“No one gets out of here alive.”

And it’s true.  At some point, some sooner than later, we all have to die.  Mama left this earthly realm at 4:25 a.m. on Tuesday, August 4.  The doctor pronounced it at 4:35 a.m., but she took her last breath ten minutes before that, while my sister and I stood on each side of her, crying, holding her hands and telling her how much we loved her.

I could write a play-by-play of how events transpired, beginning early Monday morning when my sister stopped by Mama’s house to deliver a prescription she needed.  How she noticed the corner of Mama’s mouth drooping and she immediately thought “stroke”.  How we knew Mama disliked the hospital in Clear Lake, so we took her to the hospital in Pearland, and how they didn’t have a neurologist on call with the ER, so they transported her to Memorial Hermann in Houston.  How Mama seemed better while at the Pearland hospital, passing their questions with flying colors (“Do you know the date?”  “What is your name?”  “Press against my hands — you still have good strength in your hands.”) and nodding when they observed that the drooping at the corner of her mouth seemed to have resolved itself.  How she asked several times, “After they check me out, can we go home?  I want to go home.”

My sister told her, “Mama, they are probably going to admit you so they can keep an eye on you for a day or two.”  She made a funny face.  She didn’t like that at all.  The EMS guys finally arrived to transport her, only to discover they didn’t have a piece of equipment on their truck necessary to monitor her during the trip into Houston.  Another 30 minute wait, and then the second truck arrived.  It seemed like there were six EMS guys cramming into the small trauma room to transfer her to the ambulance.  So my sister and I tried to get out of the way by stepping into the hall.

I remember looking past a couple of EMS guys and seeing her propped up in the bed.  I waved, said “we’ll see you there” and then turned to head toward my car with my sister.

I can’t remember if I told her I loved her.

You learn something new everyday, and I learned that you’re not supposed to follow an ambulance en route to a hospital.  We were hungry and decided to grab something to eat.  We figured by the time we ate and made it to the hospital, Mama would be settled in her room and we could figure out what we needed to do next.

I don’t know if I’ll ever be able to eat at a La Madeleine’s again.  At least not the one in Pearland.

We were headed up 288 toward the hospital when my phone rang.  Someone named Veronica was calling to find out if we were on our way back, and how long it would be before we got there.  I told her we were at the Beltway and 288 and we’d get there as quick as we could.  My first thought was, “Oh, great — we’re in trouble because we went to get something to eat and Mama’s wanting to know where we are.”  Then I asked my sister, “You don’t think something happened in the ambulance, do you?”  She shook her head “no” and said “surely not.”

We had a hard time finding a parking place.  Once we got inside, we asked for Veronica, who appeared a few minutes later and took us to a small room named after Dr. Red Duke.  I remember thinking the room wasn’t very fancy to have been named after someone so important.  Not only is Dr. Duke an institution in the Texas Medical Center, he also has the distinction of being the Parkland Memorial Hospital surgeon who received John F. Kennedy in the emergency room after the president was shot in Dallas.  Journalists have tried to interview him about that tragic day, but he refuses to speak of it.

Finally, a doctor came to speak with us.  Strange.  The doctor needed to speak to us before we could see Mama.  The feeling in my gut said, “this can’t be good.”  And it wasn’t.

When they brought Mama in, she appeared to be fine.  They got her situated in the trauma room to take her vitals and the doctor said she was talking and they were laughing about something —

And then she stopped breathing.

He told us they “got her back” with CPR and intubated her.  She was breathing with the help of a ventilator, and now that he’d explained everything, he would take us to her.  I don’t think I’ve ever experienced anything so gut wrenchingly painful.  Mama wasn’t there any longer.  We stood on each side of her, crying and asking her to squeeze our hands if she could hear us — but she never did.  We were told that they were waiting for a bed in ICU and as soon as they had one, they were going to move her up there.  A little while later, we all made the trek to the ICU.

The nurses in that department are wonderful.  They told us that they were going to give Mama a bath and put a fresh gown on her; that we could wait in a room down the hall and they would come get us as soon as she was more comfortable.  About 45 minutes later, we returned to her room to find her still unresponsive, but looking a little better.

