Staying Strong

Well, it looks like this might be the patch that is finally bringing balance. Since Saturday, Pop has not had the extreme nausea, and has even been able to walk-around unaccompanied. It is good to see him genuinely smiling again, and feeling better. Sure, he has episodes where he feels wiped-out, or low-grade nausea, but it is a significant improvement over the past two weeks. Today he was actually able to hold Emma (his grand-daughter) for the first time in a long time! We are grateful that he is able to find footing so quickly into the chemo/radiation process. The radiation doctor was very pleased with his progress, and was happy to see him walk in and out of the office under his own power. It may be a long road ahead, but at least it seems easier when the mountain doesn't seem as steep. As he moves along, Pop continues to lean on Christ for his strength, and even made the comment the other day, "You know...I talked to God, and like that poem, 'Footprints', I told God that there might be times that he has to carry me through this journey, and there will only be one set of footprints. And, ya know, I'm okay with that."

Break-Through

Thursday and Friday were met with additional struggles of pain and nausea. As Pop slipped between sleeping, and dry-heaving episodes, we felt helpless as the hours passed. We talked as a family, and wondered out-loud how Pop could make it through 6 weeks of this process, and how we could possibly make things easier for him. Feeling at a loss for options, we prayed that there could be a break-though in some form. A YWAM (Youth With A Mission) team, that is traveling around the east-coast, heard of Pop's journey and asked if they could come to pray for him. He was feeling quite sick when they arrived on Friday, but he was able to lay still as they gathered around and laid hands on him. It was a beautiful time of prayer, and simple worship to God. Shortly there after, Mom called the Cancer Center to inform them that we were not having any luck with the existing drugs that we were using, and to see if there were any other options to try. Amazingly, the nurse who was there informed us that they had just received a sample of a new drug that is meant to help with nausea from a chemo/radiation combo (and it came in the form of a patch)! So, we ran Pop down to the Cancer Center where they started this new 'time released' medication patch. He felt no better that night, but we held to hope that it might take a little time to become effective. This morning early, he woke feeling slightly better with decreased nausea. It was a blessing, especially with some friends and family coming to the farm for a work day. Yesterday, a tree service came and dropped two trees that were needing to be taken down (we just didn't know it would happen so quickly). With family and friends here, Pop decided to come-out for some fresh air. As the day progressed, he felt better and better. He was able to soak-up some sun, and talk with everyone here (although we wouldn't let him work, we did allow him to 'supervise'). It is wonderful to see him up and walking around, and enjoying some things that he hasn't been able to for the past 2 weeks. In fact, he is sitting in the family room now watching the Phillies :) As we all hold our breath, and pray this new medication works, we continued to be amazed at God's goodness. He has blessed us with a great family, generous friends, and a hope for tomorrow.

Today's events:















Everyone hard at work (well...Pop was making sure that we were hard at work)















Emma and Pop supervising




















Feeling blessed!

Trying to find a balance

It is the night of the third day of treatment. Pop is sleeping soundly in his bed, and Mom is reading a magazine beneath a light on the couch next to him. Her eyes are getting heavy, and she will soon be sleeping too. It has been a long three days. On Monday, when Pop started both chemotherapy and radiation, we thought we were prepared for any pain or nausea that he might experience. The problem came when the assigned drugs didn't help with the extreme nausea. There are only certain drugs that they can give to him, due to the fact that he is unable to swallow a pill, so their arsenal is limited. This led to extreme discomfort for days one and two. Finally, on day three they found a medication that knocks-him-out (almost literally), and helps to reduce the nausea. It makes him sleep immediately after administering it, and keeps him drowsy for several hours. While it may not seem ideal for the long-haul, they are simply trying to find a balance of drugs that will help him get through this process. Side-effects may alter, and medications will change, but Pop is wanting to fight. As he woke from one of his naps today, he smiled and said, "All I do is sleep, and get ready to sleep again." It is pretty much true, but if that is what it takes to get to the next step, he is willing. In fact, this evening when he woke, he was alert and even hungry...that's right....HUNGRY! We haven't heard those words in three weeks. We all laughed-out-loud when he requested mashed potatoes and roast beef. Once we realized that he wasn't kidding, Mom rushed to the kitchen and made mashed potatoes (I don't know that I would even call them mashed potatoes - more like thick milk) and we pulled out some leftover roast beef. Mom put it in a blender and made baby food (at least that is what we like to chide Pop about). Pop was actually able to eat a few spoonfuls, which was great to see (he was even able to drink a little ginger-ale)! After watching the birds for a while, and listening to Mom read to him, he was ready to sleep again. We're all celebrating this evening, and hoping that tomorrow will be similar. As everyone's eyelids grow heavy, there are smiles on each person's face. God's faithfulness is sufficient for each day we wake.

