13

When I was nine I learned that the number 13 was an unlucky number. It was my first year in the Little League Baseball program and I was on a minor league team. That meant that I was not good enough for the majors, but that was all right as 99% of all nine-year-olds were in the minor league program. Anyhow, I chose the number 13 baseball shirt. It had matching pants and the coolest baseball socks.

When I arrived at my home my mom said, “Why did you chose 13? That is an unlucky number.” I asked her why. She did not know why, but everybody knows that the number 13 is unlucky. I had already decided that I wanted to be different in the first grade when the teacher asked us what our favorite color was. Of course all the girls chose pink and purple. The guys chose red, blue, and green. Not me. I chose orange, and that has been my favorite color since then.

Since I was nine every time I had a choice in choosing the number of my sports uniform I chose the number 13. I am not big on “luck” anyhow. I don’t remember ever winning anything. I don’t even read the little notes in fortune cookies. I eat the cookies; I just don’t read the fortunes.

Today I was called in early for my treatment and was reminded by my therapist that it was treatment #13—like this is the unlucky one. Wonder what will go wrong. I didn’t think it was funny. Anyhow I am not afraid of the number 13.  It is just another number, and the fact that this treatment was #13 did not faze me.

I am confident of this: “For you formed my inward parts; you knitted me together in my mother’s womb. I praise you, for I am fearfully and wonderfully made. Wonderful are your works; my soul knows it very well.” Psalms 139:13-14 ESV

As I am writing this my dad is having a heart catheterization at Baptist Hospital in Jackson, Mississippi. Please pray for him. He was hospitalized on Saturday with chest pains and swollen ankles.

Overthinking

After my episode of not being able to contain myself long enough for the treatment on Thursday night, I reported to my radiation oncologist the problem I was having. His response was very simple—take 2 Aleve tablets morning and night. My first thought was “That’s it?” The second was “That is a big dose of Naproxen (Aleve is the brand name of Naproxen Sodium).” The third thought was “Side effects can be ulcers, kidney problems, and on and on.”

I won’t labor the point, but I had many other thoughts before I actually started taking the Naproxen. Overthinking is a regular challenge for me. I mean I even looked it up in the Oxford Dictionary: think about something too much and for too long.

Here I was trying to analyze why my radiation oncologist was over-prescribing Naproxen for me, and this is the guy who is prescribing daily doses of radiation for my body!

That dosage has taken care of my problem, and I am back to cruising through the treatments, and I am also more comfortable throughout the day and night. In my overthinking I did not think about why he prescribed that dosage. He is a smart guy—even though he is from New York—and he knew that dosage would reduce the inflammation in my prostate and give me relief.

Thinking is a good thing, but overthinking can be a challenge for many of us.

Be Still

Treatments one through ten have been rather routine—that is they have all come to pass in a very similar manner. Treatment eleven tonight was not routine. Before each treatment I drink three 8 oz. cups of water 45 minutes before my treatment. This fills the bladder and keeps it off the prostate during the radiation. That is important for quality of life after the treatments. For the past two days I have had more urgency after drinking the water—even before I go into the gantry for the 20-25 minutes that it takes for the prep work, zapping, and post process. When I get onto the table and get all lined up with lasers, I cannot talk or move.

That may sound very simple, but it takes a lot of concentration not to move or flinch even the tiniest bit. When you gotta go so bad you ache, there is no concentration. Tonight the therapists were trying to get me in position for the beam, and all I could think about was what happens if I have an accident. My pelvic bones were quivering and I said out loud, “I am sorry.” One of the therapists said, “When you talk you move and we have to start the alignment all over. Do not talk!”

I tried to concentrate, but all I could think of … yep, you are right! After what seemed a very long time, I finally said, “I can’t do this.” “That’s all right; we will get you off the table now.” I was out of there in a flash and when I had finished my business one of the therapists was waiting to tell me to get dressed, go back in the waiting room, drink water again, and we will come to get you in 45 minutes.

As I walked to the waiting area I was thinking how will I do this again if I have to do the same routine. The Lord reminded me of a scripture that I have talked about a lot over the past 20 years. Often while speaking to groups I would start to quote this verse and ask the group to finish it. I would say, “Be still and…” and the group would almost always say, “know that I am God.” That was all most people would know of that verse. It is often used to remind one that to get close to God, you had to be still. That is very appropriate in our busy world. I would recite for them the rest of the verse: “for I will be exalted among the earth. I will be exalted among all peoples.”

