Erica started a new treatment on Friday, Avastin, a medication that is expected to stall any potential tumor growth in her brain while controlling swelling and hopefully reduce some of cognitive symptoms she is experiencing. If there are no adverse effects, she will restart her Enhertu chemo treatments in three weeks along with the Avastin. This is good news because we know that the Enhertu was effective, it is radiation effects and swelling that have been her most recent battle.

It seems odd to say that a treatment day feels like normal routine, but there was something comforting to both of us as we checked in to the doctor’s office, got a thorough check up from our regular PA and found a familiar seat in the treatment room. (Erica gets the comfy reclining chair while I sit in the tiny side seat). Normally, she is about two hours for blood tests and treatment. Today, she was in the chair for 5 hours. The first treatment of any new medication takes extra time as they do extensive blood tests to be sure her body is healthy enough to receive these strong meds, followed by a slow drip of the new drug in case she has an immediate reaction. Praise God that her check up and fluid tests revealed a generally healthy body and we can proceed with the plan.

Typically, Erica naps while I work remotely with my laptop and phone. Conversations can be awkward because treatment rooms are usually open spaces shared with other treatment patients. But on this day, we were a bit more chatty as we were remembering some experiences from her physical therapy stay. Many of which, when played back in memory are pretty funny if you allow for a sense of humor. Stories about the kind-to-a-fault roommate, random wandering, the occasional bathroom mishap… Anyone who knows Erica, knows that her laughter is a gift. It is contagious.

Honestly, most of the time Erica was impatient or asleep. But I like to believe that those brief moments of laughter inspired the other treatment patients, their partners and nurses – just as they did me.

I read a Facebook post recently that touched too close to home. It was simultaneously difficult and inspiring.

“Your spouse is the one who’ll sit beside you when your parents die. Who’ll hold your hand through childbirth? Who might have to bathe you if you’re too sick to stand? This isn’t just about butterflies or date nights. It’s about choosing someone who shows up – in grief, in mess, in uncertainty. So no, I don’t believe love alone is enough. Commitment, maturity, and the ability to endure life’s ugly parts – that’s what sustains a marriage. Because when life gets painfully real, romance won’t carry your character. And the truth is, forever is only possible with someone who knows how to stay when it’s hard to love.” – copied from and unknown author.

While there is a lot of truth in this, I propose a different perspective.

True, romance will not carry us through this broken life’s challenges. But romance is not love. At best, it is only one manifestation of love. Love reveals itself in many ways, romance being one – commitment, maturity and the ability to endure life’s ugly parts is another. But what if we looked at romance differently during tough times? Is it not romantic to hold the hand of a loved one in a hospital bed until she falls asleep or to wheel them from their beige room to the hospital cafeteria for a dinner date? Do we do this out of commitment or out of love?

It is love that bears all things, believes all things, hopes all things, endures all things (1Corinthians 13:7). The irony in the statement that “it is hard to love” is that it is love itself that carries us through the hard times.

I have had the difficult privilege to observe several family members be the caregivers for their spouse. I reflect on and am inspired by their examples of commitment every day (special thank you to those who are reading this). But I am now fully aware that their commitment could only have been driven by love, albeit a hard and sometimes painful love. So I challenge the Facebook post, that commitment, maturity, and endurance is what sustains a marriage.

Perhaps, love alone IS enough.

Speaking of close to home… Erica comes home from the hospital today. Her first time home since May 16. Yay!

Eleven-thirty a.m., Thursday May 29. I was working in my office when I receive a text alert… from Erica James. A simple, “Good morning”. My heart skipped a beat with excitement. Did Erica really text me?

A sudden feeling of normal washed over me. 11:30 was about the time Erica and I would text each other on healthy days. Except for her teaching years, Erica was never an early riser. Her philosophy was always, “if I don’t have any reason to get up, then why should I.” Her happy place was morning in bed under a soft blanket. She did more work from her phone in bed than most people do in the office.

