Thursday, May 31, 2007

Living by Faith

My friend Paul just reminded me of his favorite retort – “ We don’t retreat, we just reload!” I completed the second infusion of Gemzar on Tuesday and in addition to the recurrent “pancreas pain” I have noticed some fatigue. I was up at the usual 05:30 and attended rounds at SCVMC this morning, came home and did carpentry constructing a storage shed for Jackson – but then took a 3 hour nap this afternoon. Those of you who know my habits will understand that naps are not part of my usual routine.

Michelle, Bo, Grey and Kristie returned to London this week after a busy 3 week visit with us and also with our family in Kansas. Grey recovered full use of his arm and both the kids seemed to adjust quickly to life in California. It was so good to have them with us - but they were longing to see “Papa’ and I’m sure Ralf was surprised to see the changes, especially vocabulary expands daily.

What a wonderful reunion we had this week with the Kawata family who were visiting from Japan. Makoto was a visiting Ob/Gyn scholar when I was a young asst professor – both of us working on projects in the Hertzenberg’s immunogenetics lab, only 25+ years ago. They also attended and very much enjoyed Menlo Park Presbyterian Church during that era. His daughters and wife, Mitsue, have visited us on occasions over the years and we send Christmas greetings, but Makoto was returning for the first visit back to the US. It was so good to reconnect and share many good times – they brought an album of pictures of their kids and ours - who at the time were in elementary school. Makoto’s comment was that his family wanted to come here for a vacation, but he just wanted to come and see me – a great friendship renewed. He had followed my career via the internet and had lots of questions especially about my retirement career in third world obstetrics.

Thanks to our friend, Dave, Bonnie and I have been reading the devotionals of the 17th century Catholic mystic, Francois de Salignac de La Mothe Fenelon, the Archbishop of Cambrai, France – a spiritual advisor in the court of Louis the Fourteenth. This one from yesterday resonated with my day…


Living by the Cross and by Faith – Fenelon, Let Go, letter 12

We have crosses to bear everyday. But I have learned to enjoy the bitterest of them. And it is sweet to know that the heaviest cross can be borne in peace. However, there may be times when it seems that you do not have the strength even to bear it or to drag it. All you can do is fall down beneath it, overwhelmed and exhausted. I pray that God may spare you as much as possible in proportioning your suffering, not that God delights in seeing us suffer, but He knows that we need this as much as we need our daily bread. And only God knows how much we need to accomplish His purposes in our lives. So what we must do is live by faith and live by the cross. For we are confident that God, with His true compassion, proportions our trials to the amount of strength that He has committed to us within. Even though we cannot actually see this happening, yet we believe it is true. Trial and strength are portioned out in equal measures. Living by this kind of faith demands the deepest kind of death to self.

I continue to get official calls that my authorization for stereotaxic radiation (Trilogy) is being denied and again appealed – so please continue to pray for favor from HealthNet and Medicare.

We have a big weekend upcoming with a day long Saturday Mission Seminar with the Barnabas Project in the East Bay. I’ll go from that meeting in Hayward to Elk Grove and meet up with Bonnie to celebrate our two grand daughters’ birthdays with Drew, Michele and their family. Then we have two days to get chemo and prepare to depart for Bonnie’s 50th High School reunion in Emporia, Kansas Wednesday the 6th of June.

Thursday, May 24, 2007

"Joy is a choice..."

A number of people ask me every day, “How are you doing?”

Side effects of the chemo, Gemzar, are minimal compared to some others, so I didn’t feel bad after the first dose. And I only have to go in for chemo once a week for an hour or so. Today I prepared an appeal letter for my insurance company who denied authorization for Trilogy radiation treatments – I’m told that “denial” is their default response at the first level in all cases and that final decisions occur at a higher level. Keep on praying for authorization!

Those of you who see me face to face can see that I’m doing quite well. I have been able to keep up with most of the usual meetings and volunteer work that has occupied my days in recent years. I have experienced some recurrence of back/abdominal/visceral pain and despite taking regular Tylenol, I wake every few hours needing to change position or take more pills. But I am able to get plenty of sleep, eat well, and enjoy every day!

Michelle’s clan will be with us for another week and later this week we will be going to Sacramento to join Drew and Michele’s kids 4-H fair experience – exhibiting goats, sheep, rabbits, etc. Reminiscent of my own childhood in Kansas.

About the pain, I’m reminded of a quote by Tim Hansel in his book, You Gotta Keep Dancin': In the Midst of Life's Hurts, You Can Choose Joy!