Getting ready for the Fight

After coming home from the hospital last Thursday, it has been an up and down roller-coaster. There are times when Pop feels well enough to sit up in bed, and other times when it takes considerable energy to lift his head from the pillow. Nonetheless, we sit with him as a family and tell stories, and laugh, and let him know of all the current "going-ons". He's been slowly gaining strength over these days in bed, and the feedings through the new j-tube (inserted in his small intestine) have been going well. They are trying to get as many calories into his system for the fight that lies ahead. Tomorrow morning we will be going down to the health campus for his first radiation appointment. We are praying that his stomach has healed enough, since he will need to lay flat on a bed (something he has been unable to do for the past 5 days) for 2 hours while they image the tumor for precise radiation. After that, he will be going to Lancaster Cancer Center for the start of chemotherapy. He is ready to fight. While his strength isn't where we all were hoping that it would be, it makes no difference to Pop. He is willing to do whatever is necessary to start the process. We were thinking of making a bathrobe for him to wear, you know the kind that a boxer wears when they enter the ring, but Pop put a quick end to that idea. Shocking, right? As he starts this battle, we pray for strength (both physically and mentally), endurance, health, healing, faith, and peace. We are able to do all things through Christ who strengthens us, and Pop is holding to that. Thanks to all of you as well for providing strength to Pop, and the family, through emails, cards, flowers, meals, and prayers. Your wave of love has embraced the whole family in a very real way.

We wanted to share with you too, one of the small miracles that has occurred along the way. If you have had the chance to talk to anyone in the family, you may have heard how we have had the chance to see God at work in all sorts of small ways. Here is one of those miracles: Shortly after Pop was diagnosed with cancer, and we realized the severity of it, Mom insisted that we try to get family photos as soon as possible, so that we had pictures just before Pop started getting hooked to a lot of different machines. So, we immediately called a good friend of the family, Kelly Lapp, who does professional photography, to see if she could squeeze us in on short notice. "I'd actually be able to get you guys in this Thursday evening, if that works for you," she said on a Tuesday. Amazingly enough, it suited everyone to meet at the farm that evening (and that's saying something to have everyone's schedules match-up). Kelly came and shot for a while, and we ended up have a great evening with beautiful weather. The very next day, Pop started spiking temperatures of 103 and was admitted to the hospital. He has been hooked to multiple pumps, or machines, ever since. As we think back on the events of the past 2 months, we can't help but see God at work. While the storm seem insurmountable at times, when we step back, with perspective we are able to see God orchestrating a plan. A plan far bigger than we can imagine. So, we'll rest in His grace and His love as we continue one step at a time.
You can find the photos from Kelly's photo-shoot by following the link below. We hope you enjoy them as much as we have :)

Link: http://kellylappphotography.com/2010/04/keefer-family/#more-1269

Back to Watching the Birds

Last evening Pop's pain started coming under control at the hospital. They are trying him on a few new drugs that will hopefully keep him from getting nauseous. To make his stay a little more comfortable (at least for the rest of us), they moved him to the oncology ward where there are suites for the patients and their families. This meant that Joel (who spent the night) actually has a bed to sleep on. Pop's abdomen muscles are healing nicely, but it will take a while until he is able to move around freely. With the improved pain-control, and the surgical areas healing nicely, the doctors decided that they would prep him for release this afternoon/evening. So, in celebration, two of us ran out and bought Philly cheese-steaks for everyone at 'Steak-Out' down the street (except for Pop of course, but we got his permission). At 4 o'clock we finally wheeled him out the front doors of the hospital and into the vehicle. He is now back in his "at-home hospital bed" in the front living room watching the birds at the feeder. We knew that there would be a significant amount of time spent in this bed, so Pop got himself a bird feeder and placed it right outside the window. "I never stopped to watch all the birds before, so I figured now would be a good time to start," Pop chuckled. He has always enjoyed nature, so it's fitting that he's enjoying this. It is a simple way for him (and us all) to be constantly reminded of God's beauty, splendor, and provision.

