Surgery Update #2

It is 7:00 a.m the  morning after surgery.  I sit her next to Lisa's bed in the chair that I used for my bed during the night.  I was actually quite surprised how well I slept in this partially reclining, narrow seat.  Though I certainly don't feel perky, I have had worse nice of sleep. 

I will pick up where I left off yesterday. About 1 hour after the surgery commenced, Dr. Tittensor sent a nurse to the waiting room to inform me that they had extracted two lymph nodes, tested them, and that both produced negative results for cancer.  I wrapped up my previous blog entry at that point, because I felt like I needed to quickly share that information with family and friends.  That is one blessing of texting:  instant information can be spread--even faster than email--to a large group of people.

Lisa, 30 minutes before surgery.



The sense of relief after receiving news of the lymph node testing was palpable.   That result was the key indicator I had looked for to define a truly successful day.  It all but guaranteed that the cancer had not spread, as all of the prior external testing (mammograms, MRIs, and ultrasounds) had suggested.

The next key indicator of the success of the surgery will be revealed sometime next week when the pathology report of the extracted breast tissue is completed.  That report examines all of the removed breast tissue to learn if the surgeon was able to extract all cancerous cells plus a large enough margin of healthy tissue surrounding the cancerous region.  The hope is to have a healthy margin of tissue at least 5 millimeters in all directions.  That gives the doctors enough confidence that they removed ALL of the cancer from the breast. Most importantly for us it means that we would have to undergo radiation therapy.

We have reason to believe, however, that we will not be able to avoid radiation, as Dr. Tittensor told us prior to the surgery that due to size of the infected region and its proximity to the borders of the breast that the odds of finding a 5 millimeter margin of healthy tissue (in all directions, mind you) were not good.  Thus, we have prepared for radiation therapy from the beginning, which, of course, sure beats having to do chemotherapy.  With low expectations, we'll be that much more elated if radiation is not needed.

About 45 minutes after the nurse informed of the negative results of the lymph nodes, I was surprised to see Dr. Tittensor in the waiting room.  It was about 3:45 (about 1 hour and 45 minutes after Lisa was carted off for surgery). The surgeon was there to tell me that her work was finished--that the mastectomy was complete, that Lisa responded beautifully, that the bleeding was minimal, and that procedure couldn't have gone better. 

She did mention that Dr. Bishop, one of two plastic surgeons that Dr. Tittensor works with to reconstruct breasts, was held up in another surgery in Orem (we're in the American Fork hospital), and that they were waiting for him to arrive to perform his portion of the surgery.  Thus, Lisa lay in the operating room with an anesthesiologist next to her, wound open, waiting for the next surgeon to arrive. The thought of that made me uncomfortable:  I hated to have her anesthetized  any longer than necessary.  That said, you learn really quickly not get too hyper about the about the various inconveniences of medical treatment.

About 45 minutes later Dr. Bishop arrived.  Just before 6:00 p.m. he came to speak to me and Larae, Lisa's mom, in the waiting room to tell us that he too was finished and that Lisa would be waking up in about an hour. 

The plastic surgeon's role in the process is to insert an 'expander' under the breast muscle.  The expander is filled with water and its purpose is to stretch and prepare the skin in the region of the removed breast for a future implant.  Over time they inject more water into the expander through a needle that somehow finds its way into it through the breast, and they gradually stretch the skin.  According to my limited knowledge of the subject, they very rarely complete breast reconstruction  at the time of mastectomy.  I believe this is for two reasons:  (1) there can be various complications that arise from the mastectomy (swelling, bleeding, infection) and the body may not be ready for an implant at that moment; (2) radiation therapy, which follows a significant amount of mastectomies, can wreak havoc on its targeted area.  It tends to shrink and scar the tissue it treats.  Implants in particular don't do well with the radiation.  If you were to radiate after reconstruction the outcome may not be one that you desired--unless, of course, you're happy with one of your breasts looking like a raisin (or worse, a prune).

