Andrea's Journey - Email Excerpts

As many of you know Andrea was diagnosed with Thyroid Cancer on the 22nd of August. Our Journey actually began on the 23rd of July when a visit to the doctor revealed she had a lump on the right side of her neck. I have cut and pasted many of the updates we sent family and friends over the last 6 weeks and posted them here.
It has been a crazy ride so far and we know we have a challenging road ahead but we continue to trust God for complete healing. Please continue to pray for Andrea. She begins her radioactive iodine treatment on the 15th of October.

Andrea at home - 7 days post-op

I have a link to several pictures of Andrea's journey on Flikr. Click here to view photos of Andrea.

July 27

Wanted you to know that Andrea has been at the doctors this past week. She had a stiff neck, beginning 6 days ago, that wouldn't go away. She had a tick bite a few weeks ago so wanted to make sure it wasn't a symptom of Lyme's disease. They did some blood tests and examined her thoroughly. Upon examination the doctor discovered a lump on her neck (to the right of her esophagus-her stiffness was on the opposite side of her neck, in the back). The lump is not painful or sensitive at all, but it is visible when she holds her head a certain way. The stiffness has decreased quite a bit and we have no clue if it related or not. We saw an ENT specialist and got an ultrasound today. The ultrasound showed a large "abnormal" lump 35mm x 25mm to the right of her thyroid gland. We are going back to the ENT specialist on Mon eve. to discuss the results of the Ultrasound and blood tests. we will update you on the results. Please pray.

July 30

Just to keep you posted...

We saw an ENT specialist today to go over the results of the blood tests that Andrea had last week and the Ultrasound. All of the blood tests she had were negative...so that's positive! The ultrasound was inconclusive. It confirmed there is a large mass, 'nodule', on the right side of Andrea's neck inside of her thyroid gland and another mass outside of her thyroid which is abnormal as well. We are seeing a thyroid specialist on Wednesday am. He will do another ultrasound and possibly a needle biopsy. The needle biopsy - the doctor inserts a small needle into the abnormal area. A sample of tissue is removed and given to a pathologist who looks at it under a microscope to determine what the abnormality is -- for example, cancer, a noncancerous tumor. Andrea is very anxious about this procedure.

Thanks for your prayers.

August 1

Andrea had the biopsy procedure today. She was very brave but not too pleased and found it quite uncomfortable, but she did enjoy a hot fudge sundae afterwards! There are nodules in both sides of the thyroid - abnormal masses. The right side having a much larger mass. They are fast tracking the tests and we should know the results by the end of next week....so we wait again. Thanks for your prayers.

August 1 Thank you so much for your prayers--we really feel them. Things went really well today at the doctor considering being in a foreign country and going to a hospital that looked like we were back in communism. We continue to hope for positive results and pray for patience as we wait. We have felt remarkably at peace throughout this time and have just had a few moments of fear during the late night hours or early morning when it is all quiet and there is time to think. Andreas neck has been a bit sore today after the biopsy and she has been a bit tired and emotional. It was NOT fun watching her lying on the bed with this big needle coming at her throat. She had this look of fear in her eyes and then she closed them tight during the rest of the procedure. she sat there as still as can be and tears came to her eyes after it was over. She said it was very uncomfortable and felt like someone was choking her. It brings feelings and emotions to me that I haven't felt before.

August 11

We received news from the nurse at the clinic that Andrea's nodules are benign--NOT Cancerous. Great news. She confirmed that the doc's (both ENT specialists that we are dealing with) are on holidays till aug 30, but we will be able to go to the hospital to get the official results and just see a doc who is filling in while our guy is gone--on monday. the nurse was not supposed to really tell us anything over the phone, but she knew we were anxious to know, so she just said it was benign but couldn't tell us any more. We will keep you informed as we know more. Love you all and thanks for your prayers,

August 13

Last week we received verbal information that Andrea's condition was not cancerous. Today Connie and Andrea met with an endocrinologist to discuss the results and the treatment for her thyroid. He confirmed that she would need medication to control it... They were just about to leave the office and Connie still felt uneasy and didn't feel we had all the info we needed. She asked whether the medicine would also decrease the lump on the outside of her thyroid (the one we were originally seeing the specialist about). The endocrinologist said "what bump" he said there was no information on this bump in the report from the biopsy and ultrasound from the thyroid specialist. He did another ultrasound and immediately did another biopsy - this time getting the tissue from the lump outside of the thyroid. The doc was quite upset that there was nothing in the previous report about this lump…and all along we thought that was what they were testing. The results show that this lump is cancerous (without a formal pathology report). They are saying it is thyroid cancer and are sending it to the pathologist to determine which type of thyroid cancer.