One Step at a Time

Yesterday morning we took Pop to Lancaster General for the surgery to insert his port, and his feeding tube. There were two separate doctors, one to insert the port in his chest, and another to insert the feeding tube in his small intestine, and we felt great about both of them (in fact, the doctor who inserted the port on Pop is the same doctor who did the colon-resection on Mom and inserted her port when she had cancer). The prep stages went normal (where you basically sign your life away, and say that it's okay if they leave a few rubber gloves inside of you), and he was whisked away to surgery. The doctor who was inserting the feeding tube came out when he was finished to let us know how things went. Often they try to do these surgeries laparoscopically (which means they use a small incision to insert a camera and tools to perform the surgery), but since it wasn't going easy for Pop they decided to use the "old school" method where they make a larger incision, to see what they are working with, and work manually with their hands. In the end, this was the best decision for making sure that the feeding tube was properly installed for the long-haul. In the short-term, however, it takes additional healing for one of the most used muscle groups in the body. The port insertion went off without a hitch, and the doctor was quite pleased with how things went. So, once we talked to the second doctor we figured we be heading back to see Pop shortly thereafter. Unfortunately, this wasn't the case. Due to the amount of medication that he is on right now, there is a delicate balance in the management of his pain. As to came out of sedation, his pain levels were extremely high. So began the process of figuring out how to get them under control without making him nauseous from the amount of drugs. When we finally got back to see Pop he was wiped out. He spent yesterday evening, and night, dry-heaving (which isn't helping the healing of his stomach muscles) and feeling nauseous. They are trying different pain medications, and anti-nausea medications, to see if they can get things under control this morning so that he can possibly come home. The amazing thing is that in the midst of all of this you can't take his humor away from him. As he sat dry-heaving in bed yesterday evening, there was a brief moment of peace, and he looked up with a grin on his face and said, "I don't recall this being part of the plan. I must not have read that section." Mom stayed up late reading him the Bible, and woke up by his side early this morning to continue reading. Please pray for continued wisdom for the doctors, and that Pop's pain would subside and become manageable from home. He wanted to say a huge thanks for all the prayers and thoughts. "It is these that keep me going," he whispers from bed. Thank you all!

Pieces falling into place

While the pollen is falling into the yard, and coating the driveway in a light greenish hue, Pop sits on the porch admiring the weather. He has been sitting here more and more often the past few days. He has energy to do about an hour, or hour and a half, worth of work, then he needs to rest. Somehow he is starting to see his boundaries, and is trying to keep his strength up for the coming weeks of chemo and radiation. Finally, the necessary appointments have been falling into place for him to begin treatments. Yesterday, Pop had his meeting with the doctor who will be taking care of his radiation. The doctor is great, and Mom and Dad were so happy to be under his care. For the first time since Pop's diagnosis, the doctor pulled out the PET scan and showed the family the tumor. It was strange for Pop and Mom to finally see it. As Pop put it, "Is that it? How can something like that cause so much pain and discomfort?" The doctor spent time helping to explain what was going on, as well as how the radiation would hopefully help things. The meeting was only meant as a consultation, but a cancellation in the afternoon gave an opportunity to start defining where the radiation was going to occur. So, they laid Pop down and started determining where they were going to be shooting the radiation. Now it is interesting how this is done. They will shoot radiation from different angles to try to hit the tumor from as many sides as possible. To know exactly where they are shooting, they made marks on his body with pens, but later with ink (Pop literally got tattooed). Us boys tried telling Pop that he might as well not stop there, but that they could move out to his arms and perhaps tattoo a road bike on his upper arm, or maybe the name Nancy (apparently they don't do those kind of tattoos there we were informed). The missing link, so that he can start treatment, came today. His port (where the chemo is administered in his chest) needed to be surgically placed, as well as his feeding tube (inserted through the stomach into his lower intestine). There was debate among the doctors as to the type of feeding tube that needed to be placed, but after some consulting (and persistent phone calls by Mom) the doctors came to an agreement that it would be better to place a feeding tube that allows for possible resection of the tumor in the future. This means that there will be a few more doctor visits, but next Tuesday Pop will go in to Lancaster General Hospital for a surgery to have both of these items placed at once. This will require that he stays in-patient for a day or two (which he was jumping up and down with excitement about, as you can imagine), but he should be ready to start treatment after he has recovered. That tentative start date is April 19th. We will be praying that Pop can have good health up until the surgeries, that both surgical procedures will go well, and that he is physically ready to start treatments on the 19th. Christ has walked every step of the way this far, and we know that he will continue doing so!