There’s no point in recounting the next couple of hours minute by minute, since really all we did was stand on each side of her, talking to her and telling her how much we loved her and how sorry we were for the things we wished we could have done differently — wishing we could have been there more for her.  Her blood pressure kept dropping and they kept bumping it up artificially with drugs.  She was trying to go, and they weren’t letting her.  So we talked to a kind nurse who understood that our mama did not want home healthcare or to be put in a nursing home.  We explained how many times we had asked Mama, “Can we please get some help?”  Not so we could “dump” her, but so we’d have some energy left to be able to actually make a few last memories with her.  She didn’t want anyone taking care of her but us, and her condition had passed a point where she wouldn’t be going back home.

The nurse spoke with the charge nurse, and then a doctor came in and the charge nurse said, “You have to be the one to tell the doctor what you think needs to be done.  It has to come from you.”

My sister is the bravest person in the world.  She told the doctor that the drugs and the ventilator were keeping Mama alive when Mama was trying to go.  She explained that Mama was a very private and modest person, and she would not want to live in such a dependent state, one in which she was not able to return home.  All I could manage was a nod of my head in agreement.  And so at 4:00 a.m. the nurses removed the ventilator and removed the drugs that kept her blood pressure from dropping.

Twenty-five minutes later, Mama went home to the Lord.

There’s comfort in knowing that she had a real relationship with Jesus and she will spend eternity with her savior.  While her passing was not unexpected, it was not expected quite so soon.  We thought we had a little more time — a month or two, at least.  Because of that mistaken hope, we didn’t make good use of the time we did have.  Truly, we both blame a great deal of that squarely on MD Anderson.  Mama was not in good health to begin with, and if the doctors at MD Anderson had taken her other issues into consideration, they would have said, “Ms. Swan, go home.  Spend time with your family.  Share your stories and look through your photographs.  Bake your mama’s coconut pie and sit around the table eating it straight out of the pie plate with forks.  Play cards with your grandchildren.  Give them some memories to finish out the story of your life.”

But it’s about money.  And so they prescribed radiation treatments that magnified her existing fatigue and fried her taste buds so nothing tasted good any longer.  Her already thinning hair felt out completely.  A short time before she passed, she began saying “I just want to feel good again.”  And even more recently she said, “I miss my mama and daddy.”

My comfort is that she feels better than she ever did, she has been reunited with her mama and daddy, and someday I’ll see her again.  But it’s so very hard to remember she’s gone right now when I have something to tell her and I almost reach for the phone to call her and say, “Mama, whatcha’ doing?”

So when you’re fighting a battle like this, there’s lots of poking and prodding and sticking and scanning.  The doctors have to find out just how far the bastardized cells have advanced throughout the body  and the only way to find this out is through lots of tests.

After learning from the neurologist that the first MRI indicated brain bleeds and the second MRI with contrast indicated tumors, Mama was referred to Dr. deGroot, a neuro-oncologist at MD Anderson.  We met with him, not really knowing for sure what he would say.  One thing about MD Anderson physicians — they do not waste any time.  He explained to us that surgery was really out of the question because of the number of tumors.  I can’t remember if it was my mama or my sister, but one of them said “No.  We don’t want that.  No one wants swiss cheese for a brain.”  The analogy is a bit shocking, but Dr. deGroot nodded his head and said, “That’s true.”  After he explained a few more things, we were scheduled right then to head to the diagnostics department for bloodwork, followed by a CT Neck scan, and an MRI with contrast of Mama’s entire spine.  Our appointment with Dr. deGroot was before lunch, and we did not get home from the hospital until after midnight.  We were not expecting that at all.  My sister was scheduled to work that evening and since we’d ridden together in the same car, my husband came up to the hospital from Lake Jackson to pick her up and make sure she made it to work on time.

The next day Mama and I went back to the hospital for more CT scans.  Fortunately they were scheduled for the afternoon/evening, so that gave her an opportunity to get some rest before another long day at the hospital.  One of the things we’ve noticed the last few days:  Mama gets chilled really easily, at home and in the hospital.  This is strange for someone who has always been very warm-natured.  We learned that they keep the hospital colder than “normal” because it actually helps to minimize germ activity and reduce infections.  To counter the chilly temps, patients are able to get warm blankets from just about any department they may be visiting.  At first she didn’t want to take a blanket — but after asking her numerous times, she finally decided to take one and discovered that was a pretty nice thing to have.  While we were sitting there — Mama snuggled up in her warm blanket and me fanning my face due to a “private summer” moment, we started laughing.  Talk about roles being reversed!  The nurse who started her IV for the contrast was really sweet and Mama visited with her while she diligently tried to find a vein without causing Mama too much pain.  She told Mama that she’d seen over forty patients that day and of the forty, only four, including Mama, had been able to laugh.