August 15

It is now the end of our day and we feel we have taken some good steps. We were feeling uneasy about not having one doctor who was keeping track of all our result--like we had so many specialists and different people doing tests and worried that something would get lost in the shuffle. With this last set of results we are waiting for, the specialist told us to just call the hospital to find out. None of the people who answer the phones at this hospital speak english, so we were not feeling good about it. Felt kind of like we were floating around in no man's land. I went to the Canadian medical clinic( which has nothing to do with Canada by the way) where we usually go for medical treatment yesterday and found a doctor who was willing to help us. She has contacts with the top oncology doc in the hospital (Motol) and she spent most of the morning today making sure the docs at the hospital were following through with the proper tests. We should know the results of the pathology report in the next few days. This doctor said that we are not in this alone and that they would do whatever they could to help.. They will send someone along when we go to the hospital to do the translating for us. We also had our cleaning lady (and friend) , Alena here today and she has a daughter that we know well who just happens to work at the canadian clinic as a nurse. Alena called her today while she was here and told her our situation so Alenka (her daughter) phoned me and said she will also help and she actually spent the morning with the pediatritian , helping her. So, we feel we are in good hands. Hope this all makes sense.

August 16

Dear Family and Friends,
It is hard to believe that we are nearing the end of summer and beginning another school year. We would like to update all of you on what is happening at Riverside in this coming year, but have some other news we would like to share with you and ask if you will come together with us in prayer.

A few weeks ago we discovered a lump on Andrea's neck, right next to her thyroid. We have been to the doctor (actually 5 doctors) and are going through some testing to discover what it is. She had biopsy on her thyroid and it came back benign. They sent us to another specialist to decide on a plan for her thyroid which they said was enlarged. During this visit with the Endocrinologist discovered that the previous doctor had mistakenly not done a biopsy right on the lump itself. So, Andrea went through another difficult biopsy and now we wait for the pathology report again.

We have been going from one specialist to another and feeling uneasy about not having one doctor who was keeping track of all our results--concerned that something would get lost in the shuffle. With this last set of results we are waiting for , the specialist told us to just call the hospital to find out. None of the people who answer the phones at this hospital speak english, so we were not feeling good about it. It has also been difficult trying to understand what the doc's tell us because of the language barrier. We felt uneasy, so I went to the Canadian Medical Clinic (nothing to do with Canada by the way) which caters to the international community where we usually go for medical treatment yesterday and found a doctor who was willing to help us. She has contacts with the top oncology doc in the hospital (Motol) and she spent most of the morning yesterday making sure the docs at the hospital were following through with the proper tests. We should know the results of the pathology report in the next few days. This doctor reassured us that we are not in this alone and that they would do whatever they could to help.. They will send someone along when we go to the hospital to do the translating for us. We also had our friend, Alena (who is Czech) here today and she has a daughter that we know well, who just happens to work at the canadian clinic as a nurse. Alena called her today while she was here and told her our situation. Alenka (her daughter) phoned me and said she will also help and she actually spent the morning with the pediatritian , helping her put together all the loose ends. So, we feel we are in good hands now.

It has been a long couple weeks with all the waiting and wondering but have felt God's presence through it all. We have some supportive people around us here, and also appreciate the support of all of you back home.

August 21

Dear Family and Friends, Thank you for your prayers and support over this past week. We saw an endocrinologist this morning and reviewed the pathology reports of both biopsies. The biopsy indicates that the lump beside her thyroid is malignant and is referred to as Papillary cancer. This is a type of thyroid cancer that can be treated by having the thyroid and the lump surgically removed and then waiting six weeks at which time she will begin treatment with radioactive iodine. The doctor spoke English fairly well and we went through the information in English with her. Then Alena (our Czech friend and nurse) spoke with us and the doctor in Czech and translated for us. We are quite devastated by this news but also are reassured that this is a type of cancer can be treated successfully. It was very difficult to talk about this with Andrea. We know the prognosis is good but surgery and all that goes along with it is not a fun thing to think about. We have not scheduled the surgery yet, but will keep you informed once we have discussed the options with family and doctors. Andrea's favorite verse, which is written on a poster in her room, is found in Jeremiah 29:11 'For I know the plans I have for you, declares the Lord, "plans to prosper you and not to harm you plans to give you hope and a future." We have prayed this over her from when she was first dedicated as a baby, and we continue to claim this for her life. Thank you for your continued prayers.
August 27

