New Growth: April’s Cancer Update 5.15.22

Editors Note:

(Since the posting of this blog on Sunday, April’s bilirubin numbers have increased, resulting in her being hospitalized. As of 7:15AM on 5/17/22, we are still waiting for test results which will enable her medical team to decide what to do next. Her ability to begin the Xeloda depends on her liver numbers returning to safe levels. Please pray that the tests occur in a timely fashion and that her medical team can determine the right next steps.)

We do not like bad news. And yet it is once again our currency. April’s latest scans and blood tests reveal that her cancer has once again out maneuvered her treatment regimen and has begun to grow freely. To stunt this new growth, April will take a new chemotherapy pill at the beginning of next week.

What Happened?

As the pictures on our various social media platforms make clear, this news blindsided us. Though April has had a few bad days this past week, she had regained increase mobility and strength over the last few months. She has played chauffer to our kids, cooked meals, fixed hair, helped with homework, and done many of the things that give her and all of us a taste of what life was like before cancer invaded. Perhaps even more remarkably, April completed her main physical therapy goal of walking more than a mile at a historical site. A few weeks ago, she toured Jamestown, Yorktown, and Colonial Williamsburg like a pro. She never showed the signs of extreme exhaustion and fatigue that defined her while she was on her intravenous chemotherapy regime. Despite some digestive issues (which could be noticeable at times), April seemingly had reached one of those restful plateaus within her cancer journey.

Given our most recent experiences, both April and I anticipated that her May 3rd scans would bring tidings of health. But as we all now know; those scans and the ensuing blood work would cruelly shatter our expectations. First, the scans came back showing shadowy images which suggested that the breast cancer tumors in April’s breast and lymph nodes had grown, and that a new tumor had formed in the kidney closest to her liver. To bring clarity to these images, April’s Oncologist ordered new labs to be drawn. The results of her blood work which measure tumor markers and liver function revealed that the shadowy clouds in her scans are most likely not illusions but the very thing itself. If the cancer has not grown in the spots identified in the scans, it is growing somewhere with enough force to bring deadly harm. In short, the breast cancer cells that have brought so much harm to April’s body and our lives since 2019 have once again begun marching forward bent on even greater destruction.

Thankfully, the effects of this new invasion have only just begun to materialize. This week, April’s liver produced the first signs of abdominal swelling and pain. Though the threat of additional symptoms remains forever real, they have not yet arrivied. Seeking to begin the new treatment before those effects poke significant holes into April’s quality of life, her medical team decided that she should begin taking the drug Xeloda at the beginning of next week. If the drug works, April will take three pills twice a day for two weeks. She will then take a week off. The two weeks on and one week off cycle should be able to combat April’s cancer for the next 6-8 months.

How Are We Doing?

In one sense the news of tumor growth has not shocked us. Intellectually, we both know that April’s cancer will spread, and that each treatment has a limited shelf life determined by the genetic composition of April’s cancer. And yet in another sense, the news does carry with it a certain amount of shock value, forcing us once again to think about this evil disease and the fragileness of life. Moreover, transitions between treatments prove to be an unsettling experience. Neither the medicine’s effectiveness nor its side effects come with full prove guarantees. The first 2-4 weeks of these transitions often contain a series of surprises and unanticipated twists. Few of them are good. For example, one Xeloda’s more prominent side effects is hand and foot syndrome which produces large sores in one’s palms and the soles of their feet could. April could soon struggle to walk and do simple household tasks. Though expected, the transition between treatments wearies our souls. We’d rather not go through the process of deconstructing today’s normal for the purpose of constructing a new normal that promises to be at least a little more difficult than the one we just tore down. We dislike such devolution.

And yet we remain hopefully. From a medical standpoint, April still possesses many other treatment options. Though life may get harder faster than we had anticipate, this news does not point to the end of April’s life. Her overall outlook remains unchanged.

Most importantly, our God has not changed. We know from Psalm 86 that the effectiveness of our prayer comes not from our power to persuade but from our need. The psalmist writes, “Incline your ear O Lord and answer me for I am poor and needy.” Thankfully our God who controls the stars and determined the fate of the dinosaurs still cares deeply about April, having numbered every one of her regrowing hairs. At times this week, our hearts have been very low. And our souls have felt the stresses of the moment. But our God has remained forever great. There is no one like him among the gods. Thus, we turn to him afresh, trusting that he will help us and comfort us even when we feel surrounded by cancer. Our God is gracious and merciful today just as much as he was yesterday. We look to him for hope afresh.

