THE JOURNEY CONTINUES 

Dear Ones,                               August 18, 2017

Last Monday was another new experience at University of Michigan Hospital. Del’s appointment was with a Dr Dawn Owen, MD PhD—a radiologist/oncologist. We thought we would be seeing a professional-looking female doctor in a white lab-coat. Instead this dear little Asian/Canadian lady doctor came into the exam room. She was the sweetest person—extremely intelligent and well qualified. We found out that she grew up in Toronto, Canada, not far from where I grew up, so we had fun asking back and forth, “Do you know such-and-such street?”

Dr Owen spent a couple of hours with us explaining how radiation would be used, the possible side effects, the frequency, and rationale for using radiation at this point in Del’s treatment. She said that the U of M tumor board was pleased with how the chemo has worked on Del’s form of cancer, although there are still some suspicious lymph nodes probably containing cancer cells. The radiation is to keep the cancer from coming back.

There are two main forms of radiation for dealing with the cancer area. One is the ‘exterior’ beam which is given from outside the body. It’s what I (Bryan) had for colon cancer. The other is ‘interior’ (called brachytherapy) where they use a cylinder to place a radioactive seed in the area for 2-3 hours at a time. The doctor thinks only the ‘interior’ method would be best in Del’s case. Chemo does a good job on lymph nodes, but doesn’t seem to work well on that area. Del will have 9 infusions of chemo spread over the next 3 months. The radiation would begin one month after the chemo ends. Another advantage of the interior method is that there is minimal irritation of nearby organs.

Tuesday (15^th) Del had a follow up CT scan. This is the second time that she has had an allergic reaction to the contrast media. The report showed that there was a mix of results in the affected lymph nodes.

Last week Bryan had his 8^th semi-annual urinary stent replacement in Grand Rapids. He had a few more side-effects following this procedure, but once again it appears to be a success. So far this has prevented having to go through major surgery, for which we are thankful to the Lord.

We love you folks and appreciate your friendship and prayers so very much. Thanks for all of your encouraging email notes and cards.

Lovingly in Christ,

Bryan and Del Coupland                                 

Dear Ones,                                                                         August 7, 2017

We spent a half hour on the phone with one of Del’s doctors from U of M and we got more information on the pathology report from Del’s total hysterectomy surgery as well as some of the plans going forward. I will summarize the main points of interest here:

1.    The origin of the clear-cell carcinoma was the uterus, but cancer was also found on the other parts of the female organs removed.

2.   Del’s post-op appointment with Dr. McLean, her gynecologist/oncologist/surgeon, will be September 5. It seems like a long time away, but they want to make sure she is completely healed from the surgery.

3.   Dr. M is encouraged with how well the chemo has been working despite the ongoing side effects from the neuropathy.

4.   The doctor recommends three more cycles of chemo to treat any remaining cancer cells. [A ‘cycle’ is four weeks made up of one chemo infusion each week for 3 weeks, followed by a week off.] 

5.   Dr. M met with the tumor board after they had Del’s pathology report and they felt that she may need some radiation. This would be done at U of M, while the chemo will be given in Jackson. Del has an appointment with a radiologist/oncologist at U of M on August 14 to discuss possible radiation treatment.

6.   They did not remove any ‘lymph nodes’ since there weren’t any that appeared enlarged. The risk in removing nodes unnecessarily is that it can result in ‘lymphedema’ or swelling of the legs.

7.   Del will be having another CT scan on August 15 which will help determine her chemo schedule going forward.

8.   During the surgery, they did an ‘abdominal wash’ where they flush the abdominal cavity and check for cancer cells. There weren’t any!

9.   Tomorrow will be 3 weeks since Del’s surgery and she is feeling well and back to normal strength. How we thank the Lord for His healing in her body.

Well, that’s about it for updates. Thank you so much for your continued prayers and concern. You are such an important part of our lives and we thank the Lord for each one of you.

Warmly,

Bryan, for Del too

Dear Ones,                                      July 19, 2017

        The event we looked ahead to for over half a year is now in the history books…at least our family history. We have wished that Del could have had this surgery many months ago, but the tumor board at the U of Michigan Hospital had to be convinced that there was sufficient reduction in the size of the affected lymph nodes in Del’s abdomen before they would sign off on surgery. On the basis of Del’s last CT scan, the board was in agreement to schedule the surgery for July 17—the day before yesterday.

