and this is hope

There is a difference between pleasure and blessedness. Paul experienced imprisonment, pain, sacrifice, and suffering to their very limits, yet through it all he was blessed.

Dearest tested and tried believer, it is your mission to walk onto the stage of this world in order to reveal to all of heaven and earth that the music of life lies not in your circumstances or external things but in your own soul.

~Streams in the Desert, excerpts

This morning I woke feeling a sense of instability. Equal parts joy, weariness, and expectancy. Judah is low sick. And we got amazing news. If this cancer fight has taught me anything, it’s the beauty of balance. Balancing possibility and expectation. Faith and fear. Hope and suffering. Seeking and resting. And that necessary balance is impossible without Jesus. 

Sunday Judah got a fever accompanied by a hateful cough and we had to take a trip to the Medicine Room at St. Jude. They agreed that he was wheezing a bit but felt comfortable sending us home after fluids and a prescription for a humidifier, rest, and lots of water.  By Tuesday, the cold that sent me to bed for 3 days, feeling worse than I remember ever feeling, had taken up residence in my son’s chest.  It almost delayed an exciting procedure where an ENT inflated Judah’s vocal cord to give him more support and strength. That, along with Botox injections into some of his salvitory glands to reduce secretions, hope to put an end to Judah’s micro aspirations and chronic cough. But through God’s great grace, the Nurse Practitioner and CNA saw my vulnerability and decided to go against protocol and give Judah 24hrs to sound better. And God parted the congestion, like He did for the Israelites with the Red Sea, just long enough for Judah to safely have his procedure. The congestion crashed back down on him, complete with wheezing and sinus headache. And even though Judah was sick, I praised God’s name because He blessed us.

For the last 3 weeks, I’ve woken with a different praise and worship song in my head, embedded and on repeat. Thursday I woke, dreading our long day at the hospital. I was also feeling a sadness because the day before I had finished a 40 day prayer plan that had become part of my day-to-day. It was integral in me finding my way back to the heart of Jesus. And the song Old for New by Bethel Music kept circling in my head, pushing the dread and sadness aside.

V1
What was torn you mend again
You redesign the tatter thread by thread
You take the broken and destroyed
You rebuild, You make whole
Chorus
Joy begins to rise
Hope begins to light the dark
Our God exchanges old for new
Dawn has conquered the night
Death has lost to life
V2
And now we are exchanging old for new
You turn flame into a fire
In you we walk in the impossible
We take Your love into the world
We let our light shine, we let it burn
Bridge
There’s nothing that Your love won’t do
There’s not a mountain with can’t move
There’s power in the blood
There’s power in the cross

I did as I always do, give in to the gift of a song for my day, and claim it.

And then when we got to Judah’s Neuro Oncology appointment and found out the genetic testing results were back.

For those who haven’t been following our journey, St. Jude sent a sample of Judah’s tumor to a lab to be genetic tested, broken down, to look for clues to a possible treatment option. Because in the last 9 months Judah’s tumor has shifted from a low grade Pilocytic Astrocytoma to High Grade Diffuse Intrinsic Midline Glioma, it’s terminal. Radiation has a lot of side effects and his tumor is chemo resistant. The genetic testing was our last ditch effort to find SOMETHING.

And it wasn’t until the Drs said the results were back that I realized I had hung my hope on what they were about to say. And they were smiling.

The test showed that Judah had 4 relevant gene mutations:
K27M
P53
NF-1
NF-1 (variant)

We already knew about the K27M mutation. It’s the murderer. The one no one knows how to stop. The P53 mutation is common in cancer and isn’t targetable. And then 2 variations of the NF-1 gene mutation. This is one the drs seemed excited about. 

They explained that the NF-1 gene is like a controller for cell division. It’s job is to make sure that cell division stays balanced by turning on and off. When it mutates, it never turns off.

My eyes began to blur. 

They continued. The NF-1 mutation is typically a “driver” in tumor growth. But it’s rarely found in High Grade tumors. It’s more often found in Low Grade tumors. So its possible that this mutation is what made Judah’s tumor shift from Low Grade to High Grade.

