Depression and the Presence of the Lord

Posted on: Fri, 07/27/2018 - 12:07 By: akpratt
Nothing like a Sea Fuego dahlia to lift depressed spirits

It's not that there hasn't been much to write about - because there has been lots. It's not that there hasn't been time - because other than Evan's visit last week there has been lots. But when you feel like crap and are struggling to eat - somehow writing just seems to fade into the background. At any rate accept my truly Canadian apology. I'm sorry for keeping you waiting this long.

On Sunday Jeremiah was read and I went home and read the whole book again.  Jerry has always been my favorite prophet, colorful and bold. Over the years I have taught several Bible studies on him and his struggles. He struggled with depression and that is how I was feeling. In Chapter 20 he begins describing all the ways God has abandoned him and then he says this - in the Message:

11 But God, a most fierce warrior, is at my side.
    Those who are after me will be sent sprawling—
Slapstick buffoons falling all over themselves,
    a spectacle of humiliation no one will ever forget.
12 Oh, God-of-the-Angel-Armies, no one fools you.
    You see through everyone, everything.
I want to see you pay them back for what they’ve done.
    I rest my case with you.
13 Sing to God! All praise to God!
    He saves the weak from the grip of the wicked.

That phrase "He saves the weak" I lean my full weight on that.

When I last wrote I had just completed my last chemo treatment. I would be lying if I didn't say I was glad to be done. It wasn't so much the drugs themselves but the side effects of the drugs given to manage the side effects.  And that didn't get any easier. Constipation. Hiccups. You know the drill.

When I finished radiation on July 10, the hand-written thank-you note seemed hardly enough to thank the technicians I had been seeing every day. Fortunately the ones I had seen the most were there and I was able to give them the origami peace cranes that I had managed to fold the previous week. (Though Amin insisted they were pterodactyls, he also insisted that BCHydro was treating me when I asked about the nature of beams being used in treatment.) I was expecting more of a feeling of - oh I don't know what. Celebration that it was done. Maybe. But I will almost certainly be back. Certainty that the treatment was successful?  Nope. Won't know that till six weeks out. So the middle of August. Or just relief that this daily interruption to whatever I was doing was done. Not even that. Actually kind missed the daily routine of picking up my paper and starting the Suduko or the crossword.

I met with Dr. Lund who explained that he would see me again in the middle of August to determine the success of the treatment. And he carefully went through all the side effects that I was experiencing and explained that they would slowly get better over the next two weeks. He also was greatly concerned by the lump on my back, seeing the same flecks in the PET scan that Dr Johal had seen.

I managed to keep some normalcy of schedule by going for my biopsy and aspiration of the lump on my back July 11th. The doctor removed a small vial of liquid from the lump. He was pretty convinced it was an infection and almost didn't do the requested biopsy. Over the weekend it slowly got redder and angrier, developing white pustules on the surface - though not near the biopsy site itself. I called the oncology nurse phone line and she suggested after reviewing my chart that I see my family doctor.  I went to see Dr. Walter - my family physician - and he was able to give me the results of both the biopsy - negative and microbiology - Staphylococcus lugdunensis.  A skin commensal organism that rarely causes infection and will often clear up on its own. On Thursday I saw Dr Johal and he sent me to Emergency - my family doc was now on holidays - to have it drained and antibiotics prescribed. A great bloody mess of a hand towel was made and the site was as flat as a pancake. Antibiotics prescribed and four hours later I walked out a relieved man. Until I realized that the changing of bandages was going to be a true test of my asking for help. I survived and it is healing nicely.

And so began the period known as recovery. I have survived the first round of treatment and I am still standing. I was warned that this would be a rough period. And it was. The blood tests done when my abscess was drained confirmed the chronic fatigue that I was feeling. While my white blood cell counts were up, my red blood cell counts were at their lowest levels yet.

Evan came for a week, spending a good chunk of his precious leave from the military with me. We had been planning some outdoor activities - maybe even some camping. Didn't happen. I sat in my chair and we talked. He played his guitar - highlight of the trip for me. Kid is good. I promised I wouldn't share the video that I took on social media but ask me and I'll be happy to play it for you. And he changed my bandage for me - not really his thing but he did pretty well. Cooking and cleaning. Keeping me eating and even the occasional cup of coffee. I'm lucky to have him for a son.

I finally made it back to church this past Sunday. There were a few hearty handshakes and some great hugs (careful with the back!) as I snuck into the back. Soon tears are rolling down my face at the invocation, the hymns, the absolution. Just the wonderful rhythms of the liturgical service touched me deeply. After the sermon, came the sharing of prayer requests. You kind of have to say something when the pastor stops his panning of the congregation and looks at you. So " Round one is over and I'm still standing." And the church breaks into spontaneous applause. Now this is a Lutheran church. For a really great choir number they might politely clap - once or twice a year. And the tears are really going now. I managed to share my prayer request which is for the next phase - breast surgery and meeting the next day with my breast surgeon. Truly an amazing experience of the wonder and support of God's people.

