The Final Chapter

It's been 17 days since Cheryl died. The funerals were both beautifully done. The care and concern I've received from family and friends has been amazing. I am thankful for all the kind words from every one that I have encountered in this two and a half weeks.

Some folks probably don't know what to say at a time like this and that's okay. I, we, my family, community and church have suffered a loss but we can not allow ourselves to dwell in the depths of despair. I understand that death and loss are also a part of life.

I am a better person for having known Cheryl and being married to her for 32 years. Cancer didn't defeat Cheryl, it just won out over her body. Her soul is eternally secure with the Lord.

Those of us that are left behind will go on living. We'll have a hole in our hearts where a bubbly 4' 10 1/2" lady used to be but we'll go on living.

I pray that the rest of my life will be as happy as the years we had together. I'm choosing to reach for joy instead of drowning in sorrow. I encourage you all to do the same.

Farewell my sweet lady, thanks for thirty-two good years of marriage.

A New Beginning

This has been an incredibly taxing six days. After Cheryl passed away on Wednesday, I had to go to the funeral home on Thursday to finalize the arrangements.

The visitation Friday was well attended and I saw many dear friends that Cheryl and I have made over the years. There were well over two hundred people in attendance at Saturday's funeral service at Westside Baptist. From North Carolina, Cheryl's mother, three of her four sisters and both of her aunts were able to be here for both the visitation and the service. My son Jason and his very pregnant wife Sharon were also able to attend the funeral. My co-workers and my second family at the Board of Education were so kind to prepare a marvelous meal for the family and out of town mourners after the service.

I left for Thomasville after the meal and waited for word as all of the out of town family made their way to their overnight lodging. We had about seventy people at the Sunday afternoon service, about half of which was family. Michelle, Chris and their three kids made it in from Kentucky, Jason and Sharon traveled across the state and met up with Sharon's mother and Dylan, Chris's mother and two sisters came in from North Georgia. Of course, my mom was there since she is like Cheryl's second mother, my brother and all three sisters came in from the area and even my niece Melanie (the proud wife of a US Marine) came in from North Carolina with my great-nephew and one of her friends. My loving church family from Summerhill Baptist also prepared a feast for us after the graveside service.

One couple of special note that attended the visitation and both funeral services were our dear friends, Claire and Woody Reade from Grovetown, GA. They were Cheryl's stand-in parents at our wedding 32 years ago and we have remained in close to them all these years.

Cheryl was buried near my father in Sunset Memorial gardens in Thomasville, GA late Sunday afternoon. Both funeral services and the graveside service were beautiful. Dr. Tracy Brinson (Hinesville) and Rev. Mitch Clements (Thomasville) both did an excellent job of capturing the sort of woman that Cheryl was to us all.


Thank you all for your kind words, postings here and on Facebook, cards, flowers and participation in the celebrations of her homegoing. I covet your prayers for our entire family as find a new beginning in a world without Cheryl. She will be sorely missed, she will not be soon forgotten.

The End of the Journey 1/11/2012 - 2:10 PM

At 2:10 PM this afternoon, Cheryl took a deep breath and lifted both of her arms and reached out her hands for a moment. She then folded her hands and exhaled gently. Thus ended the life of a precious godly woman.

We will have two funeral services for Cheryl.
In Hinesville, we will have visitation at the Thomas Carter Funeral Home from 6-8 PM Friday (1/13/12) and the service will be Saturday morning (1/14/12) at 10 AM at Westside Baptist Church.
In Thomasville, we will have visitation at 2 PM before the 3 PM Sunday service (1/15/12)at Summerhill Baptist Church(Boston, GA). Interment will follow at Sunset Memorial Gardens, Thomasville,GA.

I appreciate all the prayers, calls, cards and notes of encouragement you have given us during this eighteen month journey. My prayer for each of you is that you can have the peace from God that enabled Cheryl to leave this life without fear. Make sure that you let the people that matter to you know that you love them.

My final prayer request is for grace and strength for me in the days and weeks to come as I adjust to life without Cheryl. God entrusted me with a very special lady and I thank Him for our 32 years together.