Do not grieve, for the joy of the LORD is your strength. — Nehemiah 8:10

Wouldn’t it be wonderful if there was a joy pill?

She had a few days off after the tests last week, and we met with a couple of doctors on Tuesday who explained all the results of the tests.  This was the day that we found out just how many “aliens” (as Mama likes to call them) are residing in her noggin, and also learned of the spots on her lungs.  Because she was originally treated for melanoma, she met with a melanoma oncologist first.  Dr. Amaria explained the nature of the cancer and then explained what different treatment options are available.  She then explained that Mama would see a neurosurgeon, even though surgery is not on the table of possible treatments.  It appears all these doctors consult with each other so as to ensure nothing is missed, both disease-wise and treatment-wise.  Dr. Ferguson was the neurosurgeon who visited with us and discussed our mama’s situation, confirming and expanding upon what Dr. Amaria said.

At one point my sister started to ask a question and lost her train of thought.  After a second, she asked Dr. Ferguson, “Do you give family discounts?”

Sometimes you just have to laugh…

In my last post (all of ten minutes ago), I made the comment that it’s hard to find the joy when your mama’s been given less than good news at the cancer hospital.  I did think of one thing, though:

My mama knows Jesus.  She grew up going to a little country church down the road from her parents’ little country home in East Texas.  It wasn’t until she was 28 years old that she accepted Jesus as her savior at a little Baptist church in Alvin, Texas.  She made plans to be baptized.  I started asking questions about what she was doing and I ended up getting saved, too, at the age of 8.  We were baptized at the same time.  She still chuckles when she reminds me that I said “Oooh, the water’s cold!” when I stepped into the baptistry, and the entire church could hear me.

We attended that little Baptist church for two or three years, and then when Mama started learning about the gifts of the Holy Spirit, we began attending the Apostolic Faith Church, eventually becoming members of Living Stones Church.  Through all the forty-three years since she was baptized, my mama has loved the Lord and read his word.  My sister and I observed, with tear-stained faces, that Mama is always so strong in a crisis.  Mama was quick to remind us, and has reminded us since, that whatever strength she has as we face this challenge ahead is not her own, but from the Lord.

I think there’s a great deal of joy in that.

So that goal for 2015?  That subtitle of my blog?

Persistently choosing joy?

That’s going to be a bit of a challenge for a while.  Not to say it can’t be done, but it’s very difficult to find the joy when an oncologist tells you your mama’s recent mild headaches are being caused by 15 brain tumors — melanoma that metasticized from the mole she had surgically removed “successfully” three years ago. Not only that, but there’s a bonus:  six spots scattered around both lungs.

Joy unspeakable.

Because it’s hard to find right now.

So here’s the plan:  whole brain radiation for ten days (Monday thru Friday with a break for the weekend, and then Monday through Friday again), and on each of those radiation days, chemotherapy in the form of a pill.  After the radiation oncologist at MD Anderson finishes up with that, they’ll do a lung biopsy to see if the spots on her lungs are also melanoma, or another kind of cancer.  Which, the melanoma oncologist said, would be even worse luck.  I’m not sure it’s possible to measure degrees of good or bad luck when talking about cancer.  It’s CANCER.

There are three possible treatments for the lung spots:  (1) chemotherapy; (2) targeted cancer therapies; or (3) immune-based therapy.

1. Chemotherapy:  works by stopping or slowing the growth of cancer cells, which grow and divide quickly. Chemotherapy is used to:
   • Treat cancer  Chemotherapy can be used to cure cancer, lessen the chance it will return, or stop or slow its growth.
   • Ease cancer symptoms  Chemotherapy can be used to shrink tumors that are causing pain and other problems.
2. Targeted Cancer Therapies: Targeted cancer therapies are drugs or other substances that interfere with specific molecules involved in cancer cell growth and survival. Traditional chemotherapy drugs, by contrast, act against all actively dividing cells.  Targeted cancer therapies that have been approved for use against specific cancers include agents that prevent cell growth signaling, interfere with tumor blood vessel development, promote the death of cancer cells, stimulate the immune system to destroy cancer cells, and deliver toxic drugs to cancer cells.
3. Immunotherapy:  Immunotherapy is the use of medicines to stimulate a patient’s own immune system to recognize and destroy cancer cells more effectively. Several types of immunotherapy can be used to treat patients with melanoma.

