Category Archives: Zach

Zach Update # 9 – One week check

One week check

Yesterday we had the one week post-op check with the Doctor.  Everything around Zack’s eye looks really good.  The doctor was very pleased with his progress. Yea Zach!

At the surgery, Zach’s eye was replaced with an orbital implant–an acrylic sphere to which the eye muscles are reattached.  This implant is permanent and will be the spot upon which the prosthesis will be fitted in about 6 more weeks.  In the meantime he has a clear spacer to hold the place for the prosthesis.  In the photo below you can see a sketch of an orbital implant, with muscles attached.  The prosthesis (on the left) goes into the space that fits under the eye lids.

It was just two weeks ago today, that we first visited the ophthalmology clinic and heard the report of Zach’s cancer.  So much has happened in 14 days!  Thanks for your prayers, support, help, meals, cards, and more.

Two cheers!

Furthermore, the bone marrow sample revealed no concern about retinoblastoma in other parts of his body.  So now we’ve gotten negative reports (no cancer) from both the spinal fluid and the bone marrow samples.  Praise the Lord for that good news so far!

The third cheer will be raised when we hear good news from the pathology report of the eye which was removed.  That eye had 80% of the vitreous fluid (the fluid in the eye) displaced with the malignant tumor.  Typically, and very graciously, the cancer is usually  fully contained with they eye itself when caught early.  The pathology report will reveal exactly where the tumor was located and how close to the perimeter of the eye it had moved.  We are also praying and hoping that the tumor had not traveled down the optical nerve.

While this is in the back of our minds as serious threat, I am very at peace day to day and know that fretting will not help.  When the thought comes about that which we do not and cannot know at this point, I lift a prayer to God and leave it with him.

“Lord, may our dear son Zach be totally cancer free.  Would it not please you to see that this cancer has been completely removed?  Have mercy upon my son for your glory.  Thank you that at the cross you withheld your mercy upon your one and only Son, so that all that comes to us as your adopted children is only mercy all the time.  In all this we totally trust you knowing that you will either extend your grace to heal or you will amplify your grace to sustain us.  Amen.”

Grace and peace,

Tim

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Zach Reflection – God’s Providence

God’s Providence

In addition to giving updates, some of our blog entries have also become reflections.  We’ve shared some personal things that have happened and it’s been helpful for us to reflect on events over the past week or so.  In some of the continuing posts I’ll label them reflections (versus updates).  This is a reflection about God’s providence in our situation while all these events with Zach transpired.

“Providence is God’s holy, wise, and powerful preserving and governing every creature and every action.”

Do you ever doubt that God is in control?  Have you ever seen circumstance line up in an uncanny way?  Nothing happens by sheer coincidence.  God is always at work in everything.  Likewise, nothing happens by chance or is outside of God’s control–not even Zach’s retinoblastoma.  God uses all things for his purpose, even blindness.

The Sunday before Zach surgery, a nationally known Pastor in the Minneapolis/St. Paul area, Pastor John Piper preached a message on the story of the Man Born Blind.  If you recall the verse that I quoted on the Friday before the surgery, it was John 9:1-4, the very text Pastor John chose to speak of from the pulpit.  Sheer coincidence?  Divine providence!

I have found his message to be a great encouragement on a number of angles.  Of course, the common issue is blindness from birth, but it also applies to God’s purposes, His sovereignty, and His redemption.  Also, Pastor John makes some great points about loving people who have children with special needs.  This is a sermon about providence, but it is also to us an example of providence at work.

By clicking on the link below, you can read the excerpt and/or watch the sermon online.  It can also be downloaded if you prefer to listen later.  It’s about 40 minutes.

http://www.desiringgod.org/resource-library/sermons/why-was-this-child-born-blind

Update

Tomorrow we go to Ann Arbor for a one week check up as a post-surgery check up with the ophthalmologist.  I don’t know if we’ll get any new information or pathology report.  We’re waiting for that important report which is supposed to be given within two weeks from the surgery.

God bless you all.  Thanks for your prayers, your comments, and your love.