        We had to be at the U of M Hospital at 5:45 am, and surgery was scheduled for 7:30. Since we had to get up at 2:00 am, I slept about one hour because I didn’t want to sleep through the clock and be late getting to the hospital. This particular hospital is a complex of enormous buildings, quite a lot bigger than any other hospital we’ve been in. I actually couldn’t find my car in one of the parking garages at one point yesterday, but I won’t go into that. By 10:30 am the surgery was over, and while Del recovered in “Post-Op” the surgeon came and talked with our daughter Terry and I.

        The hysterectomy was done laparoscopically (5 small holes in the abdomen) and all of her female organs were removed. There were two other small spots that remained, and one of them was treated with argon gas (cryosurgery) and the other was excised (cut out). The removed tissues have been sent to the Pathology Dept. and the doctor will call us on July 27 with the results. We asked if Del will need to receive any more chemo once she recovers from the surgery, and the doctor said that they will come up with a plan of action once they get the pathology report back. It’s possible that they will recommend a few more chemo treatments to take care of any floating cancer cells and/or radiation.

        Del’s recovery from surgery has been nothing short of amazing. Yesterday afternoon, just hours after the surgery, Del was talking and interacting with the nurses. She shared the Lord with several of the nurses and discovered that at least two of them are believers. Even when the doctor came on her rounds with 5 student doctors, Del was able to share that besides the excellent work of the medical team, we are thankful to the Lord Jesus for how well everything went. We asked the surgeon if we could pray for her and for Del before the operation and she agreed—I’m sure it shocked her.

        Well, we are home now and it’s hard to believe the surgery was just the day before yesterday. We are totally convinced that the Lord Jesus is the One who has been in total control of our situation and He deserves great praise for His loving care. Thank you for your prayers as this too honors our dear Father and Savior. Our three kids and their spouses have been such a great support team and we are so thankful for them all.

Affectionately,

             Bryan Coupland, for Del too

Hi dear folks,

        One thing that Del and I have learned, having both gone through cancer and chemo, is that we don’t know a real lot about the whole area of “suffering.” The Lord does give us a few insights on the subject in His Holy Word the Bible, but beyond that, it appears to be an enormous subject that only an all-knowing God could fully understand. Here are a very few thoughts that Del and I have discussed on the subject over this past nine year journey:

·        The Lord Jesus suffered excruciating pain on Calvary’s cross in the process of paying for our sin, and His comments, while he was nailed to the cross, primarily pertained to the needs of other people.

·        When a Christian suffers, they actually “share the sufferings of Christ” [1 Peter 4:13].

·        Jesus urges us to rejoice during these times. That obviously doesn’t mean that we should somehow try and drum up a laughing giddiness in the midst of serious illness. Since truejoy comes from abiding in Christ, we should rely on Him for our attitude [4:19].

·        We are probably never so dependent on God as when we are struggling with a difficult medical condition. Our human nature tends to cause us to be independent and self-sufficient when everything is comfortable.

·        The Lord does extra-ordinary things in our lives when we are in deep physical need…what Del and I call “His touches.” It helps us to recognize different aspects of Jesus’ personality. [“That I may know Him and the power of His resurrection and the fellowship of His sufferings…” Phil. 3:10].

·        So many people are worse off than we are; physically, emotionally, and especially spiritually.

·        Other members of the Christian family become a part of the process of our suffering and become our “prayer companions.” As they praise God with us for the victories, great praise goes up to God from many sources. So, Jesus Christ is exalted and glorified…which as believers in Him is our ultimate goal.

Del had her last chemo on June 27 and the side-effects seem to intensify after each infusion. Over the July 4^thweekend, we had our annual Coupland-Duston-Calderwood family reunion at Lily Lake in central Michigan. The weather was perfect and it was great fun. Even our great-granddaughter, Alaina, was there. This coming week will be a lot more restful for Del as she prepares for her total hysterectomy surgery at Univ. of Michigan Hospital on Monday, July 17. We would be very grateful for your prayers that our heavenly Father would guide the surgical team led by Dr Karen McLean, and give them His discernment and wisdom. Thank you so much!

              Affectionately,

                   Bryan, for Del too

Family Reunion Time

If you ask any of the 11 grandkids, (several of them adults now), what one of their favorite things we do each year is, you would probably hear, Lily Lake. Mom's sister & husband have been gracious enough to let us take over their cottage for a week each summer around the 4th of July. This is where most of our kids caught their 1st fish and years of wonderful memories are connected with this place.

It's become tradition to take a picture on this swing with all of the grandkids,

now with spouses and 1st great grand baby Alaina.