Now I’m holding my breath

Drs again. And we think we can use MEK Inhibitors to counteract the NF-1 mutation. 

WHAT?!? (Internal dialogue: KIND OF BURIED THE LEAD! Are they saying they have a cure?)

Drs explain. This is ALL speculative. We do think MEK Inhibitors work to counteract the NF-1 mutation, but we do not know if the NF-1 mutation is what’s causing Judah’s tumor growth. And we won’t know until the growth halting effects of radiation wear off. In 3 months to a year we will either see tumor growth or we won’t. And there is literally NO clinical data to look to. Judah is 1 of 3 kids reported to have a shifted tumor kind with the presence of the K27M gene mutation in both tumor types. And the other 2 don’t have the NF-1 mutation, as far as we know. This is NEW territory for us. But when you brought Judah to St. Jude, we wanted to be able to give you guys hope. And this is hope!

So basically we are all stumbling around in the dark together but St.Jude and Jesus have resources like flashlights! I’ll take it. And praise God for His victory over my doubt.

Prayer is a funny thing. I’ve spent the last 8 weeks praying for healing. Praying for more time. Praying for acceptance. For daily joy. For closeness. I have been specific and general. And over time, my prayers have widened. I still pray for the same things but I have learned to pray God’s word. To pray to have his eyes and ears so I can see His hands and hear His encouragements. To pray that His will be done and mean it. To believe that God’s love for me is greater than my unbelief. His peace is greater than my fear. His strength, my only chance for strength. His word, truth. 

I have told you these things, so that in Me you may have perfect peace. In the world you have tribulation and distress and suffering, but be courageous [be confident, be undaunted, be filled with joy]; I have overcome the world. [My conquest is accomplished, My victory abiding.] John 16:33 AMP

This verse thrown around a lot when people are suffering. I’ll be honest, when I see it, I usually roll my eyes. But today when it popped up in my quiet time, I wept. Because God can overcome our cynicism. 2 months ago, when a praise and worship song came on about God being a mountain mover, or how great His love is for us, or worse, how they’ll praise Him even though everything is falling apart, I would roll my eyes and change the station. I would say, what trials have these super famous worship bands been through? When did they have to choose to praise God as their heart broke in half? It Is Well my foot. They don’t know.  

But now, I let loose my hands, close my eyes, and praise Him with the words inspired by God’s nature and goodness. Because recently I had an epiphany. It  doesn’t matter if the writer or singer or friend has been broken and spilled out. What matters is that I believe the Holy Spirit inspires, moves and works in the lives of God’s people for His glory. I must give Him glory in the big and small. For the things I asked for and the things I didn’t.

We praise God that He is showing us His works in this new treatment option for Judah. We praise Him that our hope is stronger than our strife. We praise Him that He fights for our hearts. And if there comes a time when we can no longer see Him working, we will remember His truth, that he is still working.

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real food and we get out of the PICU!

Judah got to try some yogurt for the first time since the surgery! Swallow study this afternoon will tell us if he can go back to eating regular food.

Judah passed his swallow study so he gets Chic-Fil-A for dinner tonight! We got to drive him around the hospital in a wagon with no wires and no nurses and he got a couple of stuffed animals from the gift shop. His speech is getting better his strength is growing and he’s in a better mood. Thank you for your continued prayers and praise Jesus for a happy and healing little boy!

What a day this has been! Judah wakes talking, plays hard, eats yogurt, passes his swallow study, gets out of the PICU for a wagon ride, and then comes back to his room for some Chic-Fil-A only to be told he will be moving to the floor soon!!! Praise Jesus for such a wonderful, hope restoring day.
Thank you for being a praying people.
He is now comfortably resting!

http://youtu.be/HKGV2TTXU8o

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sleepy and sore

Last night was a long night. Judah has been having a lot of breakthrough pain and its keeping him awake and grouchy. It would make me the same way. He trying so hard to be brave and we are very proud of him.
He was approved to move to the hem/oc side of the floor yesterday but there weren’t any beds and as of this morning, there still aren’t any. We are so ready to get all these wires off and have more freedom.