I have used that verse so much to get people to understand the second part of the verse and how God wanted us to share the Good News with all peoples, that I had forgotten the meaning of the first part of the verse. God was reminding me that I could be still if I would remember that He is God. Sounds so simple, but nevertheless it was a big lesson for me. I am so busy. I am working everyday trying to keep up with all the projects that are going on. I have been Martha preparing the big dinner, and I have not been Mary enough, sitting at the feet of Jesus.  

Be still and know that I am God…

Oh, by the way, I made it through the second attempt.

Dosimeter

Today at our weekly BOB meeting six alums were here for checkups. The institute has each of its former patients to return for a yearly checkup. The six alums ranged from 1-4 years since the completion of their treatment. Each of them shared their story to the group of 75 people. All related the same story of how their urologist told them that they needed to have surgery. One of the alums is a retired surgeon who shared how he came to choose proton therapy over traditional surgery. The surgeon’s brother had prostate surgery a few years before he was diagnosed. His brother chose the robotic surgery, and he had much difficulty afterwards with quality of life issues. Additionally, he had to have supplemental hormonal treatments. The alum assured us that everyone who has the surgery does not have this level of problems, but this experience was enough to convince him that proton therapy was the best treatment for his cancer.

The surgeon told another story of a colleague who is a radiologist who had the proton therapy treatment in Jacksonville. He related how every person who works around any kind of radiation wears a dosimeter badge that measures radiation exposure. When the radiologist began his treatment he asked the therapist if he could place his dosimeter on his abdomen during each treatment. They agreed that would be OK for him to do this. Each treatment the radiologist would place the badge on his abdomen. At the end of 39 treatments the dosimeter did not show any radiation exposure!

That made me feel much better. I have read; I have been told; I have seen power point presentations; and I have been assured that every time I have had a treatment that all the radiation dosage was being delivered to the prostate. But, as I have lain on that expensive table in the guts of that giant machine one thing has bothered me: why do the therapists always leave the room once they have me positioned and once the machine is perfectly lined up for the treatment. They ring this “doorbell” and immediately leave the gantry. Double doors seal with big decals on them that say “Do not enter. Danger. Radiation in progress.” A big red light comes on that says, “Beam on.” They don’t re-enter the gantry until the green light says, “Beam off.”

Now I have more assurance. The room is not full of radiation. These therapists treat 120 people a day. It’s the old adage that we grew up with—better safe than sorry. I am no longer concerned about getting too much exposure. Dosimeters don’t lie.

Fishing

As I lie on the table in the center of this giant machine I cannot move for 20-25 minutes. That is one of the cardinal rules in these treatments. That is difficult especially with all my vitals full of fluid. To help keep the arms still they give me a plastic ring to hold with my hands on my chest. Three therapists are scurrying around to send radiation into my body so precisely that 100% of the protons are delivered to my prostate and none of the radiation exits that area around this walnut-sized gland. I know the basics, but remember my roots are farming, and farmers are curious. I have studied this technology for the past five months and I still don’t have my hands on exactly how this works.

Getting my hands on something reminds me of growing up in rural Mississippi. My dad and uncles would take me with them to hand fish—some call it “noodling”—for catfish in the creek. At that time we did not have all these lakes built on creeks to control flooding, so there were many holes where the catfish would hang out. The trick was to wade slowly into these thigh-deep holes and find a catfish. When you gently touch the catfish, you have to slip both hands carefully around the three very sharp and potent spikes and quickly sling the fish to the bank of the creek.

In Exodus 4 God commanded Moses to pick up the snake by the tail. Who is dumb enough to pick up a snake by the tail? God is saying to Moses, “You let me take care of the head. Your job is to do what I am asking you to do. My job is to take care of the big things.”

That’s a lesson for me for these treatments: I don’t understand all this technology, but I am praising the Father because He has the head and He is in control. My job is not to understand all the technology, but to trust in the Lord, walk with Him, and He will take care of the big things. JOY!

Finishing

I was talking with Jeremy today about his PhD program at Ole Miss, and he told me that one of his cohorts dropped out of the program. I remember working on my degree at Ole Miss and how surprised I was at how many fellow students did 3 years of seminars and course work and then dropped out of the program. They became ABDs—all but dissertation. It surprises me how many things we start but do not finish.

I have not heard a single story of a man with prostate cancer who has started these treatments but has not finished them. These guys have come here from Maine and New York, the Carolinas, Georgia, Tennessee and many other states for treatment. Some are retired and some still in the workplace. There are business owners, policemen, career Marines, pilots, teachers and many others. They have all come here to finish treatment for their cancer or tumors. All things are not as serious as cancer treatment. What determines whether something is worth finishing or not?

I was in Iraq in June, 2004 when the USA planned to give control of the country to an Iraqi provisional government. My colleague and I planned to depart two days before the planned event—we were going to get out of Dodge before the anticipated fireworks.