3 are missing this year Noah, Nathan & Sarah.

Mom & Dad pulled out these flashy shirts for July 4th

Kelley & Todd Duston with most of their kids and 1st grandchild

Terry & Paul Calderwood and daughters + dog Lucy

Dan & Kari Coupland and kids

Next generation of our family, Alaina with her grandpa Todd 

Busy spring & summer

Spring & summer have kept us very busy. Many exciting things have happened in our family so it's time for an update.

June 3, 2017 
Summer began with a wonderful family celebration as Kelley & Todd Duston's daughter Anna married Tyson Estelle on a beautiful sunny day.

  

                                                                                                       Kelley & Todd - Mom & Dad of the bride

There was more than one lovely lady in attendance!

Because of that fact, we had much to celebrate. Mom had reached a milestone that

we didn't think was possible a few months ago. She was able to see her 1st granddaughter get married

and she looked beautiful!

There were more than a few teary eyes as Mom danced with her 2 favorite guys for the couples dance and then the mother/son dance.

The granddaughters couldn't resist getting grandma on the dance floor for 1 more dance

Next family wedding set for early 2018. Congratulations to Nathan & Sarah ! Nathan is Kelley & Todd's oldest son. 

We Praise God from whom all blessings flow

We Give Praise to God!

 Dear Ones,                                              April 25, 2017

        Yesterday was an emotional workout for us and we were both exhausted by the end of the day. At the same time we are praising and glorifying our wonderful Savior and Father for the grace and kindness He is showing us. Let me walk you through our day and you can praise the Lord with us.

        Del had an appointment in the morning with her oncologist. Dr D came in the room, asked Del how she was doing, and immediately started reading from the radiologist’s report from last week’s CT scan. Her actual words were, “The large uterine mass that was there [on the last CT scan] is no longer identified [visible].” We thought there would possibly be some news about the adjacent lymph nodes in the abdomen, but to hear that the radiologist couldn’t see any sign of the original source of the cancer blew us away. Speaking of the lymph nodes, the affected ones were either smaller or not visible at all. All we could say when the doctor read the report was, “Praise God! Praise God!”  Del’s oncologist is a believer also, and she agreed with us with a huge smile on her face.

        We realize that this is a huge victory in this battle, but the war is not over. There are still lymph nodes in her abdomen that contain metastases from the original source of cancer in the uterus. For that reason, Del will have at least three more weekly chemo treatments. The chemo agent used up to this time was TAXOL which seems to be very effective against this type of cancer, but the main side-effect is neuropathy (numbness) which is quite severe in Del’s hands and feet. For this reason, her doctor is starting Del on another agent called TAXOTERE, which is related but doesn’t normally cause neuropathy…it has other “side-effects”. So after the visit with the doctor, Del had an infusion of two different chemo agents (Taxotere and Carboplatin) . During the infusion, the nurse gave Del thick mitts to put on that were freezing cold. Apparently this chemo can cause your finger nails to stop growing and even fall off, and the cold gloves are supposed to prevent that from happening.

        One other note of praise. There is a cancer blood-marker that they regularly check called Cancer Antigen 125 and the “normal” range is from 0 to 35. For a number of months Del’s blood sample tested in the mid-forties, but yesterday it was 13.4, well within the normal range—a good sign. Only God…..

        As far as Del having a hysterectomy, the oncologist will have to judge when the lymph node involvement is minimal. Apparently opening a person up surgically can cause the cancer to spread widely if there is active cancer already in the abdomen. Most likely this surgery will be done at the University of Michigan hospital in Ann Arbor. Del has a consultation there on May 16 with her gynecologist/oncologist.

        Only eternity will tell us the effect that your prayers have accomplished. We are so thankful for your continued love and concern…they mean so much to us and I believe also glorify the Lord Jesus.

                 Blessings,

                            Bryan, for Del too

New Pictures

Hi All,

Well, it's way overdue to put some pictures up. We are very much into taking lots of pictures these days, capturing many special memories. So much has been happening throughout our family so here are a few highlights.

Dan was honored for excellence in teaching at Hillsdale College last week

All of the family that were able to attend

Beautiful honorary luncheon that followed with the guest of honor

1st great granddaughter Alaina & Tori come for a visit

Anna's bridal shower with Kelley at their church

Mom & Anna, 1st granddaughter to get married

All the granddaughters at the shower

We started on the wedding cake

Mom preparing the pans

Top layer ready to freeze

Another proposal! Congrats to Nathan & Sarah on their engagement

Little did we know that our Nathan was such a prince charming. He carried out the most romantic proposal.  

