The Halfway Point

It is difficult to sum up the last six weeks, to articulate the roller coaster of chemotherapy. There have been many sweet, normal, everyday moments, yet amongst those joys have also been the darkest days of our lives to date. That is the paradox of living life with cancer when you also have three children under five: with small children, you are guaranteed joy and laughter even in the midst of suffering. You are guaranteed a somewhat normal rhythm to your life because you cannot abandon the daily routines even when you feel like the world is crumbling around you and you want to crawl back under the covers. There are days when we join them in the tears and tantrums, and when our anxieties and fears are amplified due to our concerns for the boys. Despite the added challenges they bring, our little men have been the best medicine and have brought so much light to the darkness and levity to the heaviness.

Jonathan has completed the first two cycles of his treatment. As I type, he is receiving his second infusion of Cycle 3. Being halfway through is bittersweet. It is a marker to celebrate, and yet the thought of doing the last six weeks over again is daunting. Chemotherapy has not been easy on Jonathan; physically, mentally, emotionally, and spiritually, he is being being brought to the end of himself. It is a terrifying thing to walk into an infusion center, surrounded by many very visibly sick people, and get hooked up to a cocktail of drugs that you know are going to make you miserable on their way to saving your life. Reality hits hard and is joined by worry and fear, making that first week a constant mental battle. It seems the greatest battle against cancer is for your mind and heart. It is still a little too fresh to really wrap my head around or put words to the experiences of that first week, but I can say for certain that we experienced the darkest, most hopeless moments of our lives in those days. When you're hooked up to a chemotherapy drip or lying awake in the middle of the night, it doesn't matter that so many people have it far worse or that your eventual prognosis is pretty positive. It is still cancer, and it is still hard. Neither of us has ever been so completely dependent on Jesus for our moment-to-moment sustenance. It is the best possible place to be, and beautiful as it is painful.

(We are so grateful to the help of a wonderful counselor who helped us walk through those early weeks together. If you ever find yourself dealing with a serious illness or challenge like this, start with counseling at the onset! We received that wise advice from one of our pastors and are so grateful, as that would never have crossed our minds on our own. We have a solid marriage and good communication skills, but this is by far the hardest thing we have ever done and we definitely can't do it on our own. Our visits to the counselor have been as important as our visits to his doctors!)

Thankfully, Jonathan turned a corner partway through Week 2 and started to feel a little more like himself. He returned to work, where he was greeted by an entire staff dressed in Team Poe t-shirts! We are so grateful for the Mid-Del Vision Source team and the incredible support they have shown to our entire family. Jonathan was able to work through Week 2 and 3, which has been such a gift. Remembering that who he is aside from being a cancer patient has been vital to his well being. His hair hung in there until Week 3 but finally the tingling scalp and shedding led him to bite the bullet and shave it all off. We both anticipated this being emotionally difficult, a visual sign of his illness, but it was no big deal! The boys helped shave Daddy's head, which they thought was super fun, and he looks so great with a shaved head that it has just been a nonissue. He particularly enjoys the way it has streamlined his morning routine: shower, deodorant, done! The day after he shaved his head he hollered at me from the bathroom for taking his hair gel and then seconds later dissolved in laughter when he realized that he wouldn't be needing the hair gel for quite some time!

Cycle 2 was much more physically difficult than the first. The side effects hit sooner, harder, and lasted longer. By the end of the first week he went about 48 hours where he hardly looked at or spoke to me; it took every ounce of concentration for him to just hang on and make it moment to moment. He was up vomiting in the night and had no relief from nausea during the day. He was sleepless but unable to watch television or read without amplifying his symptoms. His senses were on overdrive, making it impossible to be around the children. Even when on their best behavior, three little boys are just plain loud and busy. It was pretty miserable. By Wednesday the fog had cleared enough for him to head back to work, and once again he was able to work through Week 6. The last few weeks have brought beautiful, unseasonably cool weather to OKC, and being able to enjoy family time outside while Jonathan has felt well has been such a gift.