In addition to inserting an expander under the breast muscle, the plastic surgeon also closes the incision the Dr. Tittensor makes.  That, of course, makes sense to have the guy who specialises in cosmetics, close the incision to minimize the scaring. 

This discussion does bring up the topic of implants.  Lisa and I have jokingly referred to the side benefit of breast cancer as vain-less and guiltless breast augmentation.  Bill Clinton (and I do find this somewhat ironic considering Bill's appreciation of breasts) signed into law in 1998 the requirement that insurance companies had to not only pay for reconstruction for mastectomy patients but also had to pay to make the non affected breast symmetrical with the newly reconstructed breast.  It wasn't that long ago that the attitude toward mastectomy patients was--"you're lucky to be alive"--and not much thought was given to the cosmetic insecurities that a woman dealt with forevermore.

Two weeks ago, Lisa and I spent the week looking at other women's breasts.  That was not on the list of activities I thought I would ever engage in. Taken out of context, that might sound pornographic.  But trust me, this whole subject matter gets very clinical very fast.  We went to interview the two plastic surgeons that Dr. Tittensor works with to learn which of the two we felt most comfortable working on Lisa.  During those appointments, we looked at multiple before, during and after photos of the whole process.  Lisa wasn't terribly encouraged by any of the photos. I had to remind her that most playboy bunnies and cover girls do not pose for breast reconstruction photos, and that perhaps the photographers retained by the plastic surgeons (their nurses) are not trained to make anything look good, particularly in florescent light!

At one point during the process Lisa and I laughed like a couple of preadolescents when one of the surgeons we interviewed took out his measuring tape and a ring of sizing cards attached to a metal ring and began to measure Lisa: from nipple to nipple, chin to nipple, from belly button to nipple, etc.  It was just too much for either of us to handle.  No, it certainly wasn't the first time in recent weeks that her breasts had been handled by a stranger, but for some reason the measuring tape just put us over the edge. I was trying not to look at Lisa, but I could tell out of my peripheral that she was looking toward me, and like that Death Star tracking beam that sucks in its victims in Star Wars, I was sucked in by her gaze.  The moment our eyes met, we burst our laughing.  We naturally tried to suppress the laughter, which only made the matter worse. Soon we were laughing because we were laughing.   Although the surgeon smiled, he did not seem to be overly amused. The surgeon looked a little surprised, as if instead of talking with two adults mature enough to deal with breast cancer he was in the process of telling two eight year-olds about the birds and the bees.
Perhaps it was out of shame that we chose the other surgeon.  I couldn't bear the thought of laughing every time I saw him or his measuring tape.

Unfortunately, there was too much laughing with Lisa post surgery.  She was in her room by seven, but was mostly out of it.  When she woke up, she felt and increasing amount of pain in the area of her lung and upper back.  I will comment more on that later. For now, I am going to eat breakfast with my wife.

The kids paid a visit to a mostly-conscious mom a few hours after surgery.



Surgery Update #1

Lisa went into surgery about 15 minutes ago.  Surreal.  I don’t have a better word to describe it. I’ve taken her to the hospital five times before—all for the occasion of delivering a baby, a part of a woman that most of are usually happy to physically detach from their bodies.  A breast—well, that’s a different story.

Lisa, Abby, and my sister Steffani a few hours before surgery. 

Steffani had two guests today:  Abby and our dog, Candi.

Though we are both in good spirits and feel very grateful for an early diagnosis, there is still an underlying tone of melancholy that accompanies this experience.  Melancholy is the right word, because it isn’t sadness.  We’re not grieving; we’re not feeling sorry for ourselves. We don’t have time for that, and we recognize that to be anything but grateful for competent medical attention and for a treatable condition would be inappropriate.  But I suspect that a feeling of loss—however bright or dim that it may be—is a natural companion to such an experience. 