Hi Everyone, We just want to begin by expressing how grateful and overwhelmed we are with the many expressions of love we have received and the prayers of so many of you. We apologize that we have not responded individually to everyone but hopefully these emails will keep you updated as to how Andrea is doing. We have continued to feel a peace that cannot be explained except by the power of Christ through the many prayers that have gone up. We had a very confirming appointment today with Professor Doctor Betka (his official title). Al, Andrea and I were in the waiting room, playing a game of dice until the Dr came. He walked in, introduced himself to Andrea and then began playing dice with her. She looked at me and giggled and so the meeting began. Dr. Betka was able to schedule a surgery time for us this Wednesday and Andy will go into the hospital tomorrow (Tues.) morning first thing for blood work and then stay in the hospital for surgery and recovery. We anticipate that she will be in the hospital for a week before she can go home. Then she will have six weeks at home with check ups in between to prepare her for the radioactive iodine treatment which will be at least two weeks in the hospital. Andrea is doing very well considering what she is facing. She is able to talk about what is happening to her and has asked many questions about the surgery and treatment. She is able to express her fears and disappointments (mostly about missing the first weeks of high school) but amazingly, she maintains a good sense of humour through it all. We have had lots of fun as a family and with friends this past week and really sense that God is going to do something good through this all. We have felt so much support from our friends here in Prague as well as family and friends from home and around the world. We will also be receiving help from some of our family members who are coming out to be with us. My sister, Cyndy, is arriving in 30 minutes (yeah!) and will stay until Al's parents arrive here on Thursday, who will stay until my (Connie's) parents arrive on September 16th. We are blessed!

August 28

I'm home from hospital and going to bed. Andrea was seen by several doctors and lab techs today. Blood tests, ECG, X-Ray, etc. She did well through it all. It was a long day. I was with Andrea and Connie until 11.30 or so and spent the rest of the day at work. Connie and Andrea watched a movie, made friendship bracelets and created picture frames. They avoided the hospital food and enjoyed a warmed up lasagna that I brought back. Andrea is in a room for two but she is the only patient there so Connie asked the nurses if she could spend the night. The nurses were very accommodating and allowed her to stay as long as she "was up by 6.00am, dressed and the bed made before the doctor came in." So Connie is spending the night next to Andrea. Andrea was very pleased. I will head back to the hospital by 6.45am. Spend some time with Andrea before they whisk her away to the operating theatre. We probably won't get to see her until Thursday am as they are very protective of ICU patients. That will be hard!

Andrea, Grandpa and Grandma - 5 Days post-op

August 29

Dear Family and Friends,

It is the end of a very long day here and we want to update you on how everything went.

The surgery was not standard as the doctors discovered the cancer was a more aggressive type of thyroid cancer than originally thought (follicular). Consequently, the surgery was more radical than they would have hoped. It lasted 6 hours and involved removal of the entire thyroid, the tumor, and all of the lymph nodes in the right side of her neck. Needless to say this was the longest and most painful wait we have every experienced.

The tumor was much larger than the ultrasound indicated and had probably been growing for several years. This tumor grew deep in the neck and surrounded the right "recurrent laryngeal nerve" - one of two nerves that control the vocal cords. This nerve was infiltrated by the cancer and a 3 cm section needed to be cut out.

The surgeon preformed reconstruction of the recurrent nerve by taking a section of another nerve in her neck and suturing it back together. This procedure is very difficult and very rarely performed. It was the first procedure of its kind (reconstruction of a laryngeal nerve using another nerve) performed at this hospital and the success rates are unknown. We are unsure what this means for Andrea. She will experience voice changes including hoarseness.

We are grateful for the team of surgeons and nurses who were able to perform such a delicate surgery and hopefully have removed all the cancer. We believe in miracles and are praying that God will do a miracle in Andy's body and the reconstructive surgery will be 100% successful and she will have 'her' voice back.

