Devotions for Cancer Survivors: A Life of Waiting

Devotions for Cancer Survivors: A Life of Waiting: “Weeping may tarry for the night, but joy comes with the morning.” Psalm 30:5 Our family was in serious “wait mode” after my cancer d...



DANA - how do I get in contact with you?   I love your blog and we're in similar shoes.

YEAR #2 -- REBUILDING

I am still working on getting back to normal. Silly me thought the magic of one year post op would have me just like new. Not So!

Yes, I am all new but I didn't realize that my muscles and joints would need renovation as much as my spine! I asked questions to everyone from doctors, physical therapists, trainers who might know something about what my body had experienced and why, why, why was I so inflexible, my muscles so nonexistent, my joints horribly stiff. Much of the first year was spent in my spine fusing and stabilizing. I was limited in my movements in order to protect this new back. Once that was complete the next step would have to be in rebuilding my muscles and becoming more flexible.

I spoke to Jean Youngblood, my surgeon's clinical nurse, about my confusion with what I should be doing and how much. She worked with Dr. Horton for nearly 20 years and KNOWS it all. She has become a wonderful friend and our lives have grown together in areas having nothing to do with my surgery. She is one incredible woman! I had lunch with her a month ago and she said, "Cheryl, you're fused! You can do whatever your body will let you do. You must now get body strong." That was what I needed to hear. The strength to gain was for me to make happen. It would not happen on it's own. In addition to my need to rebuilt muscle, I had issues with instability when walking. This would take as long as 5 years to improve. Jean told me the reason being that my body had functioned one way for 64 years and it wouldn't change overnight. So, this is the year of working on my body. It's to the gym daily, exercises at home, walking, swimming etc. These bodies of ours and don't run without our investing time in them.

VICTORY -- DECEMBER 18, 2009

It is hard to believe that 365 days have passed. My photo expresses what I feel inside -- VICTORY & MISSION ACCOMPLISHED.
It is almost impossible to describe the year. I has been filled with many new physical feelings and ones that you cannot describe unless you are in my shoes. I feel restrained by the rods in my back and will always feel this way. There are parts of me that will never be able to move like they used to. I will always set off the airport security system :) I will always have trouble doing my toenails and tying my shoes. These things are so small compared to the "life" I have been given in return for this year. I did not realize how much my lungs had collapsed and were collapsing. I found myself tired earlier and earlier in the evening and attributed it to my age. Immediately after surgery I noticed what deep breaths I could take. I now have much more energy and endurance. Before the surgery I had no idea how much damage there was.

I am very grateful in many ways.
*I am grateful for the Lord's gentle and subtle direction in leading me in the surgical path
*I am grateful for my surgeon, Dr. Horton, and his team. Who would have imagine that 12 months after surgery he would no longer be practicing his art, having to take early retirement due to arthritis in his hands.
*I am grateful for how loved I am by the Lord. He has cared for me these 12 months so gently and tenderly.
*I am grateful to have fallen hard one evening in August on concrete. I realized that my back is about as strong as the concrete is and it sustained a fall down 3 concrete steps.
*I am grateful to my family for constantly being positive and encouraging. They have listened so much to my descriptions and revelations of what I was feeling. They never gave any indication that they wanted to say -- "Can we talk about something else!!"
*I have the most incredible group of friends. I treasure the constant joy they vicariously shared with me month after month in addition to the many ways they served and ministered to me.
*I love my gym buddies. I have been gone so long but each time I'd show up they were so excited. I felt truly like a celebrity of the DeKalb Wellness Center!
*Prayers -- this should not be at the bottom of the list but should be the umbrella over all the rest of these words of gratitude. People say you can "feel" when others are praying for you. It's true! What does it feel like? To me it was peace and a sense of being held tight and securely by my God. I spent many hours alone in my bed but never felt alone or lonely.
*DOUG -- we have learned so much about one another. He showed me his love in so many unselfish ways. He is my love slave, daily helping me do things that I couldn't manage. Never did he look weary when I'd say.... "oh, one more thing". He is such a hero to me!

Am I back to normal? No and I never will be again. I am a NEW normal. There will be things I won't do any more. That's OK. I now have a new lease on life. 2010 will be a rebuilding year to gain back stamina and physical strength. I'm very excited.