“Joy is a choice – pain in is inevitable, but misery is optional.
We cannot avoid pain, but we can avoid joy.
God has given us such immense freedom that He allows us to be as miserable as we want to be.”

Thursday, May 17, 2007

Ready for chemo...

Ready for Chemo

Bonnie and I have loved the outpouring of prayers, cards, notes, calls, blog responses, and especially some extra time with our family during the last couple of weeks. We have been on the receiving end of hugs and good wishes which have kept us on a high plain emotionally and spiritually despite mostly bad news from my cancer work-up. In response to “How are we doing?”, one friend reminded me yesterday of the story which I have copied below…”I can sleep…”. This story was given to us when Heather died a couple of years by a friend, and it just reminds us once again that all of us need to be prepared for the “bumps in the night”.

At the conclusion of my staging, I do have some glimmer of good news: the PET scan confirms the CT and clinical impression that there is no evidence of spread of the pancreatic carcinoma beyond the central egg sized mass. Of course with this disease there is always the assumption that it will spread and so chemo is a mainstay of treatment from the get go. The plan then is to have chemo for several weeks and I expect to make the schedule today for weekly infusions of Gemzar. This will be followed by some form of radiation to the mass. My first choice for radiation for several reasons would be a stereo-taxic focused form called Trilogy – but that also is dependent on yet another authorization by my insurance company and provider (yet another something to pray for).

Meanwhile I am feeling pretty well much of the time and take Tylenol pretty regularly in order to function and sleep without pain. PET scans are a special form of torture where the subject has hold still on your back for 30 minutes with your arms above your head – an interval that seems like hours, during which you can debate whether the back pain or the shoulder pain is number one! Oh, did I mention that there is a follow-up scan to evaluate the response to treatment? The prep is 8 hours of nothing by mouth, so I begin to yearn for injectable Tylenol. And being a good guinea pig, I signed up for a research trial that involves doing two PET scans each time… all for the good of science. The big reward of my PET scan was that the tumor marker only showed up on the primary tumor.

Our daughter Michelle and her two toddlers along with Kristie the nanny are off to Kansas today to see our family and friends of Heather for a few days. Please pray for safe and convenient travel – and good reunion times for all.


I can sleep when the wind blows

Years ago, a farmer owned land along the Atlantic seacoast. He constantly
advertised for hired hands. Most people were reluctant to work on farms
along the Atlantic. They dreaded the awful storms that raged across the
Atlantic wreaking havoc on the buildings and crops. As the farmer interviewed
applicants for the job, he received a steady stream of refusals.

Finally, a short, thin man, well past middle age, approached the farmer. "Are you a
good farmhand?" the farmer asked him. "Well I can sleep when the wind
blows," answered the little man. Although puzzled by this answer, the farmer, desperate
for help, hired the man. The little man worked well around the farm, busy from
dawn to dusk, and the farmer felt satisfied with the man's work. Then one
night, the wind howled loudly in from offshore. Jumping out of bed, the farmer
grabbed a lantern and rushed next door to the hired hand's sleeping quarters. He
shook the little man and yelled, "Get up! A storm is coming! Tie things down before they blow away!!"

The little man rolled over in bed and said firmly, "No sir. I told
you, I can sleep when the wind blows." Enraged by the response, the farmer
was tempted to fire the man on the spot. Instead, he hurried outside to prepare
for the storm. To his amazement, he discovered that all of the haystacks had
been covered with tarpaulins. The cows were in the barn, the chickens were
in the coops, and the doors were barred. The shutters were tightly secured.
Everything was tied down. Nothing could blow away. The farmer then understood
what his hired hand meant, so he returned to his bed to also sleep while the wind blew.

MORAL: When you're prepared spiritually, mentally, and physically,
you have nothing to fear. Can you sleep when the wind blows through your life?

The hired hand in the story was able to sleep because he had secured the farm
against the storm. We as believers in Christ secure ourselves against the storms
of life by grounding ourselves in the Word of God. We don't need to understand. We just need to hold His hand to have peace in the midst of the storms.

I hope you sleep well!!

May you always have LOVE to share, HEALTH to spare and FRIENDS that
care

(A gift from a friend to Bonnie & Paul Hensleigh 6-20-05)

Friday, May 11, 2007

I’m golden! And Authorized….

Just a quick update to say that the GI endo biopsy and placement of gold seeds was totally uneventful. I remember nothing of the procedure, and had a good brief visit with Dr Van Dam before and after. The frozen confirmed this to be carcinoma – so there were no surprises. And I have no after effects, at least within the next 6 hours.

