Sunday, December 28, 2008
“There is a time for everything, and a season for every activity under heaven…”
Like all of you, we just celebrated Christmas, a time to commemorate our Lord’s human birth. We celebrated with our families (we’re pictured with David’s side) and once again we’re reminded how blessed we are. As we approach the new year, a year that will bring new experiences for our entire family, it’s time to look back and reflect on God’s grace in our lives.
David Lee spent almost eight months in Poland teaching English to Polish students and helping wherever he was needed by PROeM Ministries. He also met a young lady who has captured his heart. We have a feeling Wiola (pronounced Viola) will be a part of our lives for many years to come.
Julie began a 15-month internship at Southeast Christian Church in Louisville, Ky., where she is serving in the missions department. She has taken trips to central Asia and Poland, as well as some domestic missions trips, and is preparing to go to Ethiopia in February.
Tammy and David spent an amazing week in Poland in late July. All four of us were together at FishArt Camp, a camp where we helped young people learn to worship God through the arts (music, drama and electronic arts). It was a family reunion of sorts, but more an opportunity to serve the Lord by serving others side-by-side.
As we have written previously, Tammy’s prayer for a number of years has been to be “used in a mighty way” by God. She wasn’t sure what “big thing” was coming, but she knew that God was preparing her to make an impact for the Kingdom. We thought maybe He was preparing her for the work in Poland.
But the news we received this fall--that Tammy has the early stages of leukemia--has convinced us that this journey is the “big thing.” The time leading up to the transplant has been an adventure, and we know that the transplant and the time following will be one of the hardest ordeals we’ve ever had.
But we also know that God has been very faithful to us. He’s allowed us to see His will very clearly. When one of us is struggling, the other one reinforces what we both believe. The occasional “Why me/you?” question (from either one of us) is always answered with, “Because you/I have the faith to allow God to be glorified through it.”
We have been blessed to touch the lives of many people, through this process and even this blog. It is therapeutic to write our feelings, and allows us to crystallize our thoughts. We know this is the time that God has chosen for Tammy to go through this disease and recovery, and we hope we have kept you informed on how we’re doing.
We know we’ll be at KU Medical Center. As far as timing, we are awaiting word on whether either of Tammy’s brothers will be a match for the bone-marrow transplant. That will help determine when the transplant will be done. We ask for your continued prayers.
Thursday, December 25, 2008
"For to us a child is born, to us a son is given, and the government will be on his shoulders. And he will be called Wonderful Counselor, Mighty God, Everlasting Father, Prince of Peace. Of the increase of his government and peace there will be no end. He will reign on David's throne and over his kingdom, establishing and upholding it with justice and righteousness from that time on and forever. The zeal of the LORD Almighty will accomplish this."
"And there were shepherds living out in the fields nearby, keeping watch over their flocks at night. An angel of the Lord appeared to them, and the glory of the Lord shone around them, and they were terrified. But the angel said to them, 'Do not be afraid. I bring you good news of great joy that will be for all the people. Today in the town of David a Savior has been born to you; he is Christ the Lord. This will be a sign to you: You will find a baby wrapped in cloths and lying in a manger.' Suddenly a great company of the heavenly host appeared with the angel, praising God and saying, 'Glory to God in the highest, and on earth peace to men on whom his favor rests.'"
Wednesday, December 24, 2008
"Your father's blessings are greater than the blessings of the ancient mountains, than the bounty of the age-old hills."
As we get ready for Christmas, we are counting our blessings. They are too numerous to mention all of them, but here are a few:
* We are blessed by an amazing family. From Tammy's brothers, who elbowed each other to get in line first to see if they could be a bone-marrow match; to our wonderful parents, who raised us to walk with the Lord and still minister to us daily; to our two wonderful children, who have jumped in to help around the house and to take care of Tammy; to all of our other family members who have been praying for us, we have been carried through a difficult time.
* We are blessed by a great church family, who have been there in prayer, and in person.
* We are blessed by friends around the country who have been praying for us. We can't count how many people have offered to be tested to see if they are a match. The love and concern is very uplifting.
* We are blessed by co-workers, who care more about us than what we do in the office.
* Most of all, we are blessed by the relationship we have with our Lord and Savior, Jesus Christ. He is the reason we celebrate this season. He is the reason we exist. Our goal in this life is to glorify Him. We look forward to the day when we can see Him face to face.