Several times this week, as I went about my business--running errands, doing Christmas shopping, and engaging in all of the daily entanglements of a normal life—this thought would suddenly appear in my mind, and oddly, it appeared to be a foreign, unfamiliar revelation: your wife has cancer.  It just didn’t seem to fit.  Again, surreal. 

Let me describe what is happening right now.  Lisa is having a mastectomy of the right breast.  The cancerous cells in her breast—her DCIS—appear in two places of the breast.  One is about five centimeters and the other is about 1.5 centimeters.  It became clear that a lumpectomy—where they remove just the affected region and not the entire breast—was not option with the both growing size of the 5 centimeter region and the second region which was detected by an MRI. 

Prior to removing breast they will extract a lymph node near the armpit to confirm that the cancer has not begun to spread. Apparently, it is the lymph nodes that do most of the spreading of the cancer.  To leave the breast, the caner has to travel through the lymph nodes. Once in the lympathetic system, the cancer starts to propagate. 

Prior to surgery, they injected Lisa with a radioactive dye, which the surgeon uses in connection with a scanner to locate something called the sentinel lymph node.  If the cancer has left the breast, it will have travelled through and infected the node.  The surgeon removes one or two nodes that appear to be that sentinel lymph node. They send it immediately to a pathologist who tests it for cancer on the spot.  According to our surgeon, Dr. Tittensor, they can determine with 90% accuracy with that on-the-sport test that the node is cancer-free.

From the time that I started writing this entry, one of the surgeon’s nurses just left the operating room to tell me that they have extracted two nodes, both of which have come back negative.  Good sign!  I am going to sign off for now.  I’ll report back later and finish my explanation of what happens with the mastectomy, what the hopeful outcome of that is, and what lies ahead in the coming hours, days, and weeks.

Good News

We received the results from round two of biopsies and ultrasounds last night. Even though they found cancerous cells in another section of the right breast it doesn't appear to be spreading beyond the breast.  Great news.  That said, it won't be until during and after surgery that we'll know with certainty what the cancer has done.  Surgery is still scheduled for a week from today, Friday, the 16th.  More on that tomorrow, but for now I need some sleep.

An Evolving Diagnosis

"The information will come fast, and it will keep evolving, so get ready for a ride," our friend and fellow cancer patient, Edy Buss told us the night we received our first diagnosis.  For a week, I didn't think that was going to be our experience. Two days ago that changed.

I'll start with our first visit to Lisa's surgeon, Dr. Jennifer Tittensor, a general surgeon who specializes in breast cancer surgery.  She reaffirmed what our primary care physician has already told us (covered in the prior blog entry):  though the cancer cells showed potential (thus, the high grade mentioned below), it didn't appear to be invasive.  We spent about 45 minutes with the surgeon, asking question upon follow up question.  It was quite a pleasant visit, and one that I haven't come to expect from a doctor, most of whom seem rushed.

Forgive me if I get rather clinical here for a moment.  I'm not one to blog about my wife's breasts, but I am going to frankly discuss this to give you a sense for the kinds of things a breast cancer patient and her husband discuss.  If you don't care for the clinical explanation, skip the next few paragraphs. 

Based on the initial mammogram and biospy, Dr. Tittensor suggested that Lisa would require either a lumpectomy or a mastectomy followed up by localized radiation once a day for six weeks. The decision between a lumpectomy--where they remove the affected portion of the breast plus a surrounding margin of healthy tissue to make sure they get all the cancer--and a mastectomy--where they remove the entire breast--would largely be based on cosmetics.  The challenge with a lumpectomy is that it isn't very conducive to reconstruction:  you basically remove part of the breast tissue, and sow it back up.  The cosmetic result is, for lack a better phrase, a lopsided chest, which, as you can imagine, most women don't want.  The advantage to a lumpectomy is that you keep your breast, nipple included, and all of the functions associated therewith.  

The disadvantage of a mastectomy is that your lose your entire breast including the nipple.  The advantage of a mastectomy is that it is much more conducive to reconstruction.  That reconstruction can be done in such a way that allows a woman's chest to retain relative symmetry.  