She's Still With Us

We have watched and waited today for the Lord to come and take Cheryl home but somehow, she is still hanging on. Her breathing is shallow and she does not respond to sound, light or touch. The hospice social worker came by today and we discussed how quickly she has declined. He assured us that many patients do go through this process and seem to stall out on their way. He also told us that hearing is the last sense to cease functioning. We are still talking to her and have let her know that it is okay to let go.

My mom and sister are still here with me and have been a great help in watching over her these past couple of days. We are all tired but we know that we will be able to rest soon enough. Pray for our strength and Cheryl's easy passing on to glory.

It Won't Be Long

Cheryl is slowing down. Her breathing is short and shallow. She is still on oxygen and we have kept her medicated enough to keep her pain in check.

I will be surprised if she makes it through today.

Please pray that she will pass peacefully into our Savior's arms and that I will have the grace to let her slip away.

When her time comes, I will need to make phone calls to hospice, the undertaker, our immediate family, my church, work and community contacts so please know that even though I want to personally call and talk to each and every one of you that have gone through this ordeal with us, I will not be able to. My church prayer chain and neighborhood coordinator will spread the word and after I have family notified, I will make a short post here.

I thank God for all the love and support you all have given us during this 18 month ordeal.

Rapid Decline is Difficult to Witness

Since going into hospice care this past weekend, Cheryl has experienced a rapid decline. Her vision is getting more and more blurry, coordination and strength are waning. By Wednesday evening, she was almost too weak to walk to the bathroom with assistance and on Thursday afternoon her right leg collapsed while we were trying to get her up. The nurse came and inserted a catheter to reduce the necessity of getting up to urinate and gave us some hints on how to help her move for other needs. The nurse did an assessment of her overall condition and consulted with the doctor about doubling Cheryl's Fentanyl Patch to try and get her pain under control. She also made a recommendation to put her on oxygen to make breathing easier.

Last night was a bit disconcerting as she lay perfectly still for seven hours with only shallow breathing letting us know that she was still hanging in there. This long period without being disturbed also had its drawbacks as it took us well over an hour to get her pain under control once she did awaken. Her oxygen machine came in this afternoon and it does seem to help appear a bit more relaxed. It is getting increasingly difficult to get her to take oral meds, since she is having some trouble undertanding what we are trying to do for her.

Family visits do seem to cheer Cheryl up. Michelle and the kids left before midday today and then her two sisters, Joy and Audrey drove down from NC with our dear family friend Elaine. During Cheryl's lucid moments, she is still having reasonably clear communication but these seem to be coming further and further apart.

I had a telephone conversation with her nurse this afternoon and she told me that it appears that Cheryl's body is beginning to shut down. The process varies from person to person, but we don't expect her to hold on much longer.

Please be in prayer that she will be able to talk to the family and friends that want to come by and see her. Also pray for peace for those that don't want to see her in such a state and want to remember her better days.

The kids, I and our families are each handling the grieving process in our own way, but by the grace of God, we know that He will carry us through.

Calls and Short Visits Welcome

We're getting settled into the hospice thing. We had an enrollment visit from one nurse on Friday and got Cheryl's hospital bed and table ordered for Saturday delivery. A weekend/night nurse came out Saturday morning and did an initial assessment on Cheryl and had to do some more data entry into the system. She made a few recommendations on bathing and mobility issues to help with her care.

After lunch, Jason, Sharon and Dylan called to let us know that they would be arriving shortly and then the hospice delivery driver called to say that he was on the way with the bed. I helped Cheryl into the bathroom to freshen up and stepped into the den to get things ready for the bed delivery. I'd only been away from her about one minute when she called my name and I turned to see that she had fallen in front of the bathroom vanity. After untangling her and the walker, I was able to get her back on her feet and settled in the recliner in time for Jason and the delivery driver's arrival.

Sunday went well for Cheryl, she is showing definite signs of weakness and is having additional pain in her lower back but we are able to keep things under control with regular doses of high octane pain meds. It was very difficult day for me as I ended our Sunday morning service by asking our loving church to grant me a leave of absence during this difficult period. They graciously consented and have offered to continue my salary. I am especially thankful that Dr. Craig Dunham is willing to step in and provide preaching and pastoral support for the church during my absence.