But today, this sweet text brought a wave of hope. I knew that this was not just her first text of the day, but her first text to anyone since mid-March. Her speech therapist had just told me the day before that they were working on her communication skills and relearning the phone. This was for safety – if she has an emergency, who would she call? Those two small words, “Good morning,” said so much. They told me that she is trying. Following instruction and working so hard to do the simple things that we all take for granted. Tempted to send a long reply of praise, I opted for what she would find most familiar, my standard reply, “Good morning, Sunshine.”

Erica is now walking 300 continuous feet with a walker and climbing 12 steps using both handrails. She is easily feeding herself (and eating way too many Mike and Ikes). She tells me that every action is not physically tiring, but mentally. She has to think hard about every move. She is fighting. But as Erica always has, she is doing it Erica’s way.

Four days into In-residence Physical Therapy, Erica is thankful for the food and her new friends. The food being far more edible than the previous hospital, it actually is very good. Her appetite, enhanced by steroids, has her often requesting seconds. Her new “friends”, the trainers and nurses, have already learned Erica’s quirks, specifically, that she needs two vanilla ice cream cups between dinner and bed.

We already see improvement in Erica’s cognition and mobility. She is able to feed herself, move from sitting to standing on her own (with balance assistance) and is taking longer strides while using a walker. Her conversations are much more complete – usually including a statement about how badly she wants to go home. But she’s not ready yet. More work to do. Ten more days.

Six nights in the hospital. Five days in a ten by ten beige room waiting for a doctor to tell you if your worst fears are valid or not. This room is stripped bare and will reduce anyone to their lowest emotional point. Only thirteen channels on the TV projecting sound from tiny holes in the same remote that has the nurse call button. In the corner are two stiff chairs that discourage guests from staying too long. Conversation is limited to Erica’s condition unless someone intentionally changes the subject. This is the most uninspiring room for someone who needs to be inspired. It is easy to forget the comforts of life when everything around you reminds you how fragile life really is. It’s a wonder anyone ever gets better in the hospital. I’m just the spouse and I feel worse for being here. Erica is going stir crazy and just wants to be home. I guess this is a good sign because her energy and awareness are up enough to get pretty emotional about it.

Unfortunately, Erica is not going straight home. She will be transferred to In-patient Physical Rehabilitation Care at another hospital for the next two weeks. This is definitely worth celebrating because it means that the doctors and therapists believe that she can get better. But it also means that she will have to work and want to get better. Erica is weary and I feel it with her. The past two months have been a roller coaster seeming to have more downs than ups. And the past two years have taken a toll on her body. We are learning that all of the radiation and medication is having a lasting effect on her brain. Her treatments moving forward will need to be carefully coordinated between the radiation and medical oncology teams. But we can praise God that currently, the treatments have been very successful in fighting the tumors in her brain. Many are gone or reduced to a size so small there is no immediate concern. This will allow Erica to focus on physical therapy and getting strong again.

We praise God that the tests that she was hospitalized for have come back negative or normal and that improvement (should) start tomorrow. We thank the many friends and family that have stopped by. We cheer shrinking tumors and renewed hope!

Back in the hospital, that is. Another multi-day, waiting for tests, results and treatment plans. Another round of doctors we don’t know.
We know we are in the best hands, but this place is draining. Erica does say that being here makes her feel safe (Yay!).

We are here with renewed hope. After consultation with Erica’s radiation oncologist yesterday, who also consulted with our medical oncologist and neurosurgeon, it was recommended that we come in for a series of tests. The specialists agree that Erica’s sudden drop is not typical of the slow cognitive decline from radiation. Recent PET, MRI and CT scans are not showing progression that causes immediate concern. In fact, we are celebrating that the body is clear of any evidence of disease and many of the tumors in her brain have actually decreased or disappeared! Miracles and Medicine!

The leading theory is that the cancer may have effect on the ventricles and the pressure of the brain fluid. A lumbar puncture (spinal tap) will help determine this. Unfortunately, we were not able to schedule that procedure today, so we will continue to wait and celebrate that we still have options.