A path determined

Pop met with his oncologist yesterday for a "plan of action" consult, and to see how things were developing. Due to the tumor invading the hepatic artery, the best course of action was determined to be immediate chemotherapy (and heavy rounds of it) along with radiation. For six weeks, Pop will be hooked up to chemotherapy 24 hours a day, along with another drug (that is hard to pronounce, so we'll call it "sis") that will help to make the radiation more effective. The "sis" drug is quite powerful, and will only be administered until Pop's body can no longer take it. This is interesting, because the doctor looked at Pop and said, "Now we'll hit you hard with this until you say that it becoming too painful." We're all sitting there thinking, "Obviously you don't know this guy, or you wouldn't be telling him that, because he's never going to be telling you that it's too painful." Nevertheless, Mom will more than likely be the one telling the doctor (discreetly of course) that the medication needs to be stopped. The radiation will be administered 5 days per week. As we sat in the doctor's office and received the course of action, you could hear a collective exhale. Mom and Pop are happy to be have a direction to move in, but we all realize the extreme regiment that he will be on. What energy is left in Pop now will be stripped from him. The heavy doses of both chemo and radiation are meant to knock the tumor back, but a nasty side effect is that it will knock Pop down too. They did not paint a pretty picture of the road ahead, but we took the news in stride. Pop only grinned, and stated, "Well, let's get to it then." With that, the ball was set in-motion, and appointments for his port (a large IV, for lack of a better term (and medical ignorance), that is inserted into the chest and runs into one of the major veins near the heart, and is used for administering chemotherapy) surgery, radiation consult, and feeding tube surgery were all set-up. If everything can be done quickly, they hope to start chemo and radiation within 2 weeks. Of course with this news, Pop came home (with his pump bag in-tow) and crawled under the lawn mowers to make sure that he could get things fixed on them while he can still walk-around.
Today he is experiencing more pain, but enjoying having some small projects to tinker on. The weather was gorgeous today (up to 80 degrees), so he took time to sit outside and drink-in the sun. He'd stare off into nowhere for an hour or so, processing all that is going on. Trying to imagine how to rig-up a contraption that will carry his chemotherapy alongside his road bike :) It will be a bumpy road ahead, but with the prayers and support it is one that is walkable. We pray that this round of chemo and radiation will help to shrink the tumor, and that Pop is able to stay healthy. Thanks for your comments in response to the posts; Pop always gets a big smile as Mom reads them to him.

Feeling the Sunshine

After a restful sleep on Friday night, Pop was feeling good on Saturday morning. Every year Mom's side of the family (the Yungingers) gets together over Easter at a place called Charter Hall along the Chesapeake Bay. So, with family all being gathered together, Pop wanted to go down for the day to visit with everyone (okay, okay...maybe Mom helped him see that it would be fun...you know how he loves big groups and all :). He had a great time, and felt good enough for a fairly long walk in the sunshine. The cool breeze blowing off of the bay was a welcome scent. He sat with a grin on his face as he watched nieces and nephews playing frisbee in the yard. It was just the get-away that he needed. On the car-ride home, that afternoon, Pop caught up on the rest that he needed. Although the events may have seemed leisurely, physical activity and overall physical exertion tend to drain his energy (he'd never admit to it though). The rest in the car gave him good energy to watch the NCAA tournament that night. His snoring during the Duke vs. W. Virginia game made for interesting commentary.
Easter morning Pop was up bright and early to watch the sunrise. His bed is positioned in front of a large window on the first floor where he can see the sun come up. When he wakes at night, he also has a good view of the moon, which he frequently watches at it makes its way across the sky. Despite having some pain during the night, he very much wanted to get to church for the Sunday service. He and the family made it there and sat in the back row. As the congregation stood and sang songs of Easter morning, of salvation and hope, of the empty tomb, tears welled up and streamed from the corner of Pop's eyes. It's these moments that move us. When we are reminded of the price that was payed for us, and the gift that has been given, how can we keep from singing, crying, laughing, loving, and caring? The fellowship with people at church was a boost for Pop. We came home to a beautiful meal that Mom made, and enjoyed the company of Grandpa and Grandma Keefer along with Aunt Ann. After lunch, Grandma filled Pop in on all the going-ons of the past month, and saw to it that he was being well taken care of. Once the events of the day came to a close, Pop and Mom talked quietly in the living room (Dad's new bedroom), and she read him some cards and this blog for the first time. He's never said anything, but I can see in his eyes that he is still trying to decide what he thinks of this whole "blog thing" :). Well, a huge thanks goes out from the Keefer family for all the love and support that we have felt over this Easter season. May you all have a blessed day, and may we remember the incredible joy that today is all about!