Last week Jonathan had a mid-treatment CT, followed by an appointment with his urology oncologist on Friday to discuss treatment thus far. The day before our appointment Jonathan's blood work was showing an elevated number that had us concerned that disease was spreading. To be going through the hell of chemotherapy and think that it might not be working was a terrible feeling. Thankfully, the CT showed the lymph nodes of the retroperotineum are indeed shrinking in size in response to the chemotherapy! Dr. Cookson also confirmed that the suspicious number (LDH, for all you medical types out there), fluctuates throughout treatment and is related to tissue turnover rather than tumor growth. Basically, cancer cells are dying and releasing LDH, leading to an elevated number. We were so thankful for this good news and encouragement as we go into the second half of treatment. One month after treatment ends, Jonathan will have a post-treatment CT and appointment with his urology oncologist in early November. At this visit we will determine whether the follow-up surgery (retroperotineal lymph node dissection) is necessary. If there is any question, Jonathan wants to do it. Surgery recovery sounds like a walk in the park compared to chemo. He is ready to kick this stuff once and for all and would rather deal with surgery and recovery now than have to do any of this junk ever again! Good riddance!

There was only one negative bit at that appointment. The CT showed that a blood clot has formed on the end of the port tube. Although his ability to receive infusions is not compromised, the possibility of that clot breaking off and entering his blood stream is very dangerous. We were initially told that he would have to have surgery to replace the port, which would delay treatment and just be a pain in the...well...a pain in the chest! To think of having a second surgery for a new port that will only be in use for six weeks was maddening! After spending all of Friday on countless phone calls and lots of prayers, we were relieved to find out that surgery would not be necessary but that Jonathan would have to take twice daily injections of a blood thinner. It is a bummer to add one more thing to the smorgasbord of drugs in Jonathan's system, but we are grateful to avoid surgery and a delay of treatment. I am fulfilling my missed calling of being a nurse by administering the injections, so we are once again taking our marriage to a new level of vulnerability and closeness!

We have been overwhelmed by the love and support of our family and friends. Our parents have cared for the boys and made it possible for me to attend each of Jonathan's appointments. From help with the boys to meal deliveries on each day of treatment, to outrageously generous gifts, we have been blown away by God's use of his people to provide for our needs. Time and time again God has prompted people near and far to help us in ways that have fulfilled specific needs of ours at the perfect moment. I am embarrassingly behind on thank you notes but hopefully one of these days I will manage to express our gratitude for the many people who have reached out to our family during this difficult season. It has been an incredible picture of how God uses the Body of Christ to meet our needs and make his presence and care known in a tangible way.

Please continue to pray for our family as we tackle this last half of treatment.

• Pray that Jonathan would have peace of mind and heart and that he would have a strong sense of God's nearness and love.
• Pray that Jonathan's side effects would be manageable during these last cycles.
• Pray that Jonathan would have energy, stamina, and focus on the days he works, and that he would be able to maximize his time with the boys on his "good" days. 
• Pray for the boys to feel secure and loved amid these unusual circumstances. 
• Pray for me to have strength, energy, and perseverance as I care for Jonathan and the boys. I am hanging in there and taking it one day at a time, thanks to lots of Jesus, lots of grace with myself, lots of coffee, a little Jazzercise (because nothing takes the edge off like busting a move and punching the air for an hour), and some great girlfriends.   

I Don't Know But Thanks For Asking

As Jonathan checked in at a recent appointment at the cancer center, he overheard another receptionist asking an old man how he was doing that day. He responded with a smile, "I don't know, but thanks for asking!" We cracked up, because his response so perfectly sums up the experience of cancer. Between waiting on the next step or latest test results, or discerning how we're feeling or doing in any given moment, so often that cheerful phrase articulates where we are: 

"We don't know, but thanks for asking!" 

