestions will aid your cancer recovery?  It certainly can't hurt, and it might help--in more ways than one.  Not only does it put cancer-fighting compounds into action in your body, it's something you can do to take charge of your situation.  A good mental attitude is part of your treatment.  It makes you feel more in control, less helpless.  As I pray over my healthy food, I thank God for all the amazing plants He gives us, and ask that all those phytochemicals He created will go to work against my tumors.  That boosts my mood, too.

RECIPE
Here are some of the vegetables that go into my superfood mix: kale, swiss chard, collard greens, red-leaf lettuce, turnip greens, spinach, celery, red onion, different kinds of squash, cucumber, bell peppers (red), radish, purple cabbage, corn (cooked), broccoli, brussels sprouts, bok choy, carrots, mushrooms.  Add cut tomatoes.
Sweeten with raisins, dried blueberries, dried pomegranates, dried mixed fruit, or honey.
Stir and serve!  
 
 
I decided to split the Blog into two Blogs--one for cancer news, and one about my JPL trial story.  This is because the subjects are very different and readers might be interested in one over the other.

Below are copies of earlier posts dealing with my cancer.  To see the full editions along with the reader comments, go to the JPL Blog and read them there.
 
 
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Cancer News

This week I had 5 doctor visits and an MRI.  My surgeons, pleased (and amazed) with my progress, discussed plans for the future.  While sticking with the "standard of care" (the octreotide injections every 4 weeks), we know it will not prevent the metastatic tumors in my liver from coming back.  Since they are slow-growing, though, and since I do not have symptoms of carcinoid syndrome right now, there is not a rush to try the more aggressive targeted therapies yet. Good news: one of the primary blood markers for tumor activity has been dropping since surgery and is now in the normal range.  In addition, I've regained most of my weight since February.  I'm walking 2-4 miles a day and eating healthy food.  This should help my immune system fight the tumors. On Friday I had an MRI to try to get a better glimpse at how many tumors remain. 

City of Hope continues to be a world leader in cancer research.  A friend from Sunday School contracted another kind of cancer and is getting good treatment there.  Another friend showed me an article from CBS Los Angelesthat sounds too good to be true: a discovery at City of Hope that might not only cure cancer, but obesity as well!  (Obesity is not my problem.)  Another report from The Independent described another miracle cure being considered. In addition, a Phase III trial at Cedars-Sinai Medical Center is testing the efficacy of Lutetium-177 radioisotope therapy on neuroendocrine tumors like mine; this treatment has been shown effective in Europe.  Often hopeful treatments that work on mice turn out to have serious side effects when tried on humans, but one of my surgeons said we know much more now than we did 10-20 years ago and fewer mistakes are being made.  The question for me is whether one of these targeted therapies will become available in time for me.  Only my primary care Physician (the Lord Jesus Christ) knows for sure.

Scary thought: one of my surgeons said that on the day of surgery I was probably as little as a day away from complete bowel obstruction from the primary tumor pressing on my small intestine.  The Lord brought me to the right doctors at the right time; otherwise I could have died in February.  Praise God; I am so thankful to be given this extension of time, and need your prayers that I will use it wisely.