Thank you all (you know you you are) for keeping up with me in this blog, for speaking such uplifting and encouraging words every time you saw me. I have learned a lot in regard to treating others who are going through their own rocky road. God doesn't waste any situation and turns them into learning experiences to use in other's lives.

Am I glad I had the surgery. ABSOLUTELY. Would I do it again? ABSOLUTELY.

MY SURGEON

The piece below is outstanding. It is long but it is worth reading to see what is inside a human being. When I considered posting this piece I was yet to receive word that Dr. Horton would be retiring. I was shocked and distressed! Why would a man retire so suddenly and at 58 years old. This week I received a letter from him (& to all his patients) saying he was having to retire due to arthritis in his hands! I immediately thought of the people who would not have the privilege I had of being given "life" back. I thought of him and what it would be like to no longer do what you loved doing and were so gifted in doing. Many thoughts have come to my mind and many prayers for this man.

Take the time to read this -- it is well worth your time.

Cheryl -- 11 months post op and standing tall and feeling stronger every day.
SOLI DEO GLORIA

Dr. William Horton
Before he performed surgery, Dr. William Horton, Professor of Orthopaedic Surgery at the Emory Spine Center, transported people to surgery.

Growing up in Atlanta, Georgia, a young Bill Horton was looking for a unique summer experience. “I knew several physicians growing up, and in my senior year of high school I took a summer job as an orderly at a local hospital. After cleaning the ORs I would observe the surgeons as they worked. I was fascinated by the anatomy and what could be done for people. My time as an orderly also gave me a window into the anxiety that patients experience. When I transported them to surgery from their rooms I paid attention to the nurses and doctors who took time to comfort them and help diffuse some of their fear.”

Ethics, Morality, and Medicine
Philosophy and/or ethics are often not uppermost in someone’s mind when filling out a college application. But they were for Bill Horton. “I left high school excited about medicine, but I didn’t want to do the traditional major in chemistry or biology. The University of Virginia had a unique program that allowed undergrads to design their own major program, and at the end, tie everything together with a thesis. I was fascinated by the ethical dynamics of caring for people, so I designed a course of study that combined biology, psychology, philosophy, and religion, and wrote my thesis on euthanasia and infanticide.”

The term “bedside manner” has been tossed about for years. But Dr. Horton, with his tendency to reflect and dig deeper, would take a path few have experienced. “It was the mid-1970s, the period when Raymond Moody was featured in Time magazine for his work on near death experiences. His findings opened new territory, and made me think deeply about what is involved in the morality of caring for one another. In particular, I came to see that medicine is highly ethically charged. Doctors are often making decisions for those who can’t decide for themselves…the newborn, the unborn, the infirmed.”

Surgeons typically like black and white…concreteness. Dr. Horton, however, was willing to stay in the gray. “It was also during this thesis time that I began to think about the paradoxes inherent in medicine. No one has a crystal ball; we’re often dealing with mystery and the unknown despite all the data and objectivity because science is not fully developed in certain areas.”


e have to help patients deal with the paradoxes inherent in their experience and the emotions it brings,” states Dr. Horton. “They are frightened and frustrated that their bodies are failing and often ask, ‘What does it mean that the doctor can’t fix me?’ Partnering with them to work through these issues is an important way of honoring the mystery of how our physical body and spirit interlace and influence one another. As a doctor it is essential to understand that we’re working on the body, and, by default, on the soul and mind. In the end they are one in the same.

Opening Doors to a Fulfilling Career
Some people have their career plans firmly in hand. Others “wait and see.” Dr. Horton: “Instead of being calculating about my career, I saw that doors just began to open and I stepped through one, and then another, and another. Instead of a fixed career highway it was more like stepping stones.”

The doors then opened to the Medical College of Georgia. “During medical school I was very influenced by Dr. Gene Colborn, an anatomy professor whose teaching deepened my thinking of anatomy and its dazzling complexity to the point that knowing the human body was like marveling at the Sistine Chapel—except this was far beyond the normal human creative powers. When I later worked with a rheumatologist named Dr. Joe Bailey, I told him of my interest in orthopedics. He quickly referred me to Dr. Jim Harkess at the University of Louisville, a true renaissance man who had an incredible grasp of the art of orthopedics.”