Tim

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Zach Update # 8 Stop and Go

(by Sarah)

Stop and Go

Zach is doing great.  The swelling is mostly gone with just a little yellowing from slight bruising.  He’s smiling more and starting to coo, as babies do 🙂 He is so sweet!  He’s back to sleeping through the night ( I know, don’t hate me!) We go in and out of processing this new reality. Life keeps going, as I know you all know.  It makes it strange to deal with these kind of things because you can’t just put life on hold to process and reflect and grieve.  This week, for instance, I had to switch our clothes from winter clothes to summer clothes – a daunting task for 6 girls plus myself (in between a gazillion sizes since giving birth not long ago!)  Praise God we’re through it (98% anyway) thanks to some of you helping out here 🙂  Thank you!  Family is in town, celebrations are to be had, school work has to be checked…and then there’s Zach, with only one eye now…It just seems incongruent.

I know  any of you who’ve experienced any kind of loss or life changing reality can attest to these thoughts.  We join your ranks!  We are trying to tune in to the process and talk about it, cry about it, as we need to in bits and pieces, taking one day at a time with whatever that day gives us.  But this too is what it means to live through the human experience.  And we mourn with those who mourn and rejoice with those who rejoice.  This is the way of the Body of Christ.  We are so blessed to do this with you, our brothers and sisters.

A few facts

This being a new journey for us, I though I’d share some of the things we’ve been learning about retinoblastoma:

  • There are about 10 or so cases in MI per year – U of M will see about three of those.  Zach was their second this year.
  • There are about 300 per year nationwide.
  • RB most commonly hits infants and children 7 years and younger.
  • 1 in 18,000-33,000 children will get RB
  • RB is fatal if left untreated.
  • The smaller the tumor and the older the child the easier it is to try to eradicate the tumor.

There are other pieces of information but I thought those points were interesting.

It’s Surreal

I still can’t believe I have a baby who’s fighting cancer.  That just seems totally surreal to me.  As is the fact that he now has only one eye. I guess I can’t wrap my brain around that one.  It’ll just have to happen in it’s own time.  Though I remember the thought I had in the room we stayed in that night after his enucleation (removal of the eye.)  There was a sign on the bathroom door in the room that said something about washing your hands within 24 hours of chemo.  And I thought to myself “why would there be a sign on this door about chemo? Chemo is for people with cancer.” And then it hit me, I was on a cancer floor – all the kids on that floor had cancer.  And my first thought was, “what are WE doing here? we don’t have cancer.” But we do.  And I have to come to terms with that.

I think part of it is because in our case, this RB presented itself first and foremost as an opthalmological issue, not an onocological issue.  We went to an eye doctor not an oncologist.  Zach had his eye removed not chemo and radiation.  So in my mind, and because it happened all so quickly, we bypassed the “cancer treatment” reality.  The fact that it was so developed and its location in the eye, and Zach’s age made the treatment protocol enucleation rather than typical cancer treatment.  Many who have it first treat it as cancer and often end up enucleating at the end of that battle. But it is cancer and we need to watch the rest of his body for any signs of cancer religiously for the next couple years.  I only pray we removed any vestiges of it for good by removing his eye.

We remain fellow pilgrims on this journey of faith,

Tim and Sarah

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Zach – Discovery and Diagnosis

We’ve gotten many questions about how we discovered this tumor so I thought I’d tell the story from the beginning.  This is a window into how we discovered Zach’s condition, interacted with physicians and came to the surgery on Monday, May 23rd, 2011.  In a future posting we’ll talk about moving forward post surgery–how his prosthesis will work as well as ongoing oncology management.

Warning: this one is a little long.  Read what you want.  Also, thanks for the positive feedback about our updates.  This has been a help for us to be writing and sharing in our journey.

Sarah

Discovery

On Tuesday, May 3rd as I was burping Zach on my shoulder I was looking at him in that sweet “mommy-looking-over-at-her-baby-as-she-burps-him” kind of way.  It’s one of my favorite views of my babies—their little heads either resting on my shoulder, looking up adoringly at their human source of happiness and contentment, or else their heads bopping up and down as they strengthen their little necks, trying to hold their head up and look around…and I was looking at his eyes. I noticed that it really seemed like I could see not only my reflection in his eyes but almost that I could see into his eye—like to the back of his eyeball.  But it was only in certain light at a certain angle.  In some angles I could see the pupil and in others I couldn’t.  But then I thought maybe I was just seeing things. I kept watching him intently that day and the next, asking people I saw if his eye looked different to them or if I was just seeing things.  Wednesday night I told Tim I was concerned.  He looked and agreed.