Home for the holiday

This evening Pop made the trip home from Hershey Medical Center. While we were waiting for the visiting nurses to arrive, there was a period of time where Pop wasn't hooked to any medication pumps or tubes. So, what is the first thing he does? He climbed a ladder and tried to help move a couch. After a thorough "scolding" by his daughter (I don't think she knows how to properly administer a scolding, it comes across more like a joke), he was restricted to sitting on a couch or laying in bed. The visiting nurse arrived, and with the help of Megan and Mom, started Pop on his pump medications, while the rest of us tried to appear interested in the "medical language " that was being spoken. One of these pumps is for a substance that will act as a source of food into Pop's blood stream. Until they are able to do surgery to insert a feeding tube into his small intestine, this will be the primary way of his nutrition. Pop's spirits are high, and he is happy to be home. The change of pace has tuckered him out, so he is quietly sleeping in the neighboring room. It is good to see him regaining strength. He's already talking about getting on the bike to start training again!

The journey to this point

On February 10th, our family took a trip to Australia to pick-up Joel after his time in YWAM (he had an amazing time by the way:). We had a wonderful trip. While we were there, however, Pop started experiencing difficulty swallowing food. Once we returned from the trip, an endoscopy was scheduled, and on March 8th a cancerous tumor was found in Pop's esophagus. A barrage of test were ordered, with a follow-up ultrasound the following week. The ultrasound revealed that the tumor was outside of the esophagus, and was lying on the liver and pancreas. This categorized the cancer in advanced stages. Another round of testing was performed, and Pop started meeting with an oncologist (cancer doctor). Here they devised ways of treatment, and explored what options were available. Due to the rarity in the type of cancerous cells, treatment was put on hold until the family could speak to a surgical group at Hershey Medical Center who specialize in cancerous tumors of the digestive system. Shortly after the consultation with this specialist group, Pop began spiking high temperatures. This landed him in the hospital on March 27th, and he has been there since. On Tuesday, March 30th his temperature finally broke. He is feeling much better, and has been able to get out of bed and walk. They are hoping to have him home for Easter!

The specialist group met with the family yesterday to inform us that surgery is not an option at this point. The tumor has grown to a point where it is involving an important artery called the hepatic artery. So, they will try to get Pop to the point where he is healthy enough to undergo chemotherapy to see how the tumor responds. Between 10-20% of these tumors respond by shrinking in size, so we will see once chemo starts.

We continue to place the situation in God's hands. We know that He is in control and we rest in His peace. We could not walk this journey alone, so we thank all of you for being by our sides, and above all we thank Christ for being with us each step of the way.

A huge thanks to family and friends

We wanted to take a second to thank everyone who has reached out to share, pray, work, and walk alongside our family as Pop walks through his journey with cancer. We think of all of you as family, so we wanted a way to share this journey with you. It can certainly be a difficult road to walk down, but it is filled with miracles along the way. We will update the blog every few days so that you can be a part of Ken's race. We love you all, and your love and support means the world to our family.

P.S. - In the blog, the name Ken and Pop (Ken = Pop) are synonymous. We as kids call him Pop. Just clarifying so there is no confusion :)