Hospice is still on holiday schedule today, so we have not yet had a visit from Cheryl's assigned case worker. The nurse that came out today checked her vitals and gave me some hints on helping Cheryl move across the bed more comfortably. Per the instructions we received from the intake nurse, we've been charting Cheryl's pain medication. Based on that, the nurse conferred with the doctor and they have decided to put her on the timed release Fentanyl Patch. This should avoid the peaks and valleys that she's been experiencing with the other medications.

Keep us in your prayers as we travel this final leg of the journey. We've had 32 good years of Home, great care at the Hospital, the nurturing of Hospice and the promise of Heaven. God has been faithful through each step along the way.

It's Time For Hospice

The past several weeks have been rough for Cheryl. As I posted earlier, we came home early from a visit with my family in Thomasville, GA because Cheryl was having intense headaches, nausea and double vision. Friday evening, we went straight to the emergency room in Savannah where they got her pain down to a tolerable level. On Saturday, the doctor called her in a prescription for steroids to reduce what they thought might be brain inflammation. Then on the Monday after Thanksgiving she was admitted to the hospital and was diagnosed with metastatic tumors in her brain and cancer cells in her spinal fluid. She took the first four of ten whole brain radiation treatments while in the hospital and then continued the remainder as an outpatient until December 12th.

During this whole time she has been on Dexamethasone (oral steroid) and various pain killers and endured their side effects. We have both noticed that she has been having increased difficulty in standing, her balance is poor and her muscle tone is poor. She's having to use a walker for support unless she is standing next to a piece of furniture or other stable object that she can hold onto. She's also been commenting that her double vision has been getting worse.

This past Friday, we took her in to the Low Country Cancer Center for a bag of IV fluids and that seemed to help the headache and double vision for a few hours but by Saturday afternoon, she was having trouble reading the scores on her football games.

As the week has progressed, she has gotten weaker and her vision has gotten worse. She is no longer able to read texts on her cell phone and she has trouble focusing well enough to send out texts or read medicine labels. Cheryl had an appointment scheduled for this Friday with the oncologist but I called in yesterday and described her condition and they told me to bring her in today at 2:30.

Dr. Negrea had a short talk with us, looked her over and reviewed her file and let us know that because she has carcinomatous meningitis (the cancer has spread into the lining of the brain and the central nervous system) that there is not much else they can do for her. They had talked earlier of doing spinal chemotherapy but he said that doing that or the alternative delivery of putting a port through her skull directly into her brain would not be effective for very long. At best, going through either of these procedures might add a few weeks of life and that both had a lot of potentially bad side effects.

Dr. Negrea told us that in his opinion, if it were himself or one of his family members with this condition that he would not opt for the treatment. He recommended that we get in contact with one of the local hospice organizations and make arrangements for Cheryl's decline. I mentioned that in my reading and research that I'd seen prognosis for survival at about three months and he agreed that based on his experience, that is about as good a guess as anyone could make.

Before we left, he hugged Cheryl with tears in his eyes and told us to hold on to our faith. Pray for grace for us in the days to come and also remember those that spend their lives caring for people that often don't have long-term survival.

As we figure out what we are doing we will continue to keep the blog updated. Cheryl is up to phone calls. Don't worry about disturbing her, if she is tired, she will let you know that she doesn't feel up to talking at the moment but most of the time she is really cheered up by contact with the outside world.

Together for Another Christmas

Hallelujah, we get to celebrate another Christmas together. We are so thankful for all of our family, church family, friends and neighbors and acquaintances from years past that have dropped by, sent cards, called at just the right time, given rides to treatments, brought over food and have posted notes of encouragement here and on Facebook.

We thank you for being there with us for the celebration of what we thought was remission back in March. We thank you for your continued prayers during her second chemo series. We thank you for continuing to pray and encourage us as Cheryl continues the battle against brain and spinal cord metastases.

Since receiving this diagnosis, she was put on oral steroids to reduce inflammation and went through ten days of whole brain radiation to kill the tumors and treat the lining of the brain. She has continued to battle nausea, headaches and intermittent double vision. Friday afternoon, she lost her balance and fell off the couch. Praise the Lord, nothing was bruised or broken. The owner of one of the local flower shops was coming to the door to make a delivery when this happened. He helped her get situated and stayed with her until I got home form picking up prescriptions on post.