We are so happy for these 2 and excited to welcome Sarah to our family

Celebration Mom's 75th birthday

Dear Ones,                          April 11, 2017

        When you go through a medical crisis, you soon realize that as wonderfully  skilled and experienced as the doctors are, and as kind and compassionate as the nurses are, you are really in God’s hands. He is the One who brings healing and improvement in our body’s condition…or not. That being the case, it makes us realize all the more why “prayer” is so important. And it’s not that we are trying to argue with or manipulate God, but it’s to ask that He will have His way and that He will ultimately be glorified through our situation.

        A couple of Bible verses come to mind along this line: Zechariah 4:6, “This is the word of the Lord…saying, ‘Not by mightnor by power, but by My Spirit’ says the Lord of hosts.” And also, Psalm 127:1, “Unless the Lord builds the house, they labor in vain who build it.”

        Today (April 10) has been one of the busiest days of the last, few months. The high point is that it is Del’s 75^th birthday. We made it in time for her chemo appointment, and some of the nurses and staff came into the hallway as Del was going down to the lab to get her blood drawn, and they sang “Happy Birthday!” We met with Del’s oncologist and she would like Del to get a CT scan done next Monday (17^th). Once the doctor evaluates whether the chemo has been effective enough, she will decide whether the next step is a hysterectomy and lymph node removal, or more chemo. Del’s neuropathy (numbness and cold in the hands and feet) has just about reached the maximum point where the oncologist will say, “No more Taxol” which unfortunately is the chemo of choice for uterine cancer. If surgery is not the choice, then Del will begin a cycle of another chemo agent. On a lighter note, we brought birthday cupcakes to share with the office staff, and especially the nurses who have been so kind and caring with us over these months. In all the busyness of today, we still managed to go out to Cracker Barrel restaurant and have a nice birthday dinner.

        Thank you for your interest in our journey and especially for your prayers. Your concern means so much to us.

                Lovingly in Christ,

                    Bryan, for Del too

                       

Dear Friends,

Del and I have been reading about the life of the prophet Elijah in the Old Testament and have seen some wonderful examples of our own journey. Charles Swindoll likens God’s training of Elijah to a “boot camp,” something NTMers are familiar with. Swindoll writes, “In a very real sense, God has designed a boot camp for His children, but it doesn’t last just 8 weeks or 10 weeks. Nor is it a weekend seminar we can take or a day-long workshop we can attend. God’s boot camp takes place periodically throughout the Christian life. And there, in the very center of obstacles and pain and solitude, we come to realize how alive God is in our lives—how alive and in charge. He will invade us, reduce us, break us…so that we will become the people He intends us to be.” The natural tendency is to say, “What lousy luck I’m having right now.” But our loving Father has the situation totally in control…and it’s for our benefit!

        Del had her chemo infusion this past Monday, March 27. She always has an appointment with either her oncologist or a nurse practitioner before the infusion to determine if her blood values are within a safe range and also to have an overall exam. Because her neuropathy is so severe in her hands and feet from the chemo, her oncologist suggested that instead of having a weekly treatment for three weeks followed by a week off, she should try the reduced amount of chemo every other week—in other words, one week on and then a week off. So, Del will not have an infusion next week, but will the week after. I’m very thankful the warmer weather is coming, because it’s been hard for her to keep her hands and feet warm. We both enjoy walking, so we are anxious to get out in the Spring weather.

        We are so appreciative of the kind notes and words of encouragement. Just knowing that others are praying for Del is such a boost. What a blessing to be part of God’s family!

                   Lovingly,

                         Bryan, for Del too

                         Family blog:   thecouplandfamily.blogspot.com      

Update

Dear Friends,

        This past week was supposed to be an “off week” between cycles of three weekly chemo treatments, but it wasn’t really a rest time for Del. On Tuesday, March 21, Del had to go into Allegiance Hospital and have a “port” surgically inserted in her right shoulder area—the opposite side from her pacemaker. For the other chemo treatments she has had a PICC line in her arm, which is temporary and has to be flushed every day (I tease Del about having to have a veterinarian flush her PICC). The port makes receiving IV fluids so much easier, and blood samples can be taken from there without trying to hit a vein in her arm. Also it only has to be flushed every 4-5 weeks.

        This coming Monday, March 27, Del will start the next cycle of three weekly chemo treatments. We are so grateful to God for how well she has tolerated these reduced doses of Taxol. We are praying, of course, that the chemo agent is killing the cancer in the affected lymph nodes and elsewhere, without damaging other organs.