We were able to see Andrea for a few moments in Intensive Care. We will see her again tomorrow morning.

Thank you again for all your support and continued prayers.

First Fresh Air - 5 days post-op

Sept 5

Good Morning! (this is a long one, so you may need a cup of coffee)

Andrea has been making great progress these last few days and we are rejoicing because we have unexpectedly been able to bring her home from the hospital early. She was supposed to be in until Friday at least, but Prof. Doc. Betka came to see Andrea Monday night and said he was so pleased with her progress that he decided to let her go home the next morning.

Andrea is looking and feeling remarkable—we just give the glory to the Lord as we see she has experienced His healing touch over and over in this past week (skilled doctors, friendly nurses, His divine hand...). She is sooo excited to be home and continues to be positive and we are all enjoying her good sense of humor. She is walking around, playing games, sleeping well, resting, watching movies, checking her emails andygocrazy@hotmail.com, and of course, loving her new Nintendo DS—I think today she is even up for some reading.

Physically she is trying very hard to face the challenges of the changes in her body. Her voice has been improving and she is able to talk in a quiet, slightly raspy voice. We are grateful to the Lord that she is able to communicate. During surgery, one of her parathyroid glands had to be removed, which aids in absorption of calcium. The three remaining glands were not able to do all the work initially, but now they are now able to keep up her calcium levels. She has also had trouble moving her neck as it has been very stiff and sore. She began working with great determination –once the tubes were removed from her neck- to exercise her neck and she has made great progress (this is probably her biggest challenge right now). She has also been eating and drinking well and her strength has increased remarkably.

Pr. Dr. Betka examined Andy Tuesday morning and tested her voice. He was amazed at how well she was able to make certain sounds and asked if he could take some pictures of her vocal cords. He used a camera (only a few in the world) that takes 4000 frames per second and we were able to see how her cords moved as she made sounds. These pictures should help us to have a better idea of how she will be able to talk in the future.

Thursday morning we will be going back to see the doctor for an important check-up. We will be receiving the pathology report to see how extensive the cancer was. This will help us to determine what the next step will be in her treatment. What generally happens from here is Andrea will have to wait for six weeks at which time she will be given radioactive iodine (probably in the form of a drink). She will have to stay in the hospital for two weeks (by law) as she will be radioactive. Thankfully she should feel fine during those two weeks, so we have our challenges to try to keep her busy while she is in isolation.

The rest of the family is doing well. Mark and Sara are thrilled to have their big sister home. Andrea has to work hard to be heard amongst the hustle and bustle of daily life, but she is managing well. We are so grateful to still have Al's parents here who have been a big help and support to us all. Al and I are doing okay, trying to get through the ups and downs of each day. Al is still going in to work but it is amazing how the school has pulled together and provided such a support for us as a family and for Al in his work. Connie has been able to be home from work for now to care for Andrea. We are grateful for meals that have been provided, people who have offered rides, an extra car that we are able to use and many other ways that we have been helped by people here and back at home.

Prayer Requests:

• Andrea asked for prayer for when she stretches her neck that the stitches wouldn't feel like they are pulling out.
• That the children will have and extra measure of grace towards each other as they adjust to changes that are happening at home.
• Andrea's voice will continue to get stronger.
• That the doctors will have wisdom in knowing how to proceed with further treatment.

We continue to trust in the Lord that He will have the victory in all of our lives and that His glory will be revealed.

Thank you for all your support and the encouraging messages and phone calls. They have really helped to see us through this time. Andrea has enjoyed reading through some of the emails and is amazed at how many people are praying for her. She has been encouraged!

Andrea with her good friend Imogen - 6 days post-op

Sept 6

Just to briefly update you on Andrea.

We met with the surgeon this morning for the stitches to be removed and to hear the results of the Pathology report.

The results are not yet complete and we (without Andrea this time) will return to the hospital on Monday for further information. However, the initial analysis indicates that the cancer is more aggressive than was previously considered and that much thought will need to be given to the way forward, in particular with regard to her treatment program.

We feel we are on a bit of a roller coaster and really ask you to continue to pray for our family and especially Andrea. We will let you know more after we meet with the doctor again. This is a worrying time for us and yet we feel that God continues to have a plan for Andrea.