A couple days before our scheduled departure we were closing out the day with a prayer time with our fellow workers who lived in this house that backed up to the home of the Iraqi who had been chosen to be the leader of the provisional government. I was a little overwhelmed by the presence of Iraqi military personnel who were guarding his house. Some were perched in barricades built along the wall between the houses and others were scattered all around the area. I decided that this was either one of the safest places to be in Baghdad or it was one of the most dangerous places to be. I decided on the former and did not think any more about it.

We had a good time together with the workers sharing and praying, and it was about time to wrap up. Someone was praying. It was 10:15pm. Suddenly the ground began to tremble. The sounds of heavy machinery creaking along filled the living room. Prayer time was over. We ran to the windows to peek out and saw US military tanks and personnel carriers all around the house. I am a farmer, and farmers are curious. I wanted to go outside and find out what was happening. No one wanted to go with me. Finally, a young man decided to accompany me.

As we walked outside, a US army sergeant came up to us, introduced himself as being from Ft. Hood, and greeted us in a friendly manner; then he asked what he could do to help us. I replied that we just wanted to make sure that they knew that some Americans were in this house and that we were concerned for our safety. He assured me that he knew who was in the house and that we did not have to be concerned.

That was easy for him to say, but as we were talking, soldiers were jogging all around us setting up sentries and barricades. The roar of the tank engines almost drowned out our conversation. I asked what was happening and he replied they were on a mission. After a couple more questions to which he replied with more information about him being from California originally and other chit chat, I realized that he was not going to give us any information about this mission. So, finally, I asked him, “Sergeant, how long are you going to be positioned in our yard?” His quick response was, “Sir, we will be here until the mission is accomplished!”

Lord, when I say that I am going to do something, convict me to follow through and stay with that commitment until the mission is accomplished.

Driving to treatments

The Proton Therapy Institute is on the Shands Hospital campus, and all of these medical facilities are part of the University of Florida Medical Center in downtown Jacksonville. We are driving 30 miles one way each day for my treatment, but traffic is nothing like Atlanta traffic, so it does not take us long to get there.

I am doing a lot more driving here in Florida. Like everywhere, the road is full of aggressive drivers. I don’t know if it is the male macho thing or is it just me, but I am having challenges not reacting aggressively. It is so natural to think about what has been done to me rather than think positive thoughts about the offending driver. Did I just write that?! How do I have positive thoughts about a guy who cuts in front of me and makes me put on my brakes? That’s heavy lifting Larry boy.  

I don’t know if I am going to fix that, but I have decided long ago not to be angry. That’s right—we don’t just “get” angry, we choose to be angry. I have found that when someone makes me mad, I quickly think this: I am choosing not to be angry. I won’t lie and say it works all the time, but it does help me a lot.

I like to think that I regularly practice servant leadership:  I work hard not to lead by position, but by influence; I try to let others go first; I hold the door open for people; I speak kind words to strangers; I try not to get the best seats in meetings; and on and on.

But all this driving has made me realize that I haven’t really thought about practicing servant leadership in traffic. I am convicted. Here are some ways that I am going to serve others while I drive: don’t tailgate, let others go first (don’t be in such a rush so I can be first), and smile whenever someone gets mad at you or when you get mad at them.

Now this is another challenge: when we do good, we want others to know about it, right? That road rage guy in the big pickup is not going to know if smile when I let him cut me off. Truett Cathy has given me a new appreciation for the Golden Rule. He loves to give rulers to school children who come to visit his office. The ruler is inexpensive, but the lesson Truett gives them is invaluable: Do unto others as you would have them do unto you. Amen!

One-fourth

I am scheduled for 28 treatments, and ideally my last treatment will be May 21. However, as with all technology, sometimes there are glitches in the equipment. Occasionally, that causes a long enough delay that I would miss a day’s treatment. When that happens the institute just adds that treatment after the last scheduled day. My IT friends will love this: when they have those glitches the first thing the engineers do is reboot! The three favorite words of an IT professional: “Did you reboot?”

Regardless of what day I finish, with the treatment tonight I have completed 7 of 28 treatments—that’s one fourth of my treatment time. I have finished these treatments and the biggest problem I have had so far is tying the back of my hospital gown so my rear does not show while I walk down the hall! In the end—there are a lot of jokes related to this treatment with hidden meanings—it does not matter, as all the therapists get to know a lot about me anyhow.

JOY!

Why not Rome?