After meeting yesterday afternoon with my primary physician, Dr Burn, and laying out my choice of chemo/radiation, he was able to get me authorized for Stanford to do the stereotaxic radiotherapy (Trilogy). This was a quick answer to prayer as the authorization papers arrived in the mail within 24 hours!

Bonnie waited patiently for my discharge, and drove me home. I walked into the house, had a delayed b’fast and took a short nap. Only to be suddenly awakened to the alarm that our neighbor, who just came home from the Urgent Care post triple bypass last week, had collapsed getting out of the car. We were able to get him onto a mat and he revived quickly from the syncopal episode and was whisked away by paramedics for more evaluation at the hospital. Bonnie went right back to the hospital behind the ambulance to drive our neighbor’s wife to the ER. Both of our neighbor husbands across the street are recovering from cardiac bypass surgery – so you can see that we have something of an epidemic.

We are so thankful for the prayers of many – and also for the peace we have knowing that our lives are in the hands of a loving God!

Peace I leave you; my peace I give you. I do not give to you as the world gives. Do not let your hearts be troubled and do not be afraid. Jn 14:27

Thursday, May 10, 2007

Thursday update.

Our days have been busy with consultations both at PAMF and Stanford on ways to manage my pancreas mass – all assuming it to be carcinoma. Since it is not operable, the options are forms of chemo and radiation.

We are so thankful that we could talk with so many expert physicians this week in our effort to make an informed decision regarding treatments. And all of them took time to hear our questions and get to know us a bit. Some familiar faces appeared and a number of mutual friends had prepared the way for us – so that was a special bonus.

Tomorrow, Friday morning, I am having endoscopy for biopsy and gold marker placement. The biopsy results will be returned early next week. Already I have baseline/staging PET scans and CTs scheduled for Monday and Tuesday. So it would seem that by Wednesday I would be ready to begin treatments.

Having looked at several options, my first choice is a chemo called Gemzar which is given once a week for 3 weeks. After 2 weeks rest following this I’m opting for a targeted radiation called Trilogy which is given over a few hours at one setting. Then after two weeks more Gemzar.

The approvals and authorizations are still in the hands of the provider of my insurance, so there could be some changes. Just pray that God’s hand would be on the whole process – especially the GI endoscopist tomorrow morning, and the authorization for treatments as proposed.

Grey’s arm seems to be doing well but the kids are still adjusting to the 8 hour time zone shift so our sleep patterns are weird – along with theirs! But it is good to have Michelle and the kids with us and Kristy, the nanny, is a wonderful blessing. Their London return plans are uncertain, but it seems likely they may stay for a couple of weeks more and try to see more friends and family on this trip.

Tuesday, May 8, 2007

Tuesday May 8th report

The Hensleigh house was somewhat bursting at the seams for the weekend and it was such a treat to have Michelle’s and Drew’s families with us. We all had a great time – with one exception: Grey, our 3 year old grandson from London took a fall from my #1 horse, Jackson, and suffered a compaction fracture of the right humerus (arm). Traumatic as this felt and as much as we felt bad for him, the sports medicine orthopedist pronounced this to be a minor injury which requires no particular treatment other than a sling for comfort and some minor pain pills! Once again we are thankful for God’s protection from larger calamity despite our careless moments.

On the medical front, Bonnie and I are seeing medical oncologists and radiation oncologists at both Palo Alto Medical Foundation and Stanford today and tomorrow. We hope to be able to choose a course of treatment with a team of providers by the end of tomorrow. And there may need to be some negotiation for authorization by our HMO provider when we have reached that conclusion. Thankfully our primary care doctor has been very supportive and clearly is our advocate in this period of discernment.

So we continue to ask for your prayers that we would make wise decisions and that our trust in God’s will for us would prevail and be apparent to all around us. On the back of my business card is a title, THE HENSLEIGH FAMILY TRUST. What follows is a version of Ps 20:7, “Some trust in chariots and some trust in horses, but we trust in the name of the Lord our God”. Guess you can see where we get when we trust the horses!

Friday, May 4, 2007

Post Surgery- Oncologist's visit

Hello to all, May 4th, 2007

We have returned from our visit with Dr Jeff Norton at Stanford Cancer Center and have some disappointing news. Dr Norton agrees with others that the appearance of the CT is most probably pancreatic carcinoma and he also believes that it is not resectable. The tumor essentially encircles the mesenteric artery and precludes surgical management.