Beyond the discussion of mastectomies and lumpectomies, we discussed the possible treatments that would follow.  Apparently, about 25% of the women who have lumpectomies or mastectomies face a recurrence of cancer. That number drops to 5% if the breast surgery is followed up with radiation treatments.  When Dr. Tittensor referenced those statistics, I asked the following question, "So, what are the odds of getting cancer from the radiation therapy?"  I've always thought it quite odd that we treat cancer with an agent that causes cancer.

She replied, "Good question, and that risk is there. I suppose you must weigh the benefit of dropping the odds of recurrence from 25% to 5% versus the 1% chance of getting some other kind of cancer from radiation exposure."

Her response to my question pretty much sums up our position at this point:  we need to play the odds, particularly because we have a young family of children ranging form 16 to 2.  Though Lisa and I tend to be open to alternative forms of medicine, cancer at this stage of our lives makes it difficult for us to experiment with alternative methods.  The stakes are too high.  At this point, it's about accepting the current medical science--flawed or incomplete as it may be--and playing the odds that we're making the right decision. Obviously, whatever decision we make for long term treatment will not be made in the Vegas spirit of playing the odds--i.e, rolling the dice.  Rather, it will be made after asking every imaginable, probing question that we can think of, and gathering as much data as we can, and then making it a matter of thought and prayer.

During that first meeting with Dr. Tittensor, she suggested that because the cancer appeared to be non-invasive that chemotherapy wouldn't be necessary. Fhew!  It's funny how Lisa and I left that first appointment, happy that we only had DCIS (described below), and that chemotherapy wouldn't be necessary. Perspective is everything.

Before we left, Dr. Tittensor had her nurse schedule Lisa for an MRI--just to make sure we had a complete handle on where the cancer might be.   MRIs can do a better job at detecting cancerous tissue than mammograms.  Apparently, a mammogram is the first testing mechanism because it's simply cheaper.  MRIs, mammograms, and ultrasounds all reveal different things, and used together, can provide a cohesive set of data for diagnosis.  She did warn us that about 25% of the time (there's that percentage again) MRIs will reveal "false positives"--i.e. find cancers that aren't really there.  In other words, they can exaggerate.  Therefore, any additional MRI findings might need to be confirmed by an additional biopsy and ultrasound.

Lisa's MRI happened the next day, Friday, four days after diagnosis.  Until we received its results, we were confident that we had a pretty clear path to treatment.

On Monday, Dr. Tittensor's nurse called to say that the doctor was out of town, but that they had just received and discussed Lisa's MRI results with her.  The MRI revealed an additional cancerous region in the same breast, but in a different location.   The results confirmed another "gut feeling" that Lisa had that there were other affected parts of the breast (remember my comments on Lisa's intuition--too bad she can't use that intuition to pick stocks).  Because of those results, she scheduled another biopsy and ultrasound of the newly revealed cancerous region.

On Tuesday, Dr. Tittensor called Lisa to say that these additional results suggest that the cancer might indeed be invasive--otherwise, it's a rather large occurrence of DCIS, which is uncommon.

If that is the case, everything changes.  How does it change? We don't know.  But that nasty word chemotherapy may very well come into play.   It appears that Edy was right--the diagnosis is evolving; things are moving fast, and we're gearing up for a ride.

Interestingly, the peace is still there.  We accept it; we don't get too high or too low.  We're intrigued and a little anxious to learn what comes next, but mercifully we have been given peace--an emotion that is impossible to counterfeit. 

Good night.  

From Bad News to Breath Cancer

Within minutes of recovering from the emotional tsunami caused by learning that her mother had just been diagnosed with breast cancer, our always inquisitive nine year-old, Emma, began to ask probing questions. Among the first questions were, "So, do they put on a long glove and reach down your throat to pull out the breath cancer."