When we moved from Richmond, Virginia, to Rome, Georgia, we sent out email updates to family and friends telling them that we were going to work with WinShape Foundation, and that we would be living in Rome. Many of them wrote back and asked if we would have to learn Italian! For the past 40 years we have lived in many exotic places, so they assumed we meant Rome, Italy. We really enjoy living in Rome, Georgia. It is close enough to Atlanta and Chattanooga, but we can still live in a small town with good  colleges and great medical facilities. So, why would we come to Jacksonville, Florida, to seek medical treatment?

Yesterday I attended my first BOB meeting—that’s Brotherhood of the Balloon. It is a support group for prostate cancer patients to get together twice a month at the institute just to discuss challenges that they might be experiencing and to affirm one another during the treatment. The leader asked us (about 40 men) to hold up our hand if our urologist recommended proton therapy treatment for us. Only one hand went up. Not surprising when you think about it. Urologists are trained to do surgery. That is what they do for a living. We have a new cancer center in Rome, Georgia, and it has state of the art radiation equipment and skilled technicians. I could have stayed in Rome and had excellent radiation treatment. Why did I come to Jacksonville for my treatment?

We researched other options that would give me a better quality of life after the treatments, and that would have the least side effects. After a lot of prayer, talking with prostate cancer survivors, and our own research, we decided that proton therapy was the best treatment for me. There are only nine centers in the USA that offer proton therapy and the closest one was in Jacksonville. We also met several people who had been treated in the Jacksonville facility, and finally the Lord confirmed that was the place for me to be treated.

We have not been disappointed. Chip Pohl summed it up well when he said the staff at the University of Florida Proton Therapy Institute is so much like our team members at our Chick-fil-A restaurants that it is like getting cancer treatment at a Chick-fil-A! We are grateful for this opportunity to be here in Jacksonville for this treatment. Thank you, Lord.

Water

During my initial four day visit to the Proton Therapy Institute, I received several instructions to prepare me for these treatments. These were related to diet, lab work, restricted medications and water. Diet changes were easy—give up gas-forming foods—and the lab work was routine. However, drinking 10-12 cups of water a day was a challenge. My beloved hot tea does not count. Those of you who know me well will be surprised that I only drink one cup of tea each day now. I am drinking water!

Before every treatment I have to drink three cups of water 45 minutes before the treatment. This is not a suggestion; it is demanded for each treatment because this water fills my bladder to move it out of the path of the radiation. In this case water serves a specific purpose that we would not think of in our list of things to do with water.

In our culture we generally don’t even think about water, much less any different function that it may have. The fact is that we take water for granted. We open the tap and water flows abundantly. Our drinking water is pure. We waste water, and we live like our source of water will never end.

In West Africa where we worked for years water was the most precious commodity, and it was the dream of every family to have clean drinking water. I have a very clear image of seeing people in Burkina Faso praising God when the first water was drawn out of a new well. They are simple people living in a very simple world, but they fully understand that water is life.

  Give thanks for the things that we take for granted.

Gratitude

When Cheryl and I first learned that I had cancer, we were, as most people would be, shocked. I did not experience the “why me” feelings that I have often heard about. I think part of the reason is that I have already had an experience of “why not me.” Jason was diagnosed with testicular cancer in 2000. That was devastating news, and I struggled with the fact that our son had cancer at the age of 27. I often asked God, “why not me?” I wanted to take this cancer from his body and put it in mine. Of course, that is childish thinking, but it was the gut feeling that I had.

After our initial shock we became grateful. That might sound strange, but our first season of gratefulness was because our family doctor insisted that I see a urologist even though my PSA was in the normal range. Then we were grateful for early detection as we were diagnosed with stage one prostate cancer. As we reviewed treatment options we were grateful for having options and the fact that with this stage of prostate cancer, we could choose the type of treatment that we thought was best for us. As we were researching, I was introduced by some friends to a treatment that we had never heard of before—proton therapy. I am grateful for friends. I am so very thankful for friends like those of you who are reading this. On Sunday one of my two best friends from college died. Life is precious, and I am grateful for every day that the Lord gives me to live on this earth.

Treatment 3 went well last night, and I am scheduled for #4 at 9pm tonight. Thanks for your support.

Weekend

With no treatments on Saturday and Sunday it seems a long time between my Friday night treatment and the next one tonight at 7pm. My appointment was actually at 10pm, but I just received a call asking me to come at 7pm since they were ahead of schedule. What happens is the therapists take the appointments that are the latest at night and work them into an earlier slot so they can go home earlier. Who could blame them for wanting to finish earlier?! The challenge is that we cannot plan anything for the evenings as they can call at the last minute and ask you to come in. We don’t have a problem with schedule changes because we are here for the treatments.