The standard chemo for pancreatic cancer is not very effective, and so the protocol that Dr Norton recommended is an experimental one with standard chemo for 2-3 months followed by a targeted radiation treatment known as "cyberknife" and then more chemo. In some cases the radiation shrinks the tumor to the point that it is resectable.

We are expecting a call Monday about when the interventional radiologist could do a confirmatory biopsy, place gold markers on the tumor and possibly do a celiac plexus block for pain control.

All of this requires our gatekeeper at PAMF, the primary provider, to approve, so please pray for the plans of our "expert" to be facilitated. While this is not the news we were hoping for, we know that God is in control of all parts of life - and we just continue to seek the best advice and best hands for optimal medical care.

We are expecting Michelle, Ralf, Bo and Grey to arrive from London in a few hours and will enjoy this weekend with Drew and his family as well. What a blessing that we can share some tears and lots of hugs as we continue to pray for deliverance.

And we are very thankful for your ongoing prayers as you can see we are going to have some challenging days ahead. Today we received the same Word in 4 different places so God is upholding us. Romans 15:13 says "May the God of hope fill you with all joy and peace as you trust in Him, so that you may overflow with hope by the power of the Holy Spirit."

We are also being blessed and guided by re-reading Al Weir’s book, “When Your Doctor Has Bad News” – we highly recommend this book for every household (Zondervan 2003). Again, thank you for your love and support.

Paul and Bonnie

Tuesday, May 1, 2007

Recent history of pancreas mass

Hello friends and family,

Blogging is new to me, so bear with me on this…

Many of you are up to date on my health issues, but some are not, so today I’ll try to give a brief summary and then follow with news as it develops. A blog seems impersonal, but with the hundreds of praying friends both near and around the world, as much as I love to hear from you, I simply can’t keep up with individual responses.

So here goes:

Since February I’ve been experiencing some recurrent pains. At first I thought it as a mid back strain from some shovel and wheelbarrow work, but it was atypical and sometimes more upper abdominal. After seeing my doctor a couple of times, getting some lab tests – all normal – and trying acid inhibitors for a couple of weeks, I got a CT scan April 18th that showed a 2.5 x 4.5 cm mass in the pancreas. A few days later the tumor marker, CA 19-9 was also reported elevated to 4724, normal being up to 37. Although these are the best predictors, neither of these is 100% accurate in diagnosing carcinoma, but naturally that’s the primary concern. I anticipate the next step is to get a biopsy for diagnosis and then to resect the mass if possible. On this Friday, May 4, I’ll be seeing Jeff Norton, the oncology surgeon at the Stanford Cancer Center and rely on his expertise and advice as to the strategy for diagnosis and treatment. My prayer is that he can quickly schedule me for biopsy and surgery if feasible. In reality it may take 2-3 weeks to get scheduled in the OR.

So Bonnie and I are learning about patience and endurance. Some of you have asked if we are not overwhelmed with worry. We are not. The morning after my CT, I got new inspiration from reading Psalm 23, which of course helps us focus on The Good Shepherd, our Lord Jesus Christ. Daily readings from the Bible and devotional books we buoyed us up with God’s promises.

I have regular meetings with a number of Faith groups at our church and in the community and so they have been praying with me about this from the beginning. And the network of praying friends is global – within 24 hours of asking prayer by the Elders at Menlo Park Pres, we got email from the Fistula Hospital in Ethiopia with love and prayer from the staff where I visited in February! The result is that we have been loved and prayed for by hundreds of caring friends and our family and we have been uplifted emotionally and spiritually. Not only that, but after an intense day of meetings and prayer with laying on of hands last Tuesday, I have been free of the pain that was keeping me awake at times!

Worry has not been part of this in the last two weeks. I know that my days and my work are in God’s hands and my worry is not going to add anything to either my days or my productivity! Long ago I surrendered my life to Him and this would not be a good time to take it back. This morning I read a good passage in the Message, paraphrase of II Peter 1:5-9 which reminded me of what I need to be about these days:
“So don’t lose a minute in building on what you’ve been given, continue complementing your basic faith with good character, spiritual understanding, alert discipline, passionate patience, reverent wonder, warm friendliness, and generous love, with each dimension fitting into and developing the others, With these qualities active and growing in your lives, no grass will grow under your feet, no day will pass without its reward as you mature in your experience of our Master Jesus.

We will try to update this blog when we have further information on Friday, May 4th. Thank you for continuing prayer for accurate diagnosis and treatment, the right time for biopsy/surgery, that the mass will be benign, for His perfect healing, and in all, God will be glorified.