The next morning I made an appointment with our pediatrician for the upcoming Tuesday and an appointment at Kellogg Eye Center in Brighton for June 6 (the soonest they could get me in at the time.)  The pediatrician visit was a six-week well-baby check as well as for his eye.  When she looked she said he had no red reflex in that eye and that we should get into Kellogg as soon as possible and to tell them he had no red reflex.

When I got home, Tim did some preliminary research online on “absent red reflex.”  In that search we learned that having no red reflex is a symptom of numerous conditions, which is why you need to be seen by a specialist – to determine what is causing it.  So we called Kellogg back, telling them to let the doctor know Zach’s age and that he had no red reflex and it was a matter of some urgency.  Our ophthalmology appointment was immediately moved up to just one week later— Thursday, May 19th.

In the meantime we learned that among the conditions it could be were cataracts, cancer (retinoblastoma), detached retina etc.  So those very words entered our minds as distinct possibilities for what could be wrong with Zach.  We prayed against the worst ones, obviously!  And then we began the waiting game… 🙂

Thursday, May 19th finally came.  The morning took us dress shopping for the girls for a Bat Mitzvah we had for my cousin coming on Sunday night.  Then came the 1:00 PM eye appointment for Zach at Kellogg in Brighton with Dr. Gappy.  Tim met me there (I had Bekah and Ellie with me also) and they dilated his eyes.  We waited the 30 minutes or so and then Dr. Gappy examined him. He told us Zach had a detached retina but there were a number of things that could cause a detached retina.

*******NEWS FLASH!*********

While I was writing this part of the message, Tim simultaneously discovered right here next to me that May 8-15 is Retinoblastoma Awareness Week! How weird is that???  Our discovery and diagnosis happened on either side of this week.

Okay, back to the story…

Dr. Gappy told us he wanted us to go immediately to Ann Arbor where they could do an ultrasound on his eye to see what was causing the detachment and listed a tumor as among the possibilities.  Concerned and feeling the urgency, we made a bunch of phone calls and texts, trying to arranged for our kids to get picked up from school – Tim’s parents were able to come and take care of them, and we headed over to Ann Arbor for the emergency appointment.

I’ll never forget that moment walking to the exam room in Kellogg.  As I left the waiting room and walked through the doors toward the exam room, there at the end of the hall were at least half a dozen doctors and interns in white lab coats standing in a semi circle waiting for us.  The doctor directed us to the room they were standing near.  That image remains etched in my mind.  I think I knew something big was going to happen at that moment.

Diagnosis

The first ones to look at Zach were two Fellows, followed by Dr. Archer.  Within two minutes of looking with the main light that they shine in his eyes and the lens, and also the big contraption thy put on their head, he told us Zach had a malignant tumor in that left eye.  It was called retinoblastoma.  He brought in the pediatric oncologist, Dr. Demirci, and had him look.  Dr. Demirci went for the headset, but Dr. Archer informed him that he wouldn’t even need to put on the head contraption to see it.  He then proceeded to explain what it was, and what our treatment options were.  It was very “whirlwind-ish.”  Our heads were spinning.  I remember thinking things like, “Malignant.  that means cancer right?” and rushing through my internal dictionary of words like benign, malignant, tumor, cancer, making sure I was correctly understanding him, and more:

“is he seriously telling me the best option is to remove my son’s eye???  I just walked in this room 10 minutes ago!  You tell me my son has a cancerous tumor in his eight week old eye and then you just move right on to talking about prognosis? Can you pause for a millisecond and ask me if I’m ok?  Can I breathe?  Maybe we’re just supposed to take this like we’re having a cup of coffee over the morning newspaper.  Seriously???”

Thoughts like that were spinning around even as I listened to him inform us what we needed to do—and to do so as soon as possible.  The doctor spoke matter of factly, not unkindly, but not particularly sensitively.  And I’m thinking,

“wait, where’s the ultrasound?  Aren’t we supposed to do an ultrasound?  How are YOU so sure this is a tumor?  Are all tumors in the eye cancer?”