Sorting out your feelings (which vary from hour to hour), sorting out information related to your diagnosis (which is complicated and overwhelming), waiting for a phone call to tell you when the next step is going to happen (which can take weeks and make you feel like a tiny cog in a big machine), trying to articulate what you need and how others can help (which is hard to do when you can't even figure out what to do with yourself); all of these unknowns and varying states of being make cancer one big confusing waiting game where expectations, reality, and your own thoughts and feelings are as variable and disarming as the Oklahoma wind. In the midst of it all, we hope we can keep our smiling, cheerful, humorous, and grateful response: "We don't know, but thanks for asking!"

That said, we have more to share. It has taken me awhile to feel ready to post an update because this information has come together in bits and pieces over the last three weeks. It's hard to put incomplete information out there when you are still waiting on missing pieces. 

On June 24th we had our first appointment with his medical oncologist, the physician responsible for orchestrating Jonathan's chemotherapy treatment. It was a tough visit for a variety of reasons. First, we had spent two weeks post-surgery recovery feeling relatively normal, so the rapid return to reality was rough. Second, we did not immediately click with this doctor like we had with Dr. Cookson, Jonathan's urology oncologist. After meeting Dr. Cookson, Jonathan wanted to go hang out with him. This new doctor is fine, but we aren't going to be meeting her for a drink anytime soon. We definitely had some cultural differences hindering our communication, and I don't think she is quite used to having a patient who is well informed, well researched, and comfortable with questioning her choices. At points the visit was downright tense and awkward!  

To top that off, we had to listen to the full list of chemotherapy side effects and potential life long results of the treatment. Granted, Jonathan will likely only experience a small handful of those symptoms, but hearing them all at once is like getting blasted by a fire hose of worst case scenario information. Listening to all of that while looking at my young, strong, handsome husband just about put me over the edge. I had a lump in my throat and tears in my eyes and wasn't sure if I was going to pass out, throw up, or have an emotional breakdown. Stuff was getting real in there.

The visit was made more difficult when she concluded that Jonathan is indeed Stage Three and in the Intermediate Risk category. Although his chest CT showed his lungs are clear of disease (YAY!), his blood tumor markers (particularly his LDH number) were still high enough to push him up into Stage Three. The bummer about this is that it adds a fourth round of chemotherapy, prolonging his treatment an additional three weeks. To add insult to injury, his LDH level was JUST over the line into Stage Three, but the treatment protocol needs to be followed regardless. Jonathan feels like he got a speeding ticket for going 75 in a 70 zone and he's getting the same fine as a guy going 120. 

Finally, we were discouraged to leave the appointment without a game plan. She wanted several more tests run to get some baseline numbers before chemotherapy begins, but of course her nurse had to schedule those tests and would call us with his appointment times. He also needed to get a port, a surgical procedure that would have to be scheduled as well. After being inundated with information and expecting a plan for moving forward, it was demoralizing to leave with a "We'll call you!"

We left that visit feeling pretty angry and sad, but after processing with each other and with trusted friends in the field we were able to see that our doctor really does know what she's doing and has given him the correct diagnosis, and that it is ok to not be BFF with your oncologist. 

The next two weeks were a flurry of trying to get these tests scheduled quickly; Jonathan wanted to start chemo as soon as possible and all that stood in his way were three tests and a port. He ended up at three different medical facilities in one week just to get all of them done. He had an EKG and echocardiogram on June 30th and a pulmonary function test on July 1st. 

Last Wednesday, July 8th, he had a outpatient port installation. This was one matter of contention during his appointment with the oncologist two weeks prior. She insisted on a port, he refused. Thankfully, our good friend Blaire is an oncology nurse and was able to explain to him why a port makes life much easier during cancer treatment. They were able to do the procedure without putting him all the way under, which made recovery much more smooth. He was at work the next day and is just a little sore and feels like a SciFi character with his crazy scars and a lump under his skin. The boys think Daddy's new special button is awesome, of course. 