The doctor we spoke with is leaning toward the immunotherapy approach.  If I am remembering correctly, she said she would use Pembrolizumab (which, according to the article linked above: “By blocking PD-1, these drugs boost the immune response against melanoma cells, which can often shrink tumors and help people live longer (although it’s not yet clear if these drugs can cure melanoma).”  She seemed to think this treatment had the best possible chance of success with the fewest side effects.  The only thing (and only is a big “only”) she seemed to have a concern about is that my mother has had corneal transplants in both eyes for several years.  This therapy could perceive the transplants as “invaders” and attack them, too.  So she could lose her vision.

Ultimately what it all comes down to is this, at least as far as man is concerned:  the cancer is stage 4.  There is no “cure” to speak of.  The treatments will hopefully slow the cancer down and buy us some more time with Mom.  The only other solution is a real miracle from the Lord.

I am praying and hoping for that miracle.  In the meantime, I’m thanking the Lord for the opportunity to spend time with my mama, taking care of her and making a few more memories to last me until I see her again in heaven.

Taking a moment to say I’m still here and I plan on posting something of substance soon.  The last few weeks have been pretty full.  I am happy to say though the path has not always been smooth, I have felt the Lord’s presence in spite of myself, and I have great hope regarding many things in my life and the lives of those I love.  Have a blessed day, my friends.  Have a blessed day.

I struggle with rabbit trails.  It’s no secret that I’m easily distracted, and while I wouldn’t go so far as to label myself ADD, it takes a lot of effort to keep my thoughts on task.  Having said that, I am learning that sometimes the Lord guides us to the “rabbit trails” when we sit down to study his word. Recently I ran across an article online about why pastors don’t preach on demons.  As I read the article, I looked up the various scriptures he referenced.  Our pastor at Fathers House Church teaches that we should always measure everything against the word of God, so I’m really striving to do that in my studies.  The article is good and really drives home this truth:

For we are not fighting against flesh-and-blood enemies, but against evil rulers and authorities of the unseen world, against mighty powers in this dark world, and against evil spirits in the heavenly places. (Ephesians 6:12 NLT)

As I continued reading, the writer referenced the following:

The thief comes only to steal and kill and destroy; I have come that they may have life, and have it to the full. (emphasis added, John 10:10 NIV)

I know I’ve heard this scripture umpteen times in the course of my life.  Usually the point of the sermon is Jesus as the Good Shepherd, that the sheep know his voice and will not follow a stranger.  It’s an excellent teaching, of course, but I think the Lord was really drawing my attention to something else this time. The word “only” grabbed my attention and pulled me down that rabbit trail.

It’s been my observation (and I say this with sincere concern, not judgment) that we, as followers of Jesus, sometimes let our guard down when it comes to supposedly “harmless” things.  We open doors to things that weaken, and eventually replace our commitment to Jesus, and each other as brothers and sisters in Christ. While there are plenty of areas where this happens, one that’s been heavy on my heart (and it relates specifically to the article I was reading), is entertainment with roots in both the occult and pornography.  Walk into any bookstore, check out any theater movie schedule, peruse the current popular video/card games and find the choices rife with vampires, witches, witchcraft, etc., most of which are aimed at children, teenagers, and young adults.  The excuses made are “if it gets them reading, it’s okay!” and “it’s just make-believe.”

I can’t say whether there are really vampires and witches like those of the movies and books, but I do know that there are evil spirits behind these things — evil spirits that seek to steal and kill and destroy… While “adult” books and movies are marketed toward the “older” population, access to these materials is becoming less and less difficult to obtain by younger people.  Bodice-ripper novels are “epic in scope and usually featuring more violent sexual content, bodice rippers are the books that ushered in the era of the modern romance novel.” (Defined by Goodreads, italics added.)  Movies like Fifty Shades of Grey twist our views of healthy relationships between men and women.  Never mind scriptural definitions of man/woman relationships — any decent psychologist will tell you these are not healthy relationships.

The thief in John 10:10 isn’t interested in getting young people reading or entertaining us in a “harmless” way.  The books that get our kids reading, the movies that entertain us for a couple of hours and lighten our wallets by $40 are merely the tools by which the thief steals and kills and destroys, and that is the thief’s ONLY purpose.

Before anyone reading this rants and raves about censorship and narrow-minded legalism, I’d like to offer up this:  brush up on your skills of discernment.  Ask the Lord to show you what is good and profitable for your relationship with him.  When you read a book, are you encouraged at the end?  Do you feel stronger in your relationship with God, or are you embarrassed to know that he knows you read that book?  And he does, you know.