Prayers are needed for:
-Pain management
-Moving to the hem/oc floor
-Continued healing of swallowing mechanism (we are hoping he can pass a swallow study before discharge so he doesn’t have to go home with a feeding tube)
-Continued healing of connection between what he knows and what he can say
-Healing of speech
-Bravery and strength during PT/OT

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CT/Shunt/Therapy plans

For the last few days, they have had Judah’s Intra Cranial Pressure (ICP) drain clamped to see if he can naturally drain/absorb it. We all thought he was because his ICP’s were reading so low and he was doing so well. At 4 am they took Judah down for a CT to ck on swelling and drainage of his spinal fluid from the brain in hopes of taking the ICP drain out. However, they found that I stead of draining it was actually just forcing its way out of the surgery wound into the area between the skin and skull. So he wasn’t managing his fluid. His fluid had just found an easier way out of the brain.
So tomorrow morning, if all goes well scheduling wise, they will put in a permanent shunt that will drain fluid from the brain to his belly internally. The surgery should only take an 1-2hrs and is minimal in risk. The Dr said it shouldn’t set him back any but instead give him the freedom to move around more and dive into PT/OT for quicker recovery.
We were at first sad about the prospect of another surgery but agreed that we need to move past this drainage issue and onto the talking/walking/treating the rest of the tumor issue. This affords us that.
We would appreciate continued prayers for Judah, surgery, recovery, us, and just being separated as a family. We miss Judah and Camilla Kate together.

Judah is going to need very intensive physical/occupational/speech therapy to fully recover and the logistics of that are complicated. Most of the Drs here think he needs inpatient therapy for 3-5 weeks but there is no inpatient therapy center in all of Tennessee that takes kids his age, the closest is Atlanta. One of the Drs thinks he can work something out here at Vanderbilt to get Judah outpatient therapy but in an intensive way – say 3 or more hours a day 6 days a week.
Being able to do therapy here would be much better for us as a family so we’re asking for specific prayers for God to open doors and make the therapy choices very clear and easy.
Thanks for all the encouraging words and prayers!

The surgery to put the shunt in will be tomorrow morning at 7:30am. Should be about an hour and a half and he’ll be intubated again but the tube will come out when the surgery is over. The process used to route the shunt to his belly will be pretty painful for Judah when he wakes up and he’ll have a total of 5 or 6 incisions (including the ones he already has) and every incision is an infection risk. So please pray for a flawless surgery, minimal pain and no infections!

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visits and progress

Judah has been working so very hard today. He sat up in bed, smiled and laughed while watching Brave, squished play-doh, sort of finger painted (he hates to have dirty hands), and then made Daddy and me feel like the funniest people in the world laughing and smiling while sitting in the rocking chair all by himself. The thing I noticed that was different about today vs yesterday is that when he was done working, he didn’t freak out. He didn’t flail and yell, he whined and then we put him in his bed and after some questions to figure out what he wanted, took a rest. Our Great God is providing comfort to our sweet frustrated little boy!
We had a ton of out of town visitors and Judah responded well to all of them. Thank you for making the drive to love on us and our boy.

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smiles and giggles make hearts full

And our God, merciful and playful has returned Judah his laugh. He is hearing our prayers and answering for His glory and our joy!
We put one of his favorite movies on and he started smiling. Then a few minutes later, laughing. Just now he sat off the bed and folded himself in half then laid back down. He’s thoroughly enjoying himself!!!

After a wonderful 3 hrs with smiling and laughing and even some words Judah crashed into an angry depression. We think he may have exhausted himself but after 2 hrs of only grunting and flailing we backed off and let him be. It is so hard to see him make such progress one minute, and then the next, backslide. He was again frustrated and cried in anger.
We prayed for Jehovah Jireh to provide patience and comfort to Judah and to us and then prayed our same prayer for supernatural healing of his vocal chords, swallowing system, tongue, mouth, and that connection between what he knows and how to say it. Please continue to pray with us and for us.
We are so grateful for the glimpse at our little boy and thank God for it. We want more!!!!

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Swallowing

Praise be to our Jehovah Rapha! We prayed for supernatural healing and He has come to our aid. Judah was, yesterday, unable to swallow or keep saliva in his mouth and today he is not only swallowing but in total control of his spot. No drooling!

