Update

We’ve just come from our church, which held its service in commemoration of Martin Luther King, Jr, including a sermon by Tim Tyson (“Blood Done Sign My Name” — read it if you haven’t yet) with powerful music from Mary Williams. It was great to see that kind of spirit as we deal with our difficult news.

A CT scan late Thursday revealed that the cancer in Rebecca’s liver has progressed significantly. It appears extremely unlikely that further treatment will be possible or effective, and we are now preparing to begin hospice care, which means that we will be working to keep her as comfortable as possible rather than attempting to beat back the cancer. The doctors seem to think that she has anywhere from a few weeks to a few months left with us. We are hoping that whatever time we have can be peaceful, not requiring hospitalization.

The symptoms directly attributable to the tumors now are flank pain, which we control with dilaudid, and declining liver function. If that were all, it would be likely that Rebecca would simply get more and more tired as the liver function worsens. There are some other symptoms as well, though. She is generally short of breath due to accumulation of fluid in her lungs. She also has significant swelling of her feet and abdomen. Finally, she still has a low platelet count of unknown origin, which prevents us from draining the fluid in her lungs and from keeping her on the anticoagulant she has been taking to prevent DVTs. We are hoping that the large dose of steroids she just completed will bring the platelets back up.

We don’t know what the next weeks and months will be like. If bleeding or clotting becomes an issue, we may have some trips to the ER in store. Our hope is that Rebecca can stay home and be up and about for a few hours a couple of times each day. We’ll try to rent a wheelchair that can travel over the paths of the Duke forest around our home.

We’ve talked over the various scenarios as a family and the kids are responding with strength and grace. Yvonne will continue her senior year and start at Swarthmore in September. Jacob will return to Swarthmore in a week and we’ll fly him home for some weekends. Josh will continue to teach and supervise student research projects, but will cut back on other work activities that cannot be done from home.

It is very hard to let go, but harder still to contemplate the misery that would surely come with continued aggressive treatment. We are so grateful for the words and deeds of encouragement we’ve gotten from family, coworkers, neighbors, and old friends.