We worshipped at First Baptist Jacksonville yesterday. Our friends, George and Sharon Kemp, hosted us at their church. Mac Brunson is an awesome preacher. It was good to reconnect with him and Debbie. We really enjoyed the great music experience, also.

I finally went to the beach this weekend. Cheryl has been walking on the beach since we have been here, but I am not as excited about sand as she is. Through the years we have lived on the beach on both sides of the Atlantic, and we lived at both the southern and northern edges of the Sahara, so I have had my fill of sand. However, I do enjoy walking with Cheryl and I even help her look for shells.

Today I read the story of Jesus feeding the five thousand. How many times have I read that story! We know the story and the applications, like Jesus uses what we give Him and that He wants to multiply our gifts to feed the crowds around us every day. Isn’t it interesting how the Spirit points out things to you that you have not seen before? You are reading the same verses, but all of a sudden they have new significance for you. Mark 6:41 spoke to me today: “And he took the five loaves and the two fish, and looking up toward heaven, He blessed the food and broke the loaves and He kept giving them to the disciples to set before them…” Jesus took the bread and fish, thanked God, and broke them into pieces. Here’s what hooked me: a whole loaf of bread could not multiply itself. The bread was only available for the people after Jesus broke it. Only broken bread can be multiplied. Lord, forgive me of waiting on You to use me when I am not first willing to be broken.

Proton Technology

My appointment was originally at 9:20 last night, but the institute called mid-afternoon to say that they were running ahead of schedule and wanted me to come for a 7:25 pm treatment. As I was entering the gantry (treatment room), one of the therapists said there would be a delay as they had a problem with the X-ray machine. This proton therapy is a complicated process. I have done extensive research on this and I am still trying to figure it all out. The therapists take an X-ray before each treatment to help align the machine for the treatment.

In the meantime, I asked if Cheryl could come back to see the machine, and they agreed to bring her in. Ordinarily they are so busy pumping patients through (from 6:30 am-11:30pm) that they do not allow spouses to come into the gantry. We had a treat as one of the therapists spent 20 minutes explaining the process to us with a backstage tour. It really helped Cheryl to have a better understanding of the treatment. The therapist used my phone to take a couple photos and I am attaching one to this post. The photo does not do justice to the massiveness of the gantry, but you will get an idea of how the $1.5 million table extends into the core of the machine. The device rotates around the table and unless you focus on something outside the machine you get the sensation that you are weightless and in suspension—you are not strapped down and it feels like you are being turned over in midair. This is difficult to explain!

However, I am indeed grateful for this technology that is being used to rid my body of these cancer cells. Thank you, Lord, for giving intelligence to many people who have worked to develop this technology.

1 of 28

Our first visit today at the Proton Therapy Institute was with Keri, my nurse case manager, followed by a visit with Dr. Hoppe, my radiation oncologist. I will have a weekly visit with these two people during my treatment plan. Dr. Hoppe reviewed the treatment that he has prescribed for me using bone scan images of the pelvic region. The science is so precise that they can predict the area that will receive 100% radiation and the scope of the area that will receive no radiation. The objective, of course, is to radiate the cancer cells while doing minimum damage to the vital body parts around the prostate gland. My first treatment was at 1:30pm, and it took much longer this first time as they had to adjust the gigantic machine to properly perform its function (more on that at a later date). The radiation therapists play some music of the patient's choice during the treatments, and I chose bluegrass. It was a little difficult to concentrate on the music as one of the therapists prepared me for the "ballon" that stabilizes the rectum during the zapping. That is not easily described on a public blog, but let's just say there is no modesty in these treatments! The therapists leave the gantry during the short period of radiation, and I don't actully know when the 40 seconds of radiation enter my body. Interestingly enough, I could not feel the radiation entering my body, but I most definitely felt the presence of the Lord during this time. I was reassured that this body is not mine, but it belongs to the Father. My job is to be a good steward of this body and use it for His glory. The prayers of so many family and friends who are supporting me during this time enabled me to experience JOY during this first treatment. Thank you for walking alongside me. Treatment 1 down---27 to go!

Arrival in Jacksonville

We arrived in Jacksonville late this afternoon. This evening we have been grocery shopping and getting our "nest" set up. We are grateful to friends for allowing us to use their beach house in Jacksonville Beach. We are about 30 minutes from the University of Florida Proton Therapy Institute where Larry will have treatments once a day Monday through Friday. Larry's appointment tomorrow is at 10:30 since he has to have a consultation with the nurse who is his case manager and with his radiation oncologist before the first treatment. We are expecting to get a regular appointment at night for the first week or two since Larry is a "rookie" and they get all the less desirable appointment times.