Keep the prayers for supernatural healing of:
-voice box
-connection from cognitive to mouth (speaking what he knows)

Our God is mighty and has a glorious work to complete in Judah. He has carried us a giant step in the right direction. Keep praying for miraculous, quick and unexplainable healing.

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prayers (and a happy birthday wish) granted

There are a few good updates today (and a happy birthday wish for Wendi!). The oncologist came by yesterday to confirm that as they suspected it is a grade 1 pilocytic astrocytoma, which means it’s slow growing and extremely unlikely to spread anywhere else. Basically, if you’re going to have a brain tumor that’s the best type to have. Praise Jesus!
We’re seeing improvements. Judah has moved his face muscles more today, moving his lips and tongue. I even got him to snarl at me when I was being particularly aggravating. He’s been pretty agitated all day, but who can blame him. I’d be pretty angry too. More eye movements and head motion. God bless Mumzy’s hearing loss because it’s enabled her to find ways of communicating with him that no one else had found. And he’ll actually make an effort at high fives and fist bumps with Uncle Josh when everyone else just gets grunts. He let the speech therapist read to him for 30 minutes and she had him turning the pages. Started off with angry swats but by the end he was turning them gently and deliberately.
The neuro Drs also said they could try “clamping” his EVD (brain drain as we affectionately call it) which means they are seeing if he can self-regulate his spinal fluid. If he does well they could take the EVD out in the near future with no need for a shunt.
Things are getting better. He’s still got a long road ahead (as do we) and there are a lot of unknowns that we may still have to face. Keep the prayers up, they’re working!

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waiting for significant change is hard

They prepared us for all of this. They told us he may lose his ability to talk or swallow or breath. I (wendi) was like the mom on the play ground who refuses to believe HER CHILD would ever hit another child. And now, here we are, 1 wk post-op and he is doing better but he isn’t better. He can’t/won’t talk. At first Matthew and I convinced ourselves it was his sore throat from the ventilator. Then is was all the sedation. Then his lack of natural sleep…Now, we don’t know. He can’t/won’t swallow. He will cough, clear his throat and then, instead of swallowing, he holds it in his mouth. We have to use the suction and clean it out. But he is breathing like a champ! The apnea seems to have gone away for now and that is a HUGE answer to prayer. So maybe 1 out of 3 ain’t too bad.
It seems bad though. I spent the evening here with him last night. I climbed in his bed (against PICU rules) and prayed to my God for healing. My child, who loves language and speech, and the art of pronunciation, will only, for now, communicate in grunts and swats. I prayed that God would give him back to us the way he was before the surgery. After all, He created him. That sweet little voice with big, big words was hand picked by our Savior for Judah. And I just want to hear it.
We spent yesterday afternoon pestering him by mispronouncing dinosaur names. Foolishly, I thought that if I irritated him enough he would just shake out of it and correct me.
They say it will take time. That he is improving slowly. That it may take a lot longer than we originally thought but “let’s give him the time”. Now they are talking about sending him home on a feeding tube. He isn’t showing any swallowing improvement. No talking improvement. What a thing to say in passing. Like it is of no real consequence how he goes home.
Judah is strong and strong-willed. Qualities both Matthew and I have. He will fight. He’s been in the PICU for over 2 wks now. His little spirit is so depressed. I refuse to believe that a broken spirit, feeding tubes and no communication, from the joyous, giggly, imaginative boy who LOVES to communicate, are part of God’s plan.
I finished my prayer last night begging God to do a glorious work in Judah. And restore his talking and swallowing. Do it fast. Cause, for no better reason than we are drowning, hope is harder to cling to, and this waiting for a significant change is so hard.

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real sleep please!

The PICU team decided to stop doing hourly cks 24/7 so for the first time in 2wks Judah will get to sleep for 4hrs straight! They did a ck at 8, he fell asleep around 8:30 and has been asleep solidly since. They will wake him at midnight for a brief neuro ck and give him more Tylenol and then he’ll get to sleep another 4 hrs in a row. I think this unsedated, natural sleep is what he really needs.

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