Prayer Requests

As always, we invite you to pray for us. Pray that the new chemotherapy pills will shrink April’s breast cancer tumors. Pray that Xeloda will last the full 8 months. Pray that the drug takes effect before April’s new cancer symptoms settle in and that her side-effects will be minimal. Pray that the Xeloda pills provide April and me with a new normal that will allow her to freely walk, do housework, and homeschool our kiddos for at least one more semester. Pray for God to give us patience with our children when the days are long, and the cancer symptoms are present. And pray for God to bless us with the wisdom that we need to navigate these times of uncertainty that begin with April’s cancer’s and yet possess the power to shape most every aspect of our lives. Come talk to the God of mercies with us.

Thank you!

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An Appreciation of Mr. Sam Ruble

My first conversation with Mr. Sam Ruble revolved around the topic of cows and stoplights and how the cows outnumbered the people and the people the stoplights in Rappahannock county. In the four years since that first meaningful conversation, I have come to realize that our brother truly knows more than a thing or two about wrangling cows, taking down bucks, and rebuilding limbs. Sam knows the outdoors well, but he knows people even better. 

He knows how to make the forlorn and neglected feel welcome. He knows how to love those who have lost a loved one and readily sheds a tear here and there for the many fishing buddies, family members, and friends who have already transferred their membership to heaven. He also stands ready to rejoice with those who get good medical news or who take the first steps towards adulthood or career success. A large hug, a quick joke, and a warm smile are never more than a moment away. Our brother loves us well.

 I can say this as both his pastor and his friend. It was Sam who drove us around when April and I first came to the hills of Rappahannock county. It was Sam who took me on my first hospital visits. And it was Sam who helped my son catch his first fish and visited us when cancer raged in April’s body.  

In one sense, the loving character of our brother and of his bride, Mrs. Karen, needs no description. Without fail every new member going through our membership classes since I arrived has made reference to you guys. Some perspective members struggle to recall your name. But once they start talking about how this one slightly older couple welcomed their family the moment they walked in the door and how this couple was so nice, friendly, and kind, I need only say, “Oh, you mean Sam and Karen,” before I hear, “Yes that’s the couple, I really like them.” Sam and Karen, thank you for loving us well. 

I know that your love for us has cost you a few gray hairs. If nothing else my inability to spell your last name correctly in the bulletin and on official church documents has surely added at least one extra gray hair. 

You have also weathered some of the darker days of this congregation’s history. But instead of leaving, you both stood firm and do what you do best. You loved fiercely. You faithfully made phone call after phone call, brought meal after meal, pumped out water system after water system, visited member after member, and went to doctor’s appointment and after doctor’s appointment. Whenever the phone rang, you stood ready to serve. Undoubtedly, you earned some of your grey hairs at ABC. But these little reminders of times past are not a curse but a sweet blessing, a testimony of how well you have loved the men, women, and children of ABC. Proverbs 20:29 reminds us that,

The glory of young men is their strength, but the splendor of old men is their gray hair.

Sam and Karen we are thankful for those gray hairs that crown your head. I am here because you guys loved well. Pretty much everyone at ABC today and watching online is here because you loved the Lord your God with all your heart soul mind and strength and your neighbor as yourself. Thank you! 

Thank you for pressing on and for making the most those opportunities to do “good to everyone especially of the household of faith (Gal 6:9).” Sam and Karen as you look out on the congregation today full of happy faces, I believe you are seeing the first fruits of your labor. Our church is what it is today because hundreds of people have been able to identify you with the hands and feet of Jesus. Thank you!

Though Sam is stepping down from our deacon board today, I still affirm that he possesses the heart of a deacon. He has not grown weary either of us or of our great God. But our Lord has placed physical limitations on our brother that prevent him from continuing on as a deacon. No ministry is forever. We are all but stewards. We must all step aside at some point.  Brother you have steward your time on this deacon board well. You leave behind a legacy of care and compassion. We will miss you.  