Embarking on an orthopedic residency at the University of Louisville, Dr. Horton learned the importance of integrating X, Y, Z coordinates…i.e., 3D. “I was drawn to the spine because of the brain-body connection. But I also learned a great deal from the hand surgeons at Louisville, including Dr. Graham Lister, one of the best teachers I have ever encountered. Trained in plastic surgery, Dr. Lister had an amazing way of examining the external hand and then showing you how to visualize everything that is under the skin, and then to transfer that insight along with the diagnostic images to mental 3D and imagine exactly what you’re going to find once you’re in the OR. It was incredible to create this bridge between the exam room, the office, and the OR.”

Now an active advocate for such knowledge, Dr. Horton notes, “While some have a natural gift for such ‘vision,’ others must work to develop it. If you can’t transition between 2D and 3D it is difficult to achieve maximum safety and effectiveness in the OR. There are times during surgery when you simply can’t yet see what you ultimately need to—you must visualize and imagine beyond where you are. Fortunately, these concepts are increasingly emphasized in surgical training.”

Specializing in Spine
Even as a resident, Dr. Horton carried a sense of humility that would open his eyes and open new doors. “I became fascinated by the spine because I saw it as one of the great diagnostic and treatment challenges that remained to be solved. It became clear that diagnosis was still in the infant stages and that there was so much that needed to be developed. I was also aware that the talents of other healthcare professionals were not always well integrated. If a patient says, ‘I saw a chiropractor and he relieved my pain,’ then we should respect that and realize that all sorts of healing has its place.”

By the third year of residency, Dr. Horton had found a subspecialty that brought great emotional rewards. “I was so fortunate to work with Dr. Ken Leatherman, the head of spine at Louisville who did complex spinal deformity surgery. It was thrilling not only to do these elegant operations, but also to see the look on the patients’ faces that said, ‘I’ve got my life back!’”


he deformity touches so many areas of their lives…they have physical pain, functional issues, and often a low self image. I saw how spinal deformity work could deeply enhance life and the sense of self, helping people feel that they were as good as the next person. Treatment uncorks a sense of confidence that’s incredibly powerful in both adults and children.

Beginning his fellowship in 1986, Dr. Horton learned avant garde spinal techniques from the master. “I spent my fellowship year at the Kenton D. Leatherman Spine Center at the University of Louisville, a facility that was really cutting edge. Dr. Leatherman was the first in the U.S. to use the revolutionary Cotrel instrumentation system from France. He also did the first anterior vertebrectomy for congenital deformity in the U.S., which was dangerous pioneering work. Because there was a good working relationship between orthopedics and neurosurgery I also had a chance to learn neurosurgical techniques in spine. There was so much complex surgery going on that I became extremely comfortable with virtually any problem or unusual anatomy that presented itself.”

During this time the already empathic Dr. Horton got to see a bedside master. “Dr. Leatherman was the kind of person who would say to me, ‘Come sit beside me in Mrs. Gordon’s room and watch how we talk about her problem.’ He was able to walk with patients through their illness—and he was present to patients in a way that let them know that he was truly with them on their journey. He taught us to carefully weigh all risks and benefits and make patient decisions very personal ones. ”

Worldly Knowledge
To gain an even deeper understanding of the technical aspects of a patient’s surgical journey, Dr. Horton would take his own journey. “After finishing in Louisville I embarked on a European traveling fellowship, having my eyes opened to the many different ways of approaching the same surgery. In England I learned from Drs. Robert Dixon and Greg Houghton the British trait of being incredibly thoughtful about differential diagnoses. In France I found that they approach surgery like an art form—finely nuanced. Drs. Yves Cotrel and Daniel Chopin would make subtle but important adjustments during the surgery because they used a geometric 3D process. It was a more creative surgical approach than I had ever seen.”

And what was the surgical zeitgeist in Germany? “Germany was the anti-France, with a style that is very precise, completely black and white. I learned from Professor Klaus Zielke, a master of preoperative planning. You did steps 1 through 6 and you didn’t deviate. What is helpful about the German approach is that it is predictable. The downside of their process was that once the preop plan was done you weren’t allowed to question it…the professor is top dog and that’s that.”

Research and Academia
Returning to the U.S., Dr. Horton surveyed his career options. “I was initially turned off by academics because I had witnessed how politics and egos sometimes resulted in unhealthy and unfair treatment for many faculty members. I had been approached by Dr. Pierce Allgood, who I respected enormously. He drew me into joining his large private practice in Atlanta. It was a busy, challenging spine practice…without the bloodshed of academics. That experience was fantastic.”