We don't know whether the symptoms she continues to exhibit are caused by the cancer, after-effects of the radiation treatment, or the medicines that she is taking. Cheryl took her final dose of steroids on Christmas Eve and we hope that dropping this plus juggling her pain meds will help get her back on an even keel.

Cheryl has her next appointment with Dr. Negrea, the medical oncologist on the 30th. We should know more about the plans for her spinal chemotherapy after that meeting. I'm off this week, the laundry's caught up and the dishwasher works just fine so we should be able to spend some quiet time together over the next few days.

Keep us in your prayers as Cheryl enters the next phase of her treatment.

She's Not Glowing Yet

The weekend was rough for Cheryl with continued headaches and nausea. The local Wal-Mart pharmacists were able to track down and order the fast acting pain medicine that she needs but it won't be in until Friday. Until that time she is having to get by with ground up pain pills over applesauce to keep the worst of headaches at bay.

Yesterday she was cheered up by a surprise visit from our long-time friends Claire and Woody Reade. They spent the morning with her while I was at church and then headed home after lunch.

Today, Cheryl had her fifth dose of whole brain radiation (out of ten total). After the session, we met with the radiation oncologist to discuss how things are going. He is making some adjustments to the quantity and frequency of the steroids she has been taking for the past week. He wants to taper her down to a much lower dosage before she starts the next type of chemotherapy in her spine the week before Christmas.

We finished putting up our fall/Thanksgiving decorations today and have decided to do just some very basic decorating for Christmas. I assembled our tree that is lit with all white lights. We hung our 2011 ornament and an ornament Cheryl received from our friend Rachel. I made a simple paper ornament that has the words Faith, Hope, & Love printed across it that we hung facing in toward the den. Those are the things that we are holding on to as we enter the Christmas season this year.

We continue to covet your prayers for her recovery or at least for her to have freedom from the headache pain and nausea of the past few weeks. Don't just keep Christ in Christmas, keep Him in your heart.

Home from the Hospital--- Good News Bad News

When Dr. Negrea, Cheryl's medical oncologist came by to see her this morning, he let her know that she was being discharged today. That's the good news. Then he gave her the bad news. They discussed her condition and he told her that even though the preliminary report on the fluid pulled from the lumbar puncture looked okay, the cytology report showed that the fluid tested positive for cancer cells. He told her that this is the most likely cause of the continuing headaches that she is having since the tumors in her brain are so small.

He is going to have her continue the ten whole brain radiation treatments (she took number four today). Cheryl should finish up radiation on December 12th and then she will return to the Low Country Cancer Center to receive her first dose of intrathecal chemotherapy in the spine. She will continue to receive this chemo every two weeks. At this point we do not know how long they will continue with this therapy, but by God's grace we will handle it one day at a time.

She still has a persistent headache but it is much better than it was when she went into the hospital on Monday. The doctor sent her home with prescriptions for some strong painkillers, steroids and anti-nausea meds.

Please be in prayer for us as we continue to face whatever may come next in Cheryl's battle against ovarian cancer.

A Better Day

Cheryl had a much better day today even though she is still experiencing a lingering headache. The nurses all took note of her improved color and general appearance. She was able to eat three full meals and her nausea has substantially cleared up. She enjoyed talking to several friends and family members on the phone. To see and hear her chatting away on the bed, you would never know the seriousness of what she is facing.

The preliminary results of her lumbar puncture looks good, though they are still waiting the cytology report to declare the spine clear of any disease. She had her mammogram today, but don't yet have those results either. She had her third radiation treatment today and thus far does not seem to be suffering any ill effects from it.

When Dr. Burke came by today, he explained to her that the brain lining is also being effected by the cancer and the fluid that this produces is part of the cause of the headaches along with the tumors. If she continues to progress, he anticipates letting her go home on Friday but neither she nor I want her to leave the hospital before she is ready.

Please continue to be in prayer that the radiation treatments will be effective at destroying the tumors and giving her relief from her headaches.

Wednesday Update

Cheryl had a rough morning. Still fighting the nausea and headache, she only had a few bites to eat up through lunch time. They got her on an IV with fluids as the day progressed and this seems to be helping the nausea quite a bit.