We reassured her that mommy's cancer had nothing to do with her breath, but rather her breast (if we were more opportunistic parents we would have told her that she might get breath cancer too if she didn't continue to brush and floss everyday, but such manipulations didn't seem appropriate at that moment).  Emma's sincere question comment did prove to provide some comic relief in an otherwise sober and serious moment.

Dr. Myers, our primary care physician, had called Lisa mid-afternoon on Monday to her inform her that the results of her mammogram and biopsy suggested that the large lump in her breast was indeed cancerous--something that Lisa had known for several weeks.  Lisa was so sure that it was cancerous that she was ready to demand a "recount" if you will, had the results suggested anything but cancer.

I, on the hand, didn't expect the results to come back that way.  My head was too firmly planted in the sand to know otherwise; in fact, it was so far in the sand that on the previous Friday night when Lisa said to me as we lay in bed that "Monday was such a long time to wait," I replied, "A long time for what?"

That did not go over well.  Such a slip of the mind was infinitely worse than forgetting an anniversary or a birthday (something I have never done, primarily because Lisa and I share the same birthday which happens to also be our anniversary).  While the pending results of the biopsy that had been performed the prior Tuesday were certainly on the forefront of Lisa's mind, my mind was on, well, most everything else.    Pathetic but nevertheless true.

Best sale I ever made:  Somehow she loves me despite me.

The wait between the biopsy and its results was particularly long because the extended Thanksgiving Day weekend was sandwiched in between.  In addition, the wait from Lisa's early premonitions about having breast cancer to the moment we learned of the biopsy results was even longer, as we couldn't obtain an appointment for mammogram for several weeks.  It must be a busy time of year.

Speaking of busy, one reason that Lisa was on heightened alert for breast cancer was that our good friend and neighbor, Edy Buss, is currently being treated for breast cancer.  Edy is just a few years older than Lisa, and she was diagnosed in late August. After a successful surgery, Edy is currently undergoing chemotherapy, and she--both in body and spirit--is responding like a super-hero.  It has struck me as odd that two good friends in the same neighborhood would battle the same disease at the same time.  One can't help but wonder if there is something in the water . . .

The Phone Call
I learned from the previous Friday night, and by that next Monday I was more conscious and connected to what was coming.  Still, I didn't feel a sense of pending doom, and therefore, I wasn't expecting a diagnosis other than one that could conclude that the lump in Lisa's breast was benign.  As I left for the office Monday morning, I kissed Lisa goodbye and told her to call me if she got a call from Dr. Myers.

That call came about 3:00 p.m.  Lisa, in a very matter of fact, seemingly unemotional way, rehearsed for me her conversation with Dr. Myers, who had just delivered the bad news.  Though I didn't expect that diagnosis, when I heard Lisa talk about it, I wasn't surprised.  Her intuition had said breast cancer, and as she spoke, I wondered why I had doubted her intuition this time.  I don't recall it ever being wrong.

It wasn't wrong just over seven years ago when she told me privately, "I feel like someone is going to die soon, and I think it might be me."  A few nights later I happened to watch the movie Charlie--a movie about, among other things, a young mother who dies of cancer.  Not a good movie to watch days after your wife announces that she thinks she or someone close to us might die.

Lisa did not die a few months later, but her otherwise healthy, fit 44 year-old brother, Mark, did.  He collapsed with a heart attack while jogging one afternoon.  He spent too many minutes without oxygen, lapsed into a coma, and died 5 days later. Her intuition was right then.  It has been right countless times.

About 30 seconds into her rehearsal of her conversation with Dr. Myers, I put on my coat, and quietly left the office.  The primary message I got from Lisa as I walked from my office to my car was one of confusion:  Dr. Myers had called, said I had cancer, expressed empathy in a tender, compassionate way, told me I could call him at home anytime,  but then immediately asked me if I had a preference of surgeon, and advised me to go see one very soon.  And that was it.  Isn't he supposed to guide me.  Why do I need to call a surgeon first? Is that the first person I need to see?  I'm lost.