In Philippians 1:15-26, Paul writes about serving the Lord in all situations, and being torn whether he wants to keep serving here or to see Jesus. Philippians 1:21 is our life verse: "For to me, to live is Christ and to die is gain." We don't desire to die, but we know that when that day comes, it will be even better than anything we've ever imagined.
Our prayer for you is that you have that same peace, whether you're facing a life-threatening illness or just the mundane everyday life. God bless you. Merry Christmas.
Saturday, December 20, 2008
"God has brought me laughter, and everyone who hears about this will laugh with me."
We all know that God has a sense of humor. How else could he have created the giraffe?
Well, as dyed-in-the-wool Kansas State fans, it pains us to say that we are thrilled that, most likely, Tammy's bone-marrow transplant will take place at the University of Kansas Hospital in Kansas City. They told us they would take good care of her, even though we are Wildcats.
Yesterday, we were able to add Tammy to David's health insurance policy, giving Tammy secondary insurance. We had always kept them separate because it was more economical. But KU Med Center is in-network with David's provider, so much of what her carrier declines should be picked up by the secondary insurance. We'll find out for sure in the next couple of days, but it looks pretty good.
It's funny that we didn't think of it previously. David is an insurance agent, and Tammy works for a healthcare provider in the billing department where she is very familiar with secondary insurance. Neither of us thought about it. Our wonderful patient advocate, Betsy, who has been a huge blessing to us already, suggested it. After crying tears of joy, we laughed at our selves for not being able to see the forest for the trees.
Friday, December 19, 2008
"...the joy of the LORD is your strength."
All of the posts so far have been from both of us. We share thoughts and then I put them in the post. Tammy reads it before I publish it, and makes whatever changes she wants. This one is strictly from me.
Last night's post was mostly from me, as I faced the reality of the situation. I always knew it was serious, but hearing the details of the risks and the follow-up was devastating. I honestly believe everything we've written to this point, but giving into God's will, if it meant possibly losing Tammy, was more than I could handle in my "humanness."
I went to worship rehearsal last night and was lifted up by some very dear friends, who pointed out some things I needed to remember. God is in control. He is more powerful than anyone or anything in the universe. His will is perfect. His grace is sufficient (2 Corinthians 12:9). These are all things we've written and/or said through this process, but I needed the reminders.
Tammy has been strong all along, looking at this as an opportunity to strengthen her witness. She also recognizes is may be easier for her than it is for the rest of us. I know it would be easier for me if this was my sickness.
I'm doing better today. Sharing thoughts with Tammy, plus some timely emails from family and friends have boosted my spirits. I want to thank you for your prayers. This will not be an easy road, and I'm sure there will be other times when I question why God is doing something. But the joy of the Lord is my strength. The joy of knowing that He is in control and His will is perfect gives me the strength to get through anything and everything.
Thursday, December 18, 2008
"Even though I walk through the valley of the shadow of death, I will fear no evil, for you are with me; your rod and your staff, they comfort me."
"I lift up my eyes to the hills—where does my help come from? My help comes from the LORD, the Maker of heaven and earth. He will not let your foot slip—he who watches over you will not slumber."
Never before has it been more difficult to write those words. As human beings tonight, we are fearful. We are facing the biggest trial of our lives, and we know only God can get us through it. We believe the verses above, and ask for God's help to keep us reminded of these words.
We had our appointment at KU Medical Center today, and they agreed with the assessment of Barnes Jewish Hospital. Tammy is an ideal candidate for a bone-marrow transplant. She is in good health otherwise and is relatively young. The chances of a successful procedure are good, considering the severity of the condition.
But they also went into much greater detail of the risks and the procedure. This is not a simple case, and the risks are great. They plan to treat her aggressively with chemotherapy and/or radiation, which has greater risks but carries a better long-term prognosis if things go smoothly. They also told us that she would have to be at home with around-the-clock care for 100 days after the transplant, away from work and with very little activity, to reduce the chances of rejection—graft-versus-host disease (GvHD).
We have several concerns and request your prayers. We are concerned that we can care for Tammy during the 100 days adequately to prevent complications. (Actually, David is concerned; Tammy is fine.) David Lee returned home last night, and he is a big blessing and a big help.
We are concerned about the economics of the situation. The costs of the transplant, the medicines and the reduced income while Tammy is off work, are staggering. We're not sure how we're going to pay for it. But our God is a big God and He can do "immeasurably more than all we ask or imagine" (Ephesians 3:20). We're anxious to see how He will get us through this one.