They took her down for the lumbar puncture (spinal tap) today but we have not yet received the results of that biopsy. The good news is that she had enough pain meds in her that she barely felt the local anesthetic they gave her before doing the procedure. Cheryl did not have the planned mammogram today so we are expecting that to happen tomorrow.

Dr. Burke came by and spoke with her this morning and explained how rarely he has seen brain metastases with ovarian cancer. He said that she is responding well to the current course of meds and that we will know more about what is going on when we have he other test results. I went to work today so I did not have a chance to ask him any questions.

This evening Cheryl was able to eat part of a serving of mashed potatoes with gravy and about half a chicken tender. It stayed down and the fact that she was finally able to keep something on her stomach did perk her up a bit. I left out a little before 9 PM and she was already drifting off to sleep. I'm so glad that they are finally getting the headaches and nausea under control.

Please be in prayer that this improvement will continue. Also, pray that the results of the lumbar puncture will not show positive for cancer.

Day 2 Current Stay Update

The radiation oncologist came in this morning and told us that the MRI showed five small tumors in Cheryl's brain. There are two at the back, two in the middle and one in the front. He said that the largest is about the size of a Raisenette. The standard treatment is to do two weeks of whole brain radiation. Each daily session will last about 15 minutes. She can expect to lose her hair and may have some nausea and mild confusion. He checked her CT scans from last month and said the goods news is that the chemo appears to be working from the neck down and that her torso and abdomen show no signs of tumor activity.

They gave her the first radiation treatment today and will continue to do so until she gets out of the hospital. Then, she will continue daily (Monday-Friday)on an outpatient basis. Dr. Pederson (Radiation Oncologist) said that they usually have great success using radiation on brain mets and are able to stop the cancer's spread. They will do a follow up MRI in three months to make sure that they've got it all.

Tomorrow, she will be having a lumbar puncture (spinal tap) to check for cancer cells in the spinal fluid and a mammogram to make sure that it has not spread that route.

She is still experiencing a lot of nausea and headaches as soon as her meds wear off. I told the nurse that we can almost set a clock by her since she starts asking for the next dose right on schedule. The past several days have been really rough for nausea as she has gotten sick on almost everything she has tried to eat. She was finally able to keep down a bowl of soup at lunch and a little jello this evening.

Please be in prayer that the radiation treatments will be effective at killing the tumors in her brain and that the other tests will be negative and that the meds will keep the headaches and nausea under control.

Headaches and Hospitals

Cheryl went to see her oncologist,Dr. Negrea, this morning with another fierce headache. Along with that she's been having some nausea and even a couple of incidents of double vision. After a couple of hours in the office getting vitals and doing a basic exam, they decided to admit her to the hospital for further tests. Dr. Negrea wanted her to have an MRI and spinal tap along with any other test that these may point to and he has referred her for a neurology consult.

I had a brief conversation with the PA as we were on our way out and asked what they were looking for with these tests. She said that they are looking for brain mets (central nervous system metastases) or an infection.

We got into admissions at Memorial shortly after 1 PM. While there, they gave her some anti-nausea and pain meds. She finally got into a room shortly before 5 PM. The on call neurologist stopped by and did a couple of quick checks and said that the neurologist would review the MRI in the morning. Cheryl finally had her MRI done after 8 PM.

She's had several bouts of nausea today. It seems to be triggered by motion so we had the patient transport techs be very careful when taking her from place to place.

I left the hospital around 10 PM and she was settled in with the football game on. They had given her a dose of anti-nausea and pain meds and she seemed to be relaxing a bit.

Please be in prayer that the radiologist/neurologist/oncologist will be able to figure out the cause of the headaches and be able to find an effective treatment.

She is in room 435. The direct line is 912-350-5435.

Thanksgiving with a twist

We are most thankful to have another Thanksgiving together and to have been able to see our families during October and November. Over the past several weeks, since Cheryl finished her second course of chemotherapy, we have taken the time to travel and share time with our loved ones. We've visited Michelle, Chris, Jonas, Susannah and Abigail in Owensboro,KY, Jason, Sharon and Dylan in north Georgia, Cheryl's Mom, four sisters and two aunts in Rockingham,NC, and my Mom, four siblings and their families in Thomasville, GA.