I hung up with Lisa as I got into my car.  Tears started when I left the parking lot. On the way home I called Dr. Myers's office:  "Hi, this is Jeff Reeves. Dr. Myers just called my wife, Lisa, regarding a rather weighty diagnoses.  I have some follow-up questions.  Can you have him me asap?"

One Hot Mamma 

When I arrived home, Samantha, our 16-year old daughter, was in the kitchen with Lisa. It was obvious that Lisa had been crying, but it was also obvious that she hadn't told Samantha anything.  I knew Samantha was aware that something out of the ordinary was wrong, but she didn't probe.  Mom had been crying and Dad was home at 3:30 p.m. Something was not right. Sam left the house as Emma walked in the front door, home from school.  I still had not been able to give Lisa the long-embrace I desperately wished for.  Such an embrace would tip Emma off, and at that point we knew so little about the news we had just received that neither of us were ready show any concern in front of our children.

I made up an excuse to take Lisa out of the kitchen and into our bedroom, where we embraced. Moments later, Dr. Myers returned my phone call.  I placed him on speaker phone, and Lisa listened as I asked clarifying and probing questions. At the end of this phone call, Lisa and I had clarity.  The results from the previous week's test suggested Ductal Carcinoma in Situ (DCIS), High Grade.


Dr. Myers frankly said that the diagnosis was both good and bad.  Good--in that the term in Situ means "in its original place," which means that the cancer shows no signs of having branched out, and is likely not invasive yet.  Bad--in that it was "high grade," which means that cancerous cells were active, aggressive and are likely to become invasive if not treated quickly.

When I asked why we needed to see a surgeon first, he explain it succinctly and satisfyingly:  the tests they were able to perform on Lisa to date are limited, and while they represent a fair degree of accuracy, until a surgeon is able to open you up, it is difficult for them to predict with certainty where the cancer might have spread.

The confusion that Lisa felt after her first conversation with Dr. Myers was now gone.  We left this conversation with a clear sense of the necessary steps to take.  Our first objective was to get an appointment with a surgeon.  Thus, my first call was to our friend, Edy, who provided a wealth of information, encouragement, and empathy.   Edy not only gave the name of number of her surgeon, but she walked me through what would be our first week of the post-diagnosis period:  what we would feel, what would happen, why it would happen, and a few tips on how to deal with it all.  Minutes later I secured an appointment for that Thursday with her surgeon, Dr. Jennifer Tittensor, whose focus is breast cancer.

With Whom and When Do We Share?
In my first conversation with Edy, she had mentioned that she and her husband, Robbie, had waited two weeks before telling anyone about her cancer.  They wanted to gather all the information they could and decide what their game plan was before they worried anyone with such news.  Such an approach made perfect sense--particularly for Edy and Robbie, who are organized, deliberate, methodical, and effective people.  Intellectually, that approach made sense to me as well.  Why worry loved ones before we know how extensive it is, and how we're going to attack it?  Interestingly, Lisa, who is by nature much more private than I am, had different feelings.  As I explained that I was for adopting Edy's approach, she responded, softly, "You know, I wouldn't mind a few extra prayers in the meantime."  Nothing more needed to be said.  I was on board immediately--I wasn't going to fight that intuition again.

We first told Lisa's parents.  I stalled on telling my parents, initially deciding that I didn't want to ruin their vacation (they're in Hawaii right now).  Our kids came next--which brings us full circle to my opening comments about breath cancer.  Lisa's intuition was right again.  We shared a beautiful moment with our children.   In our specific case, it was the right thing to tell them early in the process. For one, Samantha already suspected something was terribly wrong. To leave her hanging for two weeks would have been cruel.

The initial moments were shocking to say the least.  Emma wept uncontrollably for about five minutes. Daphne, our 11 year old, immediately burst into tears simultaneous with Emma but that cooled to a sniffle more quickly than it did for Emma.  Samantha tried to hold back tears, and partially succeeded.  Jeffrey, 14-year old and lone boy, sat stoically still during our discussion.  Men tend to go into their man cave to grieve, and I believe Jeffrey was going into his figurative cave as well.