        As always, we would appreciate your prayers that her neuropathy (numbness and cold) would not increase in her hands and feet. It’s getting harder for her to do up buttons and other fine finger movements. Her appetite has picked up some, for which we are very thankful.

        Bless you for your partnership in prayer with us on this journey. Every day is a walk of faith and dependence on our heavenly Father. He alone knows what direction the journey will take, and we lean heavily on His promises like Isaiah 41:10, “Do not fear, for I [God] am with you; do not anxiously look about you, for I am your God. I willstrengthen you, surely I will help you, surely I will uphold you with My righteous right hand.”

                Warmly,

                     Bryan Coupland, for Del too

                                                                                             March 14, 2017

Dear Ones,

        Six down; three to go! Del is on a modified schedule of chemo once a week for three weeks and then a week off, and this is repeated three times making it nine chemo treatments. I don’t know of anyone who looks forward to their next chemo infusion, but in a sense it’s good news for us. Around the middle of November, 2016, she came home on “home hospice” because her oncologist felt that since she wasn’t able to tolerate her first chemo treatment and had to be hospitalized, there really was no other treatment for uterine cancer. But instead of rapidly going downhill on hospice, Del began to have more energy. That’s when her oncologist suggested, “Let’s try a lower concentration of chemo and do it weekly.” So, Del “came off hospice” and went on regular oncology care. 

        Well, now you know as much as we do. We are trusting the Lord, day by day, and we’re very thankful that “the battle is the Lord’s.” This next Tuesday (21^st) Del will have a port surgically installed, on the opposite shoulder from her pacemaker. This should make it a lot easier to infuse the chemo. Looking ahead as best as we can, the plan is for Del to have three more weekly chemos beginning March 27. After that, she will have a CT scan to see how her cancer is responding to the chemo. If the results are positive, her doctors will schedule a surgical hysterectomy to remove the source of the cancer. So, there are many steps to trust the Lord for, and we are so thankful for your prayers. One of the most difficult side-effects right now is the neuropathy or numbness in Del’s hands and feet, which leaves them cold and numb most of the time—the result of the chemo.

        I recently read an interesting review in World magazine, of the book, “Union With Christ” by Rankin Wilbourne. He wrote regarding bonding with Christ, “Imagine a storm blowing a sailboat so fast that all night long, death seems moments away, but in the morning you’re hundreds of miles closer to your destination. We can rejoice amid suffering not because we’re masochists[those who enjoy pain], but because a deeper and sweeter joy will come in the morning. And, when we stop thinking so much about our own story that we enter into God’s story, we learn that’s the biggest and best of all.”

        Thanks again for being partners in prayer with us!

                               Warmly,

                      Bryan, for Del too

       

        Dear Ones,

        We don’t have any dramatic news after Del’s chemo yesterday, but maybe that’s good. We asked the Lord to oversee every detail and it seems like He did. The morning started out with an hour-long appointment with Del’s oncologist (Dr D). As always, she was very gracious and available to answer all our questions. Here are some of her comments:

·        She was adding the chemo agent Carboplatin to the Taxol that Del took in the last cycle.

·        They took a blood sample before the appointment, and it showed that Del’s blood values were excellent.

·        Dr. D said that she is not opposed to Del trying various ‘over the counter’ remedies for treating her neuropathy. [Some oncologists don’t like you to take any supplements when you are on chemo.]

·        She suggested that Del take ‘magnesium’ daily to help with regularity.

·        The cancer marker called CA 125 which is found in the blood, was lower this time which is excellent news.

·        Dr D said that they will only consider surgery (total hysterectomy) if after the 9^th chemo treatment, the CT scan shows that the affected lymph nodes are substantially reduced in size. 

·        Del was urged to drink a lot of water following chemo to wash the chemo out of the kidneys.

Following the doctor’s appointment, Del went right away into the infusion center. The nurses are so caring and kind there, and they almost make it a pleasant experience. The chemo infusion took about four hours and Del slept a good portion of that time. Most likely the days following the chemo will be the same this time as the previous treatments. The three days right after the chemo are usually good ones where Del feels energized and eats well. During the next two days she usually feels tired and even a little nauseated, and then feels gradually better leading up to the next chemo day.

Your prayers are making a tremendous difference in our lives and we can only thank you with our deepest appreciation. We are grateful to our dear heavenly Father for you and your loving concern.

               Lovingly,

                     Bryan, for Del too