On Friday, the last piece of the puzzle fell into place. Jonathan got the call from his oncologist's nurse, Renee, that he can start chemotherapy on Monday, July 20th. Jonathan will do four cycles of BEP chemotherapy. Each cycle is three weeks long. Here's an idea of how that will go down:

WEEK ONE: Infusions every day, Monday through Friday. He will be at the cancer center at OU for 5-7 hours on these days. 

WEEK TWO: Shorter infusion on Monday, 1-2 hours

WEEK THREE: Shorter infusion on Monday, 1-2 hours

He will then repeat that cycle three times with no breaks in between unless his blood counts are too low or he gets some sort of infection that would put treatment on hold. That has him finishing up treatment in early October. At this point, we know he is guaranteed to experience fatigue, nausea, and hair loss. Time will tell what impact these side effects have on his ability to work, but he is going to play that by ear. Obviously Week One of each cycle will have him out of the office quite a bit. We are thankful for his incredibly supportive and flexible team at Mid-Del Vision Source. 

So here we are, a week away from chemotherapy. We are gearing up for the long haul, trying to balance getting our lives in order in preparation for a difficult season, while also just enjoying normal life together as a family before we enter into survival mode again. It seems the most difficult stage is around the corner, and we both know that Jonathan becoming more visibly sick will be hard. I'm not sure how to prepare for that or if it is possible to do so. 

I have a lot more to share regarding what the Lord is teaching us and how he is providing for us, but that would make this novel of a blog post an epic tale. I will try to get those thoughts into separate posts soon. 

As always, THANK YOU for your prayers and for helping our family feel so loved. Keep it coming!

 

Hurry Up and Wait

It has been three weeks since Jonathan's diagnosis. It feels like it has been much longer than that. From the first inkling of something being not quite right, Jonathan has been fast and aggressive.  He sought a doctor's advice on his own accord, bucking the typical dude stereotype of avoiding the doctor until his wife's nagging drives him to action. He scheduled his recommended ultrasound and CT scan for the next day, making the time from doctor's visit to diagnosis only about 10 days. His diagnosis came on a Friday, we were at the oncologist on Tuesday and in surgery the following Friday. From what we can gather about the typical testicular cancer experience, this is a pretty remarkable timeline.

Apparently cancer did not get the memo that it was messing with a guy who has run marathons, climbed mountains, conquered an MBA and an OD, had three kids in five years, works his tail off at a thriving optometry practice, and deals with a firecracker of a wife on a daily basis. Jonathan Poe may be quiet, calm, and collected, but he is the most detail-oriented, determined, dedicated man I know. Once he sets his sights on something, he puts the pedal to the metal and gets to work. It may look unassuming on the surface, but deep down it is fierce. Three weeks ago he set his mind to eradicate cancer from his body, and it is going down. Cancer picked the wrong dude.

All that to say, we have crammed a lot of life into three weeks. Two weeks ago Jonathan had a successful and uneventful orchiectomy, the first step in his treatment process. It was an outpatient procedure and the recovery went very well.  Thanks to our previously scheduled beach vacation, Jonathan already had the following week off, which allowed plenty of time to rest. He started the weekend unable to get up and down on his own, but he was diligent to do a little bit of movement each day and by the end of the week was fully mobile again, albeit a bit sore and slow. He returned to work this week, which was great for his mental state as he was tired of being the patient and needed the productivity to keep his mind off of waiting for pathology results.  The boys think his abdominal incision is totally awesome. :)

I have to give a HUGE thank you to Todd, Jonathan's brother, who spent the weekend after surgery in our home. He was Jonathan's primary caregiver that weekend, sleeping on an air mattress next to his bed, waking up every four hours to give him pain meds, lifting his dead weight in and out of his bed and chair all day and night. And in the midst of all that he managed to treat our contaminated water well, which is a tedious job (Long story, but due to flooding we found out the day before surgery that our water was not safe to drink! Two weeks later, today, we finally got the all clear.), rehung my living room draperies that the boys pulled down while we were at the hospital, and serve as comedian, counselor, and confidant to Jonathan in a way that only a brother can do. Todd has a very full life and a demanding work and academic load, so for him to sacrifice an entire weekend to selflessly serve our family was a treasured gift. It's funny, I have not been very teary or emotional in the last three weeks, largely because I am very much in adrenaline mode to get our family through this, but when Todd got to the front door with his bags packed on Sunday night I burst into tears and cried like a baby! Todd's presence was such a help and comfort to us and I was not ready to break up our little cocoon! Another big thank you goes out to their wonderful parents who took our big boys for the weekend and showed them a fabulous time of riding the mall escalator, eating at Chicfila, and making their first trip to the Lego store!