Lisa was strong and only shed tears when her girls lost it, at which point she began to question her decision to tell everyone.  By that time, however, I knew she had made the right decision to discuss this now. She made the perfect comment to Emma, as she tried to console her:  "Emma, I will tell you when you need to worry.  Right now you do not need to.  But I will tell you when or if you need to."  I led much of the discussion, and until I offered the family prayer at the end of our meeting, I was able to do so without too many tears.

I chose to remind our children of a similar meeting we held just over two years ago, as we sat as a family in a hotel room near Primary Children's Medical Center.  Our baby, Abigail, who had been born the day before, was in the NICU at Primary Children's, and had been diagnosed with life-threatening congenital heart defects.  I reminded them what I told them then:  that Mom and I felt peace in the face of the natural anxiety that comes with the unknown; that even though we did not know if Abigail was going to make it, we had the peace that whatever was best for our family would happen; and finally, that this was a unique opportunity for our family to grow closer to each other and to the Savior. Let's not waste it.

When I told them those words two years ago, I said it with a complete sincerity and with a confidence that only comes from feeling peace in the face of uncertainty.  I had that same confidence this time.

Abby at 9 days

Abby last spring. Her "zipper" scar remains, though faint.

Comparing the Two Medical Trials
Within moments of learning about Lisa's cancer, I began to reflect on how this latest medical crisis compared  to the last.  They are different in so many ways.  Abby's ordeal--at least the first 9 days of it--makes for a good Hollywood story:  a diagnosis that went from a mild concern that she had swallowed some meconium to a congenital heart defect within hours, multiple Life Flights, a blessing from a prophet, being whisked off to Stanford literally moments after her siblings got to touch and see for what might have been the first and last time,  mom and a dad leaving town for who knows how many weeks with only one pair of underwear and one change of clothes, her a surgery by a world-renowned pediatric heart surgeon, and her complete, total recovery and unblemished history since.  Great stuff.

Lisa's is different. For one, it unfolded much more slowly, and we didn't find ourselves dazed, and in a whirlwind when we first learned the diagnosis.  She suspects breast cancer, and goes to her primary care physician, who is concerned and tells her to check it out.  Three weeks later--after multiple attempts by her, her doctor, and her insurance company to get her an earlier appointment--she finally got in.  The mammographer was concerned and had her do a biopsy of the breast tissue on the spot.  Thanksgiving gets in the way, and so the results aren't available for another six days. In the meantime, I'm pretty much consumed with work and don't spend too much thinking about the pending test results.

The other way in which this is different is that all of this is happening with the context of our regular, daily pattern.  Dad still makes breakfast for everyone (the one thing I can cook beside frozen pizza), Mom still packs lunches, Dad still goes to work, Mom still calls contractors about the basement we're trying to finish, Dad still gets frustrated by and is still invigorated by his work, Mom gets frustrated that everyone's homework isn't done, etc.

Yet despite those differences, there is one very similar element--one very familiar element that I prize more than anything.  Marx called it "opium for the masses"; I call it the Holy Ghost.  It is something that I cannot deny, a real power that is so different from the counterfeit emotion that wishful thinking usually brings. I believe that such wishful thinking is what Marx had in mind with his opium comment.  But like any narcotic, when you hope for or put trust in things that just aren't true, you are, in the long run, left with nothing.

I have wished for things that were contrary to the laws of nature; I have wished for good things that deep down I knew would not come true; and I have felt the hallowness that accompanies such efforts.  The peace that Lisa and I feel right now is nothing like that. This is substantive.  This is satisfying. This is rejuvenating.  This is clarifying.  There is a serenity and spirit of peace in our house right now for which we are deeply grateful.

And while we sincerely apologize to my insurance company (again), we are grateful for another opportunity to grow closer to each other and to the Savior.