Sept 10

To our family and friends around the world,

This morning we had a difficult meeting with Dr. Betka, Andrea's surgeon, and he informed us of the results from her surgery. The chief pathologist analyzed her thyroid, lymph nodes and vocal cord nerve. He found that she has Insular carcinoma, is a rare type of thyroid cancer that is said to be particularly aggressive and is far more serious than papillary or follicular cancer.

In about four weeks time she will undergo radioactive iodine treatment to kill any cancer cells left behind after her surgery and to treat any thyroid cancer that may have spread. We are unsure, but she will most likely require follow up treatments in 6 months. The treatment uses a radioactive form of iodine. The iodine will circulate throughout her body in her bloodstream. Thyroid cancer cells will pick up the iodine wherever they are in her body. The radiation in the iodine will then kill the cancer cells. This is a targeted treatment. It will not affect other body cells as it is only thyroid cells that pick up iodine.

The treatment will make her slightly radioactive for a number of days, so she will be isolated until her radiation levels have fallen (usually it is a two week stay in the hospital). The time that we get to spend with her will be limited for our protection but she should be feeling okay during that time—possibly nausea.

The doctors are hopeful that the radical surgery that was performed and these iodine treatments will reap positive results. We of course trust God for complete healing.

It was difficult for Andrea to hear about the cancer being more serious and having to undergo more treatments. We are grateful that she is sharing her feelings and able to talk about how to deal with this challenge ahead of her. She has really put her trust in God and is eager to fill her locker at school and bedroom with scripture as she wants to surround herself with the Lord's promises. Andrea has been attending some classes at school and is very eager to get back into her regular routine. She loves school and being with her friends and seems to have the energy to be there for part of the day. Overall she has been very positive and has handled things with incredible maturity. Dr. Betka said today that she was one of the best patients he has ever had.

We have also shared with Sara (to a point that she would understand) and Mark. Mark responded right away with "I know she is really sick, but I'm not going to cry because I know she is going to be healed".

We asked Andrea if she had any specific things she would like us to pray about, and she said, "that all the cancer cells would be gone", and we also ask that you pray for her as we have to massage in a special ointment onto her incision that hurts and smells 'yucky'.

Thank you all your prayers, encouragement, and practical help.

Andrea with Nana and Papa

Sept 19

We met with the Head of Nuclear Medicine and Endocrinology, Dr Vlček, this morning. We had a friend who speaks Czech join us in the meeting to ensure that nothing was lost in the translation.

We have a much clearer idea of the treatment program that is planned for Andrea. We learned that Andrea will go into Motol hospital on Monday the 15th of October and stay for two weeks. From the 15th to the 17th she will undergo several tests - accumulation test, scintigraphy, blood tests and ultrasound that will help the doctors determine the appropriate dosage of radioactive iodine to administer. We are allowed to be with her during this period of diagnosis.

On Thursday, the 18th of October Andrea will move to an isolated room and will be given her radioactive iodine (RAI) drink. As she will be slightly radioactive the time that the staff spend with her is limited for their protection and we are not permitted to visit her for five days. During this time of isolation she will have access to a phone and be able to watch movies, etc. We are hoping to send in a laptop and establish communication through Skype and MSN. After the five days of isolation we will be able to see her for short visits each day – to begin with only 10 minutes each within 24 hours. We hope her radiation levels will be low enough to begin to see her for longer periods of time during her second week in the hospital.

Two weeks prior to her treatment Andrea will have to go on an iodine free diet. This essentially means cutting out fish, kiwi, salt, dairy and anything that has iodine in the ingredients. We will have to come up with some creative cooking!

Andrea's incision is healing well. We massage the area a few times a day with cream. It is a bit uncomfortable for her but the area is slowly getting less tender.

Andrea is very anxious (as are we) about her time alone in the hospital. We are thinking of creative ways for her to occupy her time and will make sure she is out-fitted with books, entertainment, and crafts…we will try to slip in a bit of homework here and there.

We continue to marvel at how well she has recovered from surgery. Today after dinner she broke out in song, singing "On Top of Spaghetti…" What a miracle…the doctors were not sure if she would ever sing again! Her voice seems to be getting stronger but she has difficulty speaking in a loud voice or for long periods of time. She is able to attend school about ¾ of the day and tries hard to get her homework done. She is eager to participate in physical activity but still has to take it easy and is very tired by the end of the day.

Once again we value your prayers and continue to experience God's grace as we walk this journey together.