Yet, we will not leave you adrift on the pond of boredom to watch the Sunset. God still has much for you to do and we will look forward to ministering beside you in the days ahead. The parameters of your service will change. But I fully expect you both to go on deaconing and serving the church until Jesus calls you up yonder. Sam, I also suspect you will rightfully be one of our deacons most trusted advisors in the days ahead as you know both this congregation and our Lord and savior well. As Paul told Timothy,

For those who serve well as deacons gain a good standing for themselves and also great confidence in the faith that is in Christ Jesus (1 Tim 3:13).

Brother by God’s grace, you have achieved such a standing at ABC.

Thank you for standing firm in the faith. Thank you for loving my family well. Thank you for loving all of us well.  

Brother, there may be more cows than people and more people than spotlights in Rappahannock county, but I would be hard pressed to find either a cow, or stoplight or even another person who has loved us as well as you and Mrs. Karen have. 

Thank you, Sam and Karen for your 18 years of faithful ministry. May God bless you richly in the days ahead!

A Firm Foundation for My Mental Health

Much like two sides to a coin, there are two sides to one’s life, the physical and the spiritual. I’m a firm believer that the two are woven together and affect each other. But they are also separate aspects of a person. Different needs are required for both.

The physical nature of the cancer in my body has certainly had a profound effect on my spiritual health. So I understand the question that medical professionals ask as well as close friends. “How are you doing?” many times means more than if I am in physical pain. People want to know how I’m internally thinking and feeling about my life since my diagnosis.

My mental health is not a stagnant pond, but more like the shore of the sea. The waves ebb and flow. The tide comes in and goes out. No day is the same; yet, there are constants. I have a Rock that is always firm despite the size and intensity of the waves of the storm.

I use this analogy partly because of Jesus’s words from the Sermon on the Mount.

“Everyone then who hears these words of mine and does them will be like a wise man who built his house on the rock. And the rain fell, and the floods came, and the winds blew and beat on that house, but it did not fall, because it had been founded on the rock” (Matthew 7:24-25).

This was also the picture I kept in my mind in the days and weeks immediately following the death of our infant son in 2013. It felt like a storm had beat on our house, and all we had was the Rock of our foundation left. While grieving our loss, my heart clung to the truth: “God is good.”

So when this breast cancer storm hit, I went back to this familiar passage for comfort once again. This second storm is greater and more intense. The winds and waves have beat on our house without end. But the Rock has not moved. And I cling to it harder than ever before.

Focusing on Things Above

I know that I did not create my faith. There is no room for me to boast about how great my faith is (Jeremiah 9:23-24; Hebrews 12:2; Ephesians 2:8-9).

Let me instead boast in God and how unchanging He is. His Word is completely true and trustworthy (1 Peter 1:24-25). The Bible comforts me by providing the framework to understand life. Yet the same way the tide rises and falls, so some days are harder than others to rest in what I know is true.

One morning only a few weeks after my diagnosis, I woke up and just lay in bed staring at the wall. The onslaught of all the new terms about breast cancer and medications made me feel so ignorant and out of control. Everything was new and unfamiliar. I was scared. But then in that moment, I realized that while I may not have a medical degree what I did have no one could take away. Who God is hadn’t changed. What I knew and had studied about Jesus was still the same. So, I determined then that I would lean hard into what I did know. I wasn’t going to go crazy researching every cancer article I could find online. I wasn’t going to buy all the books about coping with cancer or make radical life changes. Jesus was going to be my anchor.

And even though I have wonderful friends and family, it is Jesus who is always with me. When anxiety sneaks in suddenly, I cry out to the Shepherd of my soul for peace. The moments when the pain is too much to bear, I ask my Savior for mercy to endure. All alone in a waiting room or in a scan, He has not forsaken me. I never have to worry about Him not being available. There is no doubt about His love and care.

The Bible and Suffering

The Bible is full of examples of godly people experiencing suffering. Sometimes it is the result of evil forces gaining permission by God to attack the righteous (Job 1-2). Other times, it is God who lovingly decides to test the faith of His people (Hebrews 11-12).