The intellectual stimulation of a scholastic environment, however, remained alluring. Dr. Horton: “In 1989 I got a call from Dr. Tom Whitesides at Emory who told me that he and Dr. Lamar Fleming wanted to build an international spine center. I had long admired Tom’s creative thinking and technical innovations, as well as his rich character. The more he talked the more I became interested. It was an opportunity to enhance a fulfilling clinical practice with teaching and research. So I accepted their offer, to a great extent because they were focused on building something special while getting past the strife of academia.”

Free to treat patients and conduct research in a collegial environment, Dr. Horton set off to explore biomechanics. “I could see that current methods of treating kyphosis, a condition which has the highest risk of paralysis, had shortcomings. I developed a technique for reducing severe kyphosis that was a different clinical approach; instead of working from the ends of the deformity I reversed the paradigm and started from the apex using gradual reductions…one vertebra at a time.”


hat study involved complex kyphosis cases with some of the best correction rates ever reported,” says Dr. Horton. “But more importantly, there were virtually no complications related to the correction, which was usually fraught with neurologic complications and problems at the ends of the system. This new technique nearly eliminated that kind of problem, and has had a significant effect on how surgeons reduce all types of kyphoses.

“I then became curious about the biomechanics of the sternum,” continues Dr. Horton. “We all get blinders on from time to time…and spine surgeons are guilty of looking at the spine but forgetting about the torso. Our work was honored with the Russell Hibbs Award for Basic Science, given by the Scoliosis Research Society. The research elucidated the value of doing osteotomies to correct the spine, and highlighted the importance of the sternum in spine biomechanics. A sternal osteotomy is rarely indicated, but this work shed light down a dark hole in spinal biomechanics, and is relevant in trauma and tumor reconstruction as well as deformity.”

Yet another area that drew his interest and knowledge is international orthopedic education. Dr. Horton: “A year and a half ago we started the Emory Spine Center for Outreach and Medical Education. Having worked with Orthopedics Overseas in underdeveloped areas I was sensitive to the power of international relationships and how important it is to learn from one another. The program is focused on delivering mentored education for doctors in developing countries, with China hosting the pilot program. Doctors in the developing world are often extremely bright and desperately looking for seasoned teaching and advice, and they can’t often find it. We want to change that.”

Life at Home
He really shouldn’t have any time left to himself. But alas, he constantly tries to live a balanced and active personal life. “For 31 years I have been married to my wife Leah, who is an incredible woman and a pastor with Trinity Presbyterian Church in Atlanta, a place we love very much. We have three daughters. One is a senior in college who has a penchant for English and French, another is going to medical school, and the third is studying for a Masters in Public Health. They are three wonderfully adventurous women who have all lived near a pig sty in the West Indies, gone sailing in the Pacific, and enjoyed the messiness of trout fishing in North Georgia.”

“I enjoy the outdoors,” adds Dr. Horton, “and I am fortunate to have a group of buddies who bike together and coax each other into doing things we probably shouldn’t—like Olympic triathalons. Music is a passion of mine (a lot more passion than talent) and I goofed around in a bluegrass band in medical school. I enjoy reading nonfiction and writings about spirituality. I enjoy grilling food, and am a major enthusiast of The Green Egg for steaks or anything.”

Dr. Bill Horton…orthopedist, philosopher, renaissance man.

AMAZING DOCTOR REPORT

You will love this post! My spine is 95% fused. I saw my surgeon yesterday for my 8 month appt. I had a CAT scan and xrays. In my mind I thought we'd see more "fuzz" and be told to keep up the protein consumption.

The doctor walked in with copies of my scan and xrays. He showed us the bone growth which was incredible. He said you are 95% fused! I had to have him repeat it because to me it wasn't possible yet. He answered a few questions and said he didn't need to see me for 12 months. WHAT -- we're done?

What are my limitations -- no boxing, no wrestling, no basketball, no tennis, no sky diving i.e. nothing with contact. No problem with these. Other then these I can do whatever I want and am able to do.

I sat in the room with Doug thinking.. we're done? No diploma. No certificate of promotion to re-enter life. It caught me totally by surprise that the world of scoliosis had been defeated in me.