So many people have been so kind to check in and ask if we have any news. Yes and no. We do have some news, but we are still in a waiting period. We are learning that cancer diagnosis and treatment are a series of steps, each contingent on the one before, with periods of waiting in between. All that to say, we can't always answer your questions, especially about timing, because we don't know the answers either! That said, here are the facts:

Jonathan's primary tumor was 95% embryonal carcinoma and 5% yolk sac carcinoma (feel free to Google those terms; the American Cancer Society provides helpful information on specific tumor types). The tumor had clear margins and no evidence of invasiveness beyond the confines of the tumor. That is good news. This type of tumor is responsive to chemotherapy. Also good news. However, Jonathan's abdominal CT scan before surgery did confirm presence of disease in the retroperitoneal lymph nodes (think lower back area). Essentially, cancer cells other than the tumor itself travel through the lymphatic system and spread first to the retroperitoneum.

There are two big pieces of information that we are waiting on before moving forward:
1) Blood Tumor Markers. Hormone levels in your blood indicate what the cancer is up to. Jonathan had blood work done on the day of diagnosis to establish a base line and had more done today. We need to see what those hormone levels are doing. Do they return to normal? Do they remain elevated? Those tumor marker numbers play into how they stage his cancer and which chemotherapy path they choose.
2) Chest CT Scan. Jonathan had an abdominal CT scan that confirmed disease, but he only had a chest X-Ray. The X-ray showed that his lungs were clear, but our doctor ordered a chest CT scan to get a better look. Right now we know his cancer is at least stage two, but if disease shows up on the chest CT he will be stage three. This matters more for the diagnostic staging process, as treatment does not change either way.

On the 24th he will have that chest CT done and we will have our first meeting with his medical oncologist, the physician who oversees the chemotherapy treatment plan. A friend compared this process to Jonathan's urology oncologist, a surgeon, being a quarterback who passes the ball to a receiver who is going to do his thing. The quarterback is still calling the shots and overseeing the big picture of the game plan, but he's handing off the next step of the play to the appropriate expert. At that point we will have the blood work back and the CT scan and can choose the most appropriate regimen of chemotherapy.

During and after chemotherapy they will continue to monitor those blood tumor markers and do another CT scan. At that point we will be able to determine if any residual disease remains and whether further surgery is necessary. That surgery is called a Retroperitoneal Lymph Node Dissection (RPLND). It is a doozy of an operation with at least a 5 day hospital stay and 6-8 week recovery. Feel free to Google that one too. We hope to avoid that possibility, but obviously Jonathan has his game face on for that if it is what it takes to be DONE with this disease and not have to constantly wonder if cancer is still there or coming back.

So, that is what we know. Here are some specific ways to pray:

• This is my big bold prayer request: that Jonathan will never have to have the RPLND surgery. I want that chemotherapy to wipe out every trace of disease so that surgery is unnecessary. 
• That the chest CT scan will be clear. 
• That the correct plan for chemotherapy would be clear
• That Jonathan would respond well to chemotherapy, both in terms of disease eradication and in terms of side effects. May he have minimal nausea and fatigue and be able to work through his treatment.
• That Jonathan would continue to feel peace and contentment. Jonathan is naturally bent toward anxiety, and that has obviously been a struggle in the last few weeks. Several of you have been praying specifically for that and the latter half of this week he has felt such peace and absence of fear. 
• That the logistics of Jonathan's work schedule and treatment would fall into place and that he would be able to continue seeing patients throughout this process. Optometrists don't get paid if they aren't seeing patients, which is one factor, but more than that working is just good for Jonathan's spirits. He has an incredible team and they are so supportive. Going to work is good for Jonathan. 
• That we would continue to get good rest. The boys have slept well the last few nights and it has been such a gift!
• That I would have strength, endurance, patience, and a servant's heart as I care for these four guys of mine. I thought I knew how lucky I was to have an equal partner in matters of parenting and housekeeping, but removing his help from the picture shows how much I rely on our partnership in this crazy life! 