The answers to those questions were confirmed.  We did see the tumor in the ultrasound, and quickly came to realize that this tumor was so large that what we saw when we looked at him, thinking it was the back of his eye, was in fact the tumor – totally visible to the naked eye.  And we discovered that tumors like this in the eye are always malignant.

The news began to hit me emotionally in the quiet after the doctors left the room.  It was now me and Zach and Tim and our stroller, diaper bag, my computer bag (you never know how long you’ll have to wait in doctor’s offices!), my coffee, water bottle… I held Zach and began to cry.  I couldn’t believe it.  This sweet, beautiful little baby boy God had just given us has this thing growing in his eye that he can’t see through.  When he looks at me, all he sees through that eye are shadows at best.  Funny how it since he moved it so readily it seemed like he totally was seeing things! Tears streamed gently from my face as I took him in with both my eyes, I thought about the loss, almost as if I’d lost him.  We’d only just gotten there, we’d only just left Brighton, it had only been a few minutes…this news shouldn’t be ours…it was just surreal.

And yet I didn’t feel hysterical and confused. Somehow God enabled me to have enough composure to walk through all the next steps with clarity and a sort of matter of fact-ness that really was probably necessary.  We made the appointments for surgery on Monday and left, discussing how we’d tell the girls, pouring our broken hearts out to God, asking him to be glorified in all the things that would come to pass and praying, through our tears, for a miracle.

On the drive home I called a friend of ours whose daughter (friends with my oldest) has a prosthetic eye and I told her about our most recent news.  She proceeded to tell me that that was precisely what had happened with her daughter and immediately entered into our experience with such compassion and encouragement I couldn’t help but give God glory as I thought about the odds that we’d know a young girl with a prosthetic eye who had had RB!  More than that, with only around 10 cases of RB in MI per year, it was helpful to learn that Dr. Archer was her current doctor!  She told us Dr. Archer was one of the top specialists in the country and we were working with the best!

From there it was a whirlwind of phone calls, emotions, logistics, prayer gatherings, constant prayers, tears, emails, research, talking with different doctors, seeking second and third opinions, asking God for healing, and trying alternative measures in the three days we had till surgery.

We prayed for wisdom—and God answered with the ability to reach 8 specialists in less than four days.  We prayed for healing—the elders of our church came and prayer with us for Zach.

We even pursued a fast acting homeopathic cancer remedy that has been known to shrink tumors considerably within 24 hours! Those events and connections were invaluable even in just seeing God’s hand of providence at work – being able to connect with people who are rarely at their phone, :), finding new kindred spirits and alternative health counselors.

We came to Monday morning still hopeful that the first stage of surgery, the exam under anesthesia would reveal a miraculous healing.  However, it did not happen.  Dr. Archer came out to the waiting room where my parents, Tim’s parents, my sister Abby and brother Ben were gathered around and showed us the pictures of the MRI and the photos of his eyes.  The tumor was 80% or more of his left eye.  His sight could not be saved and the rapid growth of the tumor and it’s closeness to the optical nerve (being a port to the brain) made removing the eye the wisest measure to remove the cancer from his little body. We had prayed for wisdom and clarity and we felt both at that time. Knowing the risk of all other treatment options we chose his life over his eye.

And that, dear reader, brings us up to Update #1 in this blog…

Sarah

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Zach Update # 7: it hit me…

(by Sarah)

Well, it finally hit me this morning.  Today was hard.  The tears flowed freely throughout the day as I saw my son’s eye, no longer there.  It’s not awful to look at – just pink, with a clear plastic lens over it.  But as the swelling dissipated and his eyes were open the reality began to hit.  I’ll be so glad when he gets his prosthetic eye!… I think the grieving will come in waves, perhaps when I least expect it…

I wrote him a letter this morning to give to him some day when he’s older.  It was good to do.

I’ve been reflecting on how we grieve so differently from the world when our trust is in Jesus.  In Christ grief and hope coexist in a heart going through pain.  The pain is so real in the moment and yet so is the total confidence that there is a purpose that God is working out.  I can live with those in tension.  I have to.  And I am pleased to.  Because in that relinquishment I get to be fully human – experiencing the emotion that God intends and also trust that God will be fully God in his perfect ordering of our lives.  God gets to be God and I get to be me.

Sarah

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