Cheryl has been having a problem with headaches for the past couple of weeks and she has also been having intermittent nausea. The pain in her head worsened to the point that she asked me to call Dr. Negrea's office while we were visiting in Thomasville. The doctor's assistant told us to get the emergency room at Memorial Hospital in Savannah and have them do a head workup to rule out inter-cranial metastasis and give her something for her pain and nausea.

We cut our visit short and left Thomasville shortly after lunch and arrived at Savannah around 6PM. We made a couple of brief stops for Cheryl to get out and move around and we stopped by the house to swap out bags in case they decided to admit her.

She received a couple doses of high strength pain reliever and repeated doses of anti-nausea medicine before going down for a CT of her head. Shortly after 11PM, the nurse let us know that her status had been changed to pending discharge since the CT had not shown any visible tumors in her head. The doctor did say that a CT is not the ideal way to check for brain mets (cancer that has spread into the cranium) but that he was sure that Dr. Negrea would order additional tests after her appointment on Tuesday. We were sent home with prescriptions for two types of pain medicine and a relatively high dose of anti-nausea medicine.

After waiting a half an hour at the 24 hour CVS, we finally made it home just before 1 AM. During the night Cheryl took the first dose of one pain med found that it made her nauseous. We are now trying to juggle the combination so she will have a good dose of the anti-nausea meds in her system when she takes her pain pills.

Cheryl is still complaining about intense pain in the back of her head and we are hoping that the medicine that she is taking will hold it to a tolerable level until she gets in to see the oncologist.

Please be praying with us that the pain / nausea meds will work and that these symptoms that she is having are not caused by a recurrence or spread of her cancer.

A Change in Chemotherapy

Cheryl got a call from Dr. Negrea, (medical oncologist) last week to let her know that her CA125 marker had effectively doubled in the thirty days since her last round of Doxil/Gemzar. This usually indicates that the cancer is active in the body.

Today, she had an appointment with Dr. Burke,(gynecologic oncologist that did her initial diagnosis and surgery). We discussed what the doubling of her CA125 means. He reviewed her CAT scan from August and said that it showed no evidence of disease progression but since the doubling has occurred since then, he would like for her to have another scan this month to see if anything shows up.

He said that Cheryl will no longer take the Doxil/Gemzar combination since it is not dropping or controlling her count and that he wants to put her on a different regimen of Avastin and a daily oral chemotherapy. This will all need to be coordinated with insurance and she should begin this new treatment after Thanksgiving.

Please keep Cheryl in your prayers as this new drug does have a fairly high potential for side-effects.

Back Out in Public

Cheryl and I went shopping at the mall Friday afternoon and today, she was able to make it to church for the Homecoming service and fellowship afterwards. It was great to be able to see everyone and get caught up on goings on. Don't we make a cute couple in our color coordinated outfits???

We are praying that this will be the first of many weeks back in fellowship.

Chemo- Not Over Yet

Cheryl finished the second session of round six of her chemotherapy on Friday. She also had an appointment with the oncologist, Dr. Negrea. They discussed the fact that her count has not dropped as far as they would like so he is recommending that she continue chemotherapy indefinitely to keep the cancer at bay.

Since she is tolerating it well, he feels that this is the best course to follow. She will be able to go out in public again, attend church,do some shopping, etc as long as she observes reasonable precautions. The plan is for her to receive the same medicines that she has been on but it may take a bit for them to line up additional Doxil since it is in short supply. She will be on a flexible schedule so we can visit family and do some holiday traveling.

Pray that this new treatment plan will be effective and that Cheryl will continue to tolerate it well.

Round Six Underway

Cheryl had her first session of round six of chemotherapy on Friday. The session went well and she had an informative appointment with the PA. She also had a chance to show off pictures of our newest granddaughter, Abigail Rose Nebel.

Yesterday and today she has been extremely tired and feeling generally miserable. This coming Friday will be her final session of chemo so we are praying that it will have the desired effect and push the cancer into a lengthy remission.

Cheryl says that all of this is worth it since we are planning to go visit Abigail(and the rest of the Nebel family) in a few weeks.