Finally, but most importantly, THANK YOU! Thank you for your texts, phone calls, and messages, for your cards, for the yard work, for the creative and thoughtful deliveries that show up on our doorsteps at just the right moment, for the delicious meals, for the visits, and for caring for our children. Someday I will get all caught up on thank you notes and respond to every email, but until then, please know how absolutely grateful we are for the love we have been shown. Seriously, we have been blown away by the generosity and care of our people. 

We are most grateful, however, for your prayers. There is just no way that we should be functioning as well as we are during this difficult time. Your prayers are quite literally holding us up throughout each day. There are days when I don't even know what or how to pray, and I can rest knowing that someone, somewhere is covering our family in prayer, articulating the things that we are longing for and needing when all we can say is, "Jesus!" (My friend Audrey sent me a precious email with this jewel: "It's ok to be mad, and it's ok to not know what to pray--ask us to pray for it." What freedom I have found in those words!).

In the last weeks I've heard people say I'm "so strong" and "super woman" and that Jonathan and I have such strong faith. Well folks, I'm glad we've got you fooled. ;) But really, we are so so weak. We are sinners. We are doubters. On Sunday Jonathan felt so mad he could hardly sing or pray. Last Thursday we were totally over being patient and caregiver and were snippy and snarky with each other until we finally had to separate for the afternoon! We lose our cool with our kids, complain about impositions to our own desires, and cling to our perceived rights far too tightly. It is a daily, hourly, momentary choice to bring our junk to the feet of Jesus, to confess our need for him, and to keep pressing forward. We don't always submit to that process. But when we do--heck, even when we don't--He is faithful to us. He provides for our needs. He comforts and quiets our hearts. He provides strength and energy beyond what anyone should expect to have on three hours of sleep and relentless days at home with three little boys. He fills us with his Holy Spirit and allows us to be used by him for his glory in spite of our failings. So we are not strong and faithful. Jesus is strong and faithful, and we are just trying to abide in him and be more like him at the end of all of this. 

An Invitation to Trust God

Every time I think about sharing this news my stomach does a somersault and my heartbeat quickens and throbs in my throat.  Keeping information among close friends and family in real time feels safe and secretive in this modern age, as though reality doesn't exist until shared on the internet for all to know. If it isn't on my Instagram or Facebook page, it isn't really happening.  The words are hard enough to say, but typing them out is just too much.

Jonathan has cancer.

There. This is real. This is happening. Cancer has hit my family, my person, my husband, and I hate it.

After several months of sporadic pain, joined by a chronic lower back ache at the beginning of this month, Jonathan went through a series of tests.  Last Friday, they confirmed what my gut already knew: testicular cancer, stage two. At this point, disease has spread from a primary tumor in his groin into the lymph nodes and possibly some surrounding tissues in his retroperitoneum, the lining of abdominal cavity near his kidneys.

Tomorrow at 8 am a urology oncologist will remove the primary tumor. The subsequent pathology report will take about a week to determine exactly what kind of tumor we are battling.  That information, in combination with his tumor markers from a blood test at two weeks post-surgery, will determine what chemotherapy regimen will be the best combination of eradicating disease while minimizing long term negative effects. The hope is that the chemotherapy will reduce the abdominal presence of disease to the point that abdominal surgery is unnecessary or at least more straightforward than it would be if they operated on that area pre-chemo.  