What are my emotions like? I am one very grateful woman. I have had it easy compared to many. My recovery has been very
"textbook", smooth and uneventful. The prayers joined to God's heart have taken me to where and who I now am. I have learned a lot about myself and about the role of being a cheerleader for others. The Lord continues to give me ones coming behind me in surgery and it is a joy and privilege to encourage them and help them take their steps forward.

Month #7

Dear ones,

As I write this today, July 26, I have passed 7 months! The winter of December seems a long time ago -- well it is.
I am doing extremely well. As an example, I accompanied a friend last week who had an evaluation by my surgeon. Dr. Horton recognized me as one of his patients and said, "Stand up Cheryl and let me look at you". He felt along my spine and said -- you're doing fantastic. That was a nice unexpected blessing since it wasn't even an appointment! I will see him on August 10th and have a CAT scan that day. I'm looking forward to how the bone growth is growing.

One of the barometers of progress is how many things can be moved off the counter tops to their belonging places. Another is the discontinuing of "tools" like elevated toilet seat, grabbers, and of course the best - energy level and flexibility. I can report that the counters are looking far less crowded. The toilet seat is gone and I now use a public toilet as well. My energy is increasing each week. I am realizing how diminished my energy was last December and even before that because I now have the new energy. I had no idea that I was slowing down and now realize a lot had to do with the diminishing lung capacity. I swim several times a week and can feel my lungs happily filling with air. When I started back swimming it was all I could do to do 1 stroke of the crawl. I can now do 8 laps of the crawl plus some breast and back stroke. Progress no matter how small is a gift to observe.

My time with my 2 post scoliosis surgery friends has been very satisfying to me. To see them in their beginning stages of recovery has shocked me because that was "me" just a short time ago. I am so happy to be able to encourage them and to tell them how well they are doing... and they really are. As I said earlier, it is good to have someone alongside you who has already gone where you are going. So many similarities in much of our life spiritually and in life lessons. We are all to be there for others to be their encouragers and cheerleaders. It gives both of us pleasure.

What's next? I've got a ticket to visit Tim in Eugene, OR on Aug 20. This will be yet another 1st-- 5 hours on a plane. I am looking forward to this time so much -- for my sake but to see Tim's world.

I can never close without thanking you so many times for your continual prayer and love for me. I feel it -- it is something one can only know by experiencing it. I feel like a new woman and in ways I look like it too -- +3 inches!

Fondly,
Cheryl

DEC 18 - JUNE 18

We're pretty excited realizing we are 6 months post surgery -- TODAY. I continue to check in with my surgeon's clinical nurse who tells me I'm doing splendidly. I thought so too :) She says the next 6 months will bring changes but oh so small. For instance I have a good amount of swelling in my lower back. She said that will take about 6 months to resolve. It's not a hindrance, except that my pants don't fit!

I'm feeling better and better and can feel myself with more energy these days. I'm trying to go to the gym or swim M-F. It isn't as much of a struggle to get up and out of here to do that like it used to be. A lot of the joint pain is waning -- oh happy day. Getting up from a chair, especially after 15-20 minutes is still very hard. I was told by the physical therapist that with my back being "rearranged" my nerves and muscles are struggling with what they are to do and how to do it. They are looking for their old paths or creating new ones. Amazing body God made for us with the ability to rearrange and recover. Walking quickly is hard. I still need my grabber to dress and use my handy sock tool to put on socks BUT I'm doing it myself.

It has been quite a journey. I did not believe them when they said 12 months recovery. Goodness, nothing takes 12 months. I think differently now.

The Lord has brought several others into my life who are approaching "THE" surgery. I cannot tell you how satisfying it is to encourage them and give insight into what recovery will be like. ( I remember this was one of my early prayer requests before surgery!!) Until now I have never known anyone who had had this humongous surgery so my trip has been very eye-opening. I have seen how some have struggled in ways I have not -- both with complications and with anxiety. I know as I have never known before how strong the prayers of God's people are in sustaining and encouraging. It is impossible to explain or put into words -- but it is so real.

Doug leaves next Wednesday for Nigeria for 3 weeks as a translation consultant (Wycliffe Bible Translators) for people groups with no written language and thus no Bible in their heart language. I am in a good place now and can manage myself fine. I'm very excited for his trip and what God allows to be done through him as well as what God does in him. It's pretty awesome and he's very grateful for the privilege.

Again, thank you for your continued prayers and interest in my progress. I still have 6 months more of bone growth to go.

Fondly,
Tall Cheryl