(We have pretty much made the decision to have the transplant done in Kansas City at KU. The cost of living in St. Louis for 100 days, only 28 of them in the hospital, makes the in-network/out-of-network issue almost moot. We'd spend a lot of money going to and from St. Louis and finding a place for Tammy to stay while she recovers, probably as much as we'd spend even if KU remains out-of-network. And since she would need a care-giver full time, it would be difficult for David to keep his business while taking care of her away from Kansas City.)
Finally, we're concerned about the seriousness of the treatment. A bone-marrow transplant is not without risk, even in the best of situations. The mortality of the situation is chilling. Once again, we ask for your prayers for peace and contentment.
People have told us they appreciate our descriptions of our faith in God's will. We appreciate those comments. It is only through the grace of God that we can have any peace. It's difficult to remain faithful, but God knows we're human and that we have emotions. He knows we're hurting. He is the source of comfort. Please continue to pray for that comfort.
Wednesday, December 17, 2008
"Consider it pure joy, my brothers, whenever you face trials of many kinds, because you know that the testing of your faith develops perseverance."
Today is a special day for us. Our son, David, is returning home from Poland, where he has been serving in the missions field since early May. We were able to see him in July when we went there on a short-term missions trip, but it will be the first time the grandparents and other friends from the area have seen him in more than seven months.
David is such a joy in our lives, as is our daughter, Julie. He brightens the room when he walks in. His love for people is very evident, as proved by his willingness to give up the comforts of home to serve others thousands of miles away. But even when he's just chatting with someone, the love he received from Christ is easily passed on to each person he encounters.
Having him home for the next year or so will be a huge blessing as we go through this journey. Having another set of eyes to see if Tammy needs anything, another set of ears to listen to the doctors' instructions, another set of feet to help us run errands, another set of hands to help around the house, and mostly another heart to give and receive love, will be a great benefit to our family.
Please pray him home as he has to go through Chicago, which is being inundated with a winter storm. We have our appointment with KU Medical Center tomorrow. Please continue to keep that in your prayers as well.
We are greatly blessed by your prayers and concern.
Monday, December 15, 2008
"Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus."
Sometimes the answer to our prayers is "no." Sometimes it's "not now." Sometimes it's "yes." We are praying a very specific prayer right now, but have the "peace of God, which transcends all understanding" that God's will is correct and He knows what's best.
Tammy has an appointment at KU Med Center Thursday afternoon. This is the first step in the process to see if KU will take the case and if Tammy's insurance will cover it in-network. There is no in-network hospital in Kansas City that does bone-marrow transplants, which is why we went to St. Louis a couple of weeks ago. We found out this morning that her out-of-pocket maximum for out-of-network service is $8,000.
Our prayer is that KU would accept the case and that the appeal to have it treated as in-network would be successful. We can't afford $8,000, especially when Barnes Jewish Hospital in St. Louis would cost us $500.
We are at peace with whatever God decides to do, but it doesn't keep us from praying for an option we desire. We appreciate your prayers.
Friday, December 12, 2008
Acts 17: 24-28
"The God who made the world and everything in it is the Lord of heaven and earth and does not live in temples built by hands. And he is not served by human hands, as if he needed anything, because he himself gives all men life and breath and everything else. From one man he made every nation of men, that they should inhabit the whole earth; and he determined the times set for them and the exact places where they should live. God did this so that men would seek him and perhaps reach out for him and find him, though he is not far from each one of us. 'For in him we live and move and have our being.' As some of your own poets have said, 'We are his offspring.'”
Tammy was a preschool teacher for 10 years. She used this verse to teach the kids how God created them. She used the analogy of them building something with Legos. They knew what they wanted to make and how they wanted to make it. If it broke, they knew how to fix it. God is our Creator. He built us, and He knows how to fix us. That is a great source of peace for us, as we await word on where Tammy will be “repaired.”
We are getting closer to making a decision on which hospital will do the bone-marrow transplant. To catch you up, we went to Barnes Jewish Hospital in St. Louis 10 days ago. This is one of the best transplant hospitals in the country. Though they were very willing to take Tammy's case, they didn't think it was necessary for us to come there. They felt any good transplant hospital could do this successfully, because Tammy is young enough and in good enough health otherwise.
The only problem is that the one hospital in Kansas City that could do it—KU Medical Center—is not in Tammy's insurance network. We will appeal that decision, but we can't appeal until a denial is actually issued.
Next Thursday, we will have a consultation with the doctors at KU so they can decide if they think she needs a transplant. That's a no-brainer. Then they'll submit it to Tammy's insurance and see what they say.