As members of the homeschooling community (eight year members, if we’re being specific), we knew people who subscribed to both ends of the spectrum when it came to dating and courtship.  Less conservative members of our circle were okay with dating, while the more conservative members pursued the courtship model, where daughters stayed home and potential suitors presented their cases to the fathers for consideration.   We fell somewhere in the middle — dating within boundaries, with the understanding that potentially serious contenders would spend time with us as well, so we could get to know them, too.  After all, there’s a lot of truth in the saying that you don’t just marry your spouse — you marry their family, too.  In addition, ultimately our girl would be the one living with whomever she married, so she needed to be the one to make that decision — not us.

Unfortunately, the word “courtship” can hold negative connotations to the young person who feels it’s simply a method of control, a way to keep him or her from growing up.  It’s so challenging as a parent to communicate what we’re really trying to do — help our children transition to adulthood with as little heartache as possible.  Maybe that’s a naive hope.  But it certainly doesn’t keep us from trying.

To my way of thinking, the extreme courtship model was an effort to combat the dating scene that is so prevalent:  the scene in which two people use each other more for entertainment and selfish desires than to get to know each other with the possibility of lifelong commitment.  The scene where young people struggle to differentiate between love and hormones.  And how can they not struggle, when the word “love” is thrown around so casually in every book, movie, song, and conversation that its meaning is diluted from overuse?  Seriously, we love pizza, we love that song, we love books, we love the way that girl cuts our hair, we love, we love, we love!  Thank you, English language for not giving us more specific words to really explain what we mean in each of these cases.

Perhaps it’s not so much that the word is diluted as it is misunderstood or misapplied, because more than one type of love exists.  Specifically, agape, phileo, and eros — and the confusion of these types of love can lead to difficult situations and great hurt.

Agape love is a selfless love that does not take into consideration one’s personal feelings.  It’s the kind of sacrificial love that Jesus Christ showed when he gave his life for us, even while we were still sinners.

Phileo love is the kind of affection that we have for our friends — brotherly love not necessarily rooted in sacrifice or service to another.

Finally, there’s eros — a sexual, erotic love that is rooted in desire for another.

While agape love can be considered the best of the three, because it’s when showing another person agape love that we come closest to emulating the Lord, each has its place in the proper context.  I think you can compare it to the old cliché about getting the cart before the horse.  When young people start to notice those of the opposite sex, they tend to skip straight to the eros kind of love — hormones are raging, the heart is racing, and all they can think about is how much they want the other person.  But why do they want the other person?  For the way the other person makes them feel.  It’s a selfish, not selfless, kind of love that makes demands and doesn’t consider what’s best for the other person.

However, when relationships are started and nurtured in the proper order, affection has time to grow into love and then desire, desire that is rooted in caring for each other rather than thinking about how to get what one wants from the relationship.

We were not big fans of either extreme courtship or casual dating.  I wish the article linked below had been around to help us explain our views a little more clearly whenever the subject came up in conversation, because I think it really comes close to what I believe:

5 Reasons Men Should Start Courting Women Again | James Michael Sama.

We decided to break the trip into two parts.  On Sunday we drove from Jones Creek to New Orleans, where we took advantage of the opportunity to visit my dad and his girlfriend.  Early this morning, after breakfast and an all-to-brief visit with them, we loaded everything into the car again and got back on the road, bound for Decatur, Alabama.

I will be honest.  While I’ve been very excited at the prospect of visiting our dear friends after too long a separation, I have not been excited about the prospect of the travel involved in this visit.  First of all, I’ve never traveled so far from home without my husband.  While I’m perfectly capable (for the most part), there’s just something comforting about knowing he’s there in an emergency.  So that’s been worrying me.  And then there’s the weather forecast.

Oh. My.

For days, every weather forecast I reviewed promised unpleasant, if not downright terrible, weather.  The further north our route took us, the greater risk we seemed to be for icy roads and worse.  I kept checking the forecast and asking my husband questions about tires and ice and what one does when encountering icy conditions.  (My dad advised pulling over into the first available motel.)

Sunday morning after the service, I asked our associate pastor if he would keep us in prayer while we traveled.  He prayed for us right then and there, and I immediately felt better about everything.  We hopped in the car and began heading toward New Orleans.

I am so happy to share that we did not encounter one bit of rain, ice, sleet, or snow on either day of our travels!  It is such a comfort to know that God has everything under control, and He cares about our every need.