We are heartbroken and sad, scared and anxious, and more than a little angry that this stupid disease is messing with our lives.  We were supposed to be leaving for our first family vacation to the beach tomorrow, and instead we had to tell our five year old that Daddy is sick and the beach will have to wait. Gut-wrenching. Instead of relaxing on the beach, Jonathan will be recovering in a hospital bed and awaiting the next steps in this journey of healing.

But.

BUT. There is hope. Praise God, there is HOPE! And by hope I do not mean the high success rate for treating and beating testicular cancer.  Yes, that statistic does bring me great hope. But the hope of which I speak is THE hope that surpasses every heartache of this broken world. The hope of Jesus Christ, who promises that there is more than this life for those who trust in and follow Him. This life is hard, messy, unfair, and ugly. Only in Jesus do we receive the guarantee that all that ugly can be redeemed and made beautiful, and that in the process we will never be separated from his love and presence. What is more, through these trials we are given the opportunity to know him--the God of the Universe!--more intimately and to bring him glory.

Not that any of this comes easily. We are riding a roller coaster of emotion, and fear tends to be the conductor on that ride.  In a recent sermon on fear, our pastor taught that fear is intended to lead us into paralyzation or into sin.  We are either petrified to the point of inaction, failing to move forward into what God has for us, or we are convinced that through our own control, anxiety, or avoidance we can alter the circumstances that scare us.  Neither should be the function of fear for the follower of Christ.

Fear is an invitation to trust God. To run to him with our fears, pour our anxiety at his feet, pound our fists in anger on his chest.  To let him have it, knowing he can take it, and then accept his invitation to trust him with it all and walk forward into a deeper level of knowing and being known and used by God.

And so that's what we are doing.  Daily, hourly, moment by moment. We accept the invitation to trust God, and ask that you would join us in prayer during this difficult time in our lives. Here are a few specific ways to pray and a few sporadic thoughts.

• Most urgently, pray that tomorrow's surgery at 8 a.m. would go smoothly and that Jonathan would have a swift and easy recovery. 
• Pray for relief from Jonathan's pain.  Since tomorrow's surgery is only on the primary tumor in his groin, the disease in his abdomen will remain for now, and that is what is causing him persistent back pain.  
• Pray that the pathology report would reveal run-of-the-mill testicular cancer (seminoma or non-seminoma), which has a very high rate of survival with treatment and a straightforward protocol for treatment. We do not want some rare, rogue tumor type.  
• Pray that we would continue to feel the presence of Jesus and see his hand of care. I could write a book on what he has already done, from how quickly things moved along in finding this problem to how the timing of our vacation is allowing Jonathan to have surgery without taking additional time off.
• Pray that we would have strength and courage for these coming months and that we would continue to take our thoughts captive and view this as a one-step-at-a-time process rather than getting freaked out by big picture possibilities. 
• Pray for physical strength, endurance, and rest.  Pray that our boys would sleep soundly through the night, which is not typically the case (most nights we feel tag-teamed; if the baby sleeps, a big boy wakes, or vice versa!). This stuff is emotional and exhausting enough without trying to do it sleep deprived!  
• Pray that our boys would feel secure and loved during these out of the ordinary times. Pray that we would see our children and have a sense of their deeper individual needs when our own needs feel very big and unavoidable. Pray that his experience will point them to Jesus. 
• Pray that we would be faithful to walk with Jesus, knowing him more closely and making him known more broadly through this trial.   
• Pray that we would run to those in our community who love us and want to help. My old friend Brandy Greer, when faced with her own cancer diagnosis, told her husband Stanton to "run to the Body." Well, the Body has been running to us and we are flat-out floored.  If you want to get Jonathan crying, just get him talking about how loved and supported he feels. Pray that we would receive the blessings that our loved ones want to pour out on us with open arms, and that we would not be deceived into feeling alone.  THANK YOU to those of you who have been loving on us already through texts, messages, phone calls, snail mails, meals, visits, and helping with the boys.  We are overwhelmed with gratitude.