We're leaning toward going to KU either way, as long as the out-of-pocket maximum is not too much. We believe her recovery would go smoother if she is close to family and friends. The extra expense will be worth it, as long as we can afford to do it. We may have to come up with some creative ways of paying the extra cost. (Anyone want to buy a homemade pie?) We should find out the out-of-pocket maximum next week.
We're still very much at peace with whatever God decides to do in this situation. If He wants her at Barnes, we'll gladly go there. If He wants her at KU, we'll go there. We appreciate your prayers for God's will to be done, and for grace and peace to accept whatever His decision is.
Tuesday, December 9, 2008
"...Pray for each other so that you may be healed. The prayer of a righteous man is powerful and effective."We got snow in Kansas City today, and the city was a mess. There were accidents all over the place, as people had to be reminded that snow means slick. It took Tammy an hour to get home from work, on a drive that usually takes 15-20 minutes. Thankfully, we both made it home safely, and we thanked the Lord for that. We pray for those who have to be out in the bad weather tonight.
We also prayed for David's uncle, Rick, who underwent an 8-hour surgery for cancer. He came through okay and the surgeon is confident he got it all. He is optimistic for a full recovery.
We also prayed for David's uncle, David, who is having some issues with his pacemaker. We are praying that the problems can be resolved quickly and easily.
It is such a privilege to pray for others. It gets our minds off our own difficulties and let's us share in the "carrying to the Throne." We appreciate all of you remembering us in your prayers, even as you go through various trials in your own lives.
We still very much loved.
Sunday, December 7, 2008
Joshua 8:1"... 'Do not be afraid; do not be discouraged.'"
We had a wonderful time in worship this morning. The message was good, as we were reminded that even if our children are grown, as ours are, we still have a role in their lives and in the lives of other young people in our church and in our lives.
We also were blessed by the smiles and friendly greetings of our church family. It's in times of difficulty that we try the most to look for our blessings, and our family and friends are near the top of the list. Person after person came up to us and told us they were praying for us. We feel so comforted. Many people have offered to help in any way we need it, and although we haven't had the opportunity to take them up on it yet, we appreciate the concern so much.
Tammy had a very restful afternoon. She slept for about three hours. We are both ready for another week of work after a good relaxing weekend. We both enjoy our jobs and have very supportive friends and co-workers.
Our prayer is that you will be blessed in a special way this week, as you look to the Lord who encourages us to not be afraid or discouraged, much like He encouraged Joshua.
Friday, December 5, 2008
“Be patient, then, brothers, until the Lord’s coming. See how the farmer waits for the land to yield its valuable crop and how patient he is for the autumn and spring rains. You too, be patient and stand firm, because the Lord's coming is near.”
Waiting is so hard. We want answers now. How many times have you prayed, “Lord, give me patience, and give it to me now”? Often, we learn patience by being forced to have patience.
We are in waiting mode right now. We are waiting to see if Tammy’s brothers are matches for a possible donation. We are waiting to see if Tammy’s insurance will reconsider and allow KU Medical Center in Kansas City to be in-network so we can use it for the transplant. We are waiting to see what our out-of-pocket expenses will be if KU remains out-of-network. It will probably be at least a week before we find out any of these answers.
Mostly, we are waiting on the Lord. We know He is in control. We know He has everything in His plan. His love and grace have been so evident to us in the first week and a half since we found out about the need for a transplant. We are trying to be patient as we wait for the next step.
Thank you for your words of encouragement and prayers so far. We ask that you keep them going.
Many of you have sent us emails or posted comments on this blog, thanking us for the blog. It is a great pleasure to post to it. It is therapeutic, and we are greatly encouraged by the responses to it. (For some reason, not everybody has been able to post comments. We wish we knew what to tell you. Just keep trying, or you can send us emails at DavidDSmale@gmail.com.) We hope you continue to read the blog, and if you are blessed by it, give all the credit to the Lord.
Wednesday, December 3, 2008
Tammy and I love to hug each other. The warmth we feel when we are in each other's arms is so comforting. We are not only husband and wife, and parents of our children. We are best friends. A hug is a great way to show each other how we feel.
We feel the same way about the comfort we have received from so many of you, as you have lifted us up in your prayers and corresponded with us. We feel "hugged."
We continue to investigate having the transplant done in Kansas City, but there is no new news. We also have started the process of determining if either of Tammy's brothers is a match. That is the goal, because a sibling match is the best match and lessens the chance of rejection. We ask for your continued prayers in both of these areas.