And that brings me almost up to date. My meeting with my breast surgeon was interesting. She and the navigator nurse had been speaking of me just the week before and wondering where I was at and  what was happening. Unfortunately she hadn't spoken to my oncologist so she was wondering what his expectations were. She did check the two breast tumors which have shrunk significantly with the chemo and decided that reimaging was the first order of business. That is scheduled for Friday, July 27 via ultrasound. She was wondering out loud about lumpectomies. I suggested that I really didn't want to be looking over my shoulder at breast cancers while navigating lung cancer. And right now I'm pretty healthy - a good candidate for surgery. In a few months that may not be the case. So I think that we are back to radical mastectomies. The remaining question is lymph nodes. Do we take sentinel or not? On one or both sides?

And the next stage in the lung cancer treatment? I meet with Dr Lund and Dr Johal on the 14th and 15th of August to see how successful the treatment so far is. Amazing to me that a simple Xray will give them the information that they need at this point. They are planning to start me on a new immunotherapy drug.

To that end I had a call earlier this week from the "Drug Navigator" - a really cool title for a really  difficult job. She was letting me know that she has applied for compassionate access to Imfinzi. Imfinzi is only recently approved for use in Canada. And indeed can't be administered by the Cancer Agency but will require going to a private infusion clinic. It is part of a new class of treatments for cancer called immunotherapy. It basically helps the bodies natural immune system to attack cancer cells - something it doesn't normally do. The challenge is that it can also attack normal organs. The greatest risk however is that it can cause allergic reactions and strokes. However I'm excited about the potential. My radiation oncologist described it as the greatest change in cancer treatment since he left medical school. Which begs the question "How old is he?" and my answer is "I don't know."  As I wait for the drug company interview I'm sitting on the edge of my chair, jumping every time the phone rings . More waiting.

One of the jumps for the phone ringing was to give me my appointment with the cancer genetics group at the end of August. My breast surgeon let the cat out of the bag, saying that she had seen a note somewhere in my file that there was a rare genetic mutation found. And that it would have significant implications for family screening. More on that as it unfolds.

The blog is up at and is slowly being populated with content. Some of it is these newsletters but some of it thoughts on cancer and treatment. And some of it resources that I have stumbled across. There is also a connection to my social media accounts on Facebook, Twitter, and Instagram.

Another prayer supporter asked a question that I hadn't thought about much. "Do you have a favorite wild animal, one who brings you strength and comfort?" I thought about the question for a week or so. It really became a trip down memory lane. Here are parts of my answer:

What immediately came to mind was a small band of about 30 to 35 woodland caribou that I encountered on a trip in northern Saskatchewan. Known as the ghosts of the woodland, I had seen a few solitary animals in my travels but as I sat and watched till they passed  I was struck by the way they seemed to effortlessly glide over the snow. I didn't know the significance of what I had seen till several weeks later I was at a forestry conference and they were talking about indicator species for planning forestry cuts. The biologist made the point during his talk that one of the problems was that they really didn't know how many woodland caribou there were in Northern Saskatchewan. It could be 30 or 300 or 3000. I might have actually seen the total population of the animals in Saskatchewan! I learned talking to him afterwards that the estimate is that there are about 1,000 animals. But that was the biggest herd sighting that he had learned of in a long time. And it was in a place where they didn't realize there was even a herd! For me it became a reminder of the fragility of the ecosystem  and the humility of scientists being able to say "We don't know."

But when I settled on a memorable animal it was one that I have only seen once in the wild. I was inspecting a blueberry patch that Saskatchewan Agriculture was managing in a logging cutover in an attempt to increase  production. I stopped for lunch near the edge of the cutover where there was a pile of slash. I had just sat down when I felt that tingle that tells you that you are being watched. I was thinking bear and prepared to move slowly back to my truck when I spotted the lynx. Amazing. About ten feet away, neither of us felt any threat. We watched each other for a few minutes and then he turned, stepped toward the slash and was gone with a bound. These days I would have a cell picture to record the encounter. Maybe.  Even now the tufts of hair on his ears and the golden glow of his eyes are indelibly etched in my memory.

I'm not sure that I look to animals for strength and comfort - well maybe dogs at least for companionship. But I see them as an amazing part of God's creation to be respected and admired for their resilience in the face of all that mankind does to their habitat.

The chronic fatigue depression is passing. I'm back to eating salads and good meat and enjoying the abundance of Pacific North West fresh fruit. The Lord is good!

Thank you for your continued prayers and interest in this journey.