Hebrews reminds us “My son, do not regard lightly the discipline of the Lord, nor be weary when reproved by him. For the Lord disciplines the one he loves and chastises every son whom he receives” (Hebrews 12:5-6). Likewise, the Apostle Peter wrote to suffering Christians, “Beloved, do not be surprised at the fiery trial when it comes upon you to test you, as though something strange were happening to you” (1 Peter 4:12) and “In this you rejoice, though now for a little while, if necessary, you have been grieved by various trials, so that the tested genuineness of your faith—more precious than gold that perishes though it is tested by fire—may be found to result in praise and glory and honor at the revelation of Jesus Christ” (1 Peter 1:6-7).

Suffering shouldn’t surprise me. God in His perfect power and wisdom is testing my faith so that it will lead to praise and glory and honor. It is for my good.

Making Sense of the Physical

While all I can see is this physical life, I know it is not all that exists. I very much live in the here and now, doing laundry, cooking meals and picking up children from school. But this will not last. I am being prepared for a more permanent life to come. And it is this spiritual understanding that guides my thoughts through days filled with sadness in this current life.

I believe God cares about how I physically feel. I know that He is the one who supplies all my needs, whether that is food, clothing or medical care (Matthew 6:25-34). That’s why I pray for God to sustain my life. I’m not afraid to ask Him for temporary things in this life, like raising my children and owning our own home. He wants me to go to Him about the things that are important to me (1 Peter 5:7).

My Biblical Framework

The Bible creates a framework for me to understand and process life. My theology (my beliefs about God and this world) were firmly in place before I was sick. I have not abandoned what I knew or added to it. But I do have a deeper, fuller grasp of the great truths I hold dear. God has proven Himself to be good and faithful to me through my affliction.

I understand that sin and suffering exist in this world and affect me and my family because of Adam’s first rebellious act against God (Genesis 3; Romans 5). While I don’t believe that my cancer is a result of a specific sin in my life, I do believe that sickness is a result of sin infecting the whole world. Brokenness marks all aspects of life. Jesus came as the Savior of the world to rescue sinners from the curse of sin and death. He offered His body as a sacrifice for the forgiveness of sins to God. And His resurrection from the dead proves it was accepted. Jesus has promised that all who believe in Him will have eternal life (John 3:16). He is going to resurrect all believers to a new life in a new and perfect Heaven and Earth (2 Peter 3).

“Then I saw a new heaven and a new earth, for the first heaven and the first earth had passed away, and the sea was no more. And I saw the holy city, new Jerusalem, coming down out of heaven from God, prepared as a bride adorned for her husband. And I heard a loud voice from the throne saying, “Behold, the dwelling place of God is with man. He will dwell with them, and they will be his people, and God himself will be with them as their God. He will wipe away every tear from their eyes, and death shall be no more, neither shall there be mourning, nor crying, nor pain anymore, for the former things have passed away. And he who was seated on the throne said, “Behold, I am making all things new.” Also he said, “Write this down, for these words are trustworthy and true” (Revelation 21:1-5).

The Bible tells me how things like cancer can exist. And why bad things can happen to good people. But it also provides hope for a future. And peace and grace for today. This is a strong and sturdy foundation to build a life upon. For those who put their trust in God will never be ashamed or disappointed.

The lyrics to the hymn “How Firm a Foundation” seem a fitting way to end this post. The firm foundation of God’s Word provides me with all the hope and stability I need to navigate the various paths of my heart and mind through life’s storms. My God truly supplies for my every need and that includes my mental health.

“How Firm a Foundation” (1787)
How firm a foundation, ye saints of the Lord
Is laid for your faith in His excellent Word
What more can He say than to you He hath said
To you who for refuge to Jesus have fled

Fear not, I am with thee; oh be not dismayed
For I am thy God and will still give thee aid
I’ll strengthen thee, help thee, and cause thee to stand
Upheld by My righteous, omnipotent hand

When through the deep waters I call thee to go
The rivers of sorrow shall not overflow
For I will be with thee, thy troubles to bless
And sanctify to thee thy deepest distress

When through fiery trials thy pathways shall lie
My grace all sufficient shall be thy supply
The flame shall not hurt thee; I only design
Thy dross to consume and thy gold to refine

The soul that on Jesus has leaned for repose
I will not, I will not desert to its foes
That soul, though all hell should endeavor to shake
I’ll never, no never, no never forsake