Comfort one another as the Lord comforts you.
Tuesday, December 2, 2008
28 Do you not know?
Have you not heard?
The LORD is the everlasting God,
the Creator of the ends of the earth.
He will not grow tired or weary,
and his understanding no one can fathom.
29 He gives strength to the weary
and increases the power of the weak.
30 Even youths grow tired and weary,
and young men stumble and fall;
31 but those who hope in the LORD
will renew their strength.
They will soar on wings like eagles;
they will run and not grow weary,
they will walk and not be faint.
It was a little overwhelming to walk into the Siteman Cancer Center. We knew what we were dealing with was the precursor to leukemia, a form of cancer. But to know we were going there for Tammy's evaluation was a little chilling. That section of the hospital was filled with people all battling cancer. Tammy felt a little out of place, because she still feels pretty good. To know that without treatment, she soon will be like many of those people who need assistance to perform everyday functions makes us that much more determined to take care of this right away.
The care we received there was remarkable. There's a reason that Barnes has the reputation of one of the best cancer hospitals in the nation. The process was organized and very smooth. The people were gracious and caring. They were thorough and willing to meet with us until all our questions were answered. We left there with the feeling that if we do decide to have the transplant done there, we will be in extremely good hands.
They also were very "human." We told the lead doctor that our desire was to have the transplant done in Kansas City, at KU Medical Center, so Tammy would be closer to friends and family during the preparatory and recovery periods. KU is the only hospital in Kansas City capable of doing the bone-marrow transplant. The doctor told us he had full confidence that KU would do an excellent job and he is willing to help us in the process.
We are still investigating that possibility. There are a lot of details that have to fall into place in order for that to be a possibility. We ask for your prayers that all of those details would fall into God's will, and that we will graciously accept whatever His decision is.
We are tired today. A long day yesterday, followed by a short night, made it tough to work today (yes, Tammy went back to work). But we are relying on the Lord, who will renew our strength. We will run and not grow weary. We will walk and not be faint.
Monday, December 1, 2008
We'll update again tomorrow. Thanks for your prayers.
Our day started very early as the alarm went off at 3:45 so we could take Julie to the airport. She was such a blessing to us this weekend, but she had to get back to Louisville and go back to work. Her flight left at 6:20 and we headed east for the four-hour drive. It took a little longer because of construction in St. Louis, but we got to the hospital in plenty of time.
Tammy had lab work done at 1 p.m. and then we went over to the doctors' wing. We went in to see the doctor at about 2:45 and left at 5 p.m. We got lots of questions answered, but left a lot of things still to be determined.
The doctors definitely agree that Tammy needs a bone-marrow transplant. She is the perfect candidate for that, because she is still pretty young and otherwise healthy. The other options are temporary and only mask the problem. A transplant is curative.
The next step is to see if Tammy's brothers are matches. They are the most likely to be matches as they share the same genetic structure because they have the same parents. If they are not matches, we will look at the worldwide donor pool to find the match. That could take a few months, but they were pretty confident they could find a match.
Once a match is found, they will determine if Tammy needs pre-procedural chemotherapy or can go straight to a transplant. Thus, there are several questions left to be answered.
One thing we are praying for is a possible successful appeal of the insurance company's decision to not cover Tammy at KU Med Center, the only hospital in Kansas City that does bone-marrow transplants. We plan to appeal this through the hemotologist. This would save a lot of time traveling to and from St. Louis for treatments, plus time Tammy would not have to be alone during the month-long treatment once the transplant is scheduled. We would appreciate your prayers for this as well.
We are still very much at peace about where we are right now. It is our desire to have it done in Kansas City, if at all possible. If not, we're pleased with the level of care we would get here in St. Louis. Please pray for safe travel for us home tonight. We're both tired from a long, stressful day, and we've got a four-hour ride ahead of us.
We'll update more tomorrow. We love you all and appreciate your prayers. As always, we feel like we're being carried on a pillow of prayers.
If you are interested in possibly jumping into the potential donor "pool," go to www.marrow.org and follow the instructions. Some insurance plans pay for the tests, others do not. They can cost up to $150 (sometimes half that), but generally for ethnic minorities there is no charge.
Check out the web site and check with your health insurance provider to see if it's something you can do. Someone out there will save Tammy's life, because they are willing to be a donor. We would consider it a great honor if any of you became potential donors on Tammy's behalf.