We scheduled an appointment with Erica’s neurologist just to be sure that we were covering all perspectives of the brain situation (perhaps one day I’ll write a retrospect of her first experience with the neurologist and the amazing outcome of that episode). We truly expected the neurologist to say that Erica’s condition was related to the tumors or brain swelling and would improve if we took care of those. Unfortunately, that may not be the case. Over the past two years of radiation, medication and the cancer itself, Erica’s brain has been significantly damaged and is failing throughout. This has real potential to be the root cause of her challenged cognition and mobility and clarifies why her symptoms reflect those of dementia. As mentioned in the prior post, this horrible reality is devastating to Erica. Treatments, the cancer and time alone will continue to worsen the condition. We are stunned, sad and facing very difficult decisions as we anticipate more radiation on existing tumors.

I did not expect that our second blog post would be this difficult. I nearly dropped the whole project knowing that they may only get harder. But we recognize that we have been praying to understand what is causing Erica’s condition. This news brings us closer to an answer to that prayer and closer to decisions and plans accordingly. So carry on.

Our youngest son, Bram, returned from college yesterday. This is not the circumstance we planned to greet him with. As we share his mom’s news, he brings joy to her with a big hug, and then goes on to tell us of the shenanigans of his most recent work shift. We are all laughing out loud and immediately experience the mood-changing truth that laughter is the best medicine.

Eight p.m. Saturday before Mother’s Day, sitting at the dining table with Erica, her mother and mine. The perfect pre-mother’s day moment? Could be, except that the mothers did not come for the celebration, they are here to assist Erica… and me.

For the past few weeks, Erica has been incapable of independence. Unable to stand without assistance, unable to walk, unable to deliver her thoughts or find her words. Having recently lost her father to dementia, this feels too similar. Too hopeless, like we know how this will end. But it’s not dementia, it’s cancer – metastatic breast cancer that found it’s way to her brain. And she was not like this six weeks ago. And the physicals and blood tests are not concerning. And the tumors do not match the symptoms. So what is going on?! My exhaustion is only surpassed by my will to fight for her and against the non-stop waves of panic attacks that wash over me.

It was March 22, 2025 when Erica checked in to the emergency room due to a brief moment of double vision, a symptom that 2 years prior lead us to discover the brain metastases. This time, we find no significant change to her tumors, just minor swelling around that area. Four days later, numerous tests and scans, dozens of doctors and nurses and heavy doses of steroids and seizure preventatives, Erica was determined stable and released. Follow ups with her oncologists confirmed that she was on the best treatment, the same treatment that one week ago she was living a normal life. The days that followed spiraled down a slide of fatigue. She slept almost all day for nearly two weeks. She ignored her phone, no texts, no email, no social media, no shopping. Clearly something wrong. When she began to move it was weak, slow and confused. Weaned off the steroid and seizure meds, she showed minor improvement.

It took two of us to help Erica to the table this night. We sit down, pray, and Erica vomits. And not just a little. The moms flash into super mom mode. Like the hulk when angered, but instant and gentle. I was the one that turned green. Frozen. Pushing back another panic attack. Knowing exactly what was happening – either more brain swelling or the tumors. Within minutes, the moms have the table and floor clean and Erica in the bathroom. And with a deep, calming breath I dial her radiation oncologist. Yes, 8:30 on a Saturday night, I dial the personal mobile phone number of her doctor. Because I am not taking Erica back to the emergency room. Within minutes, the doctor calls back. She asks if I have any dexamethasone left, the steroid Erica just weaned off of. I had one pill. Give it to her. The doctor begins to call pharmacies. All closed. I agree to watch Erica closely through the night and pick up more steroids when they open in the morning. She sleeps very well. I do not.

I am writing this post three days after that event. Erica’s coordination and cognition show improvement. I celebrate that Erica’s oncologist called me back at 8:30 on a Saturday night. I celebrate that I had one steroid pill. And I celebrate the moms!

We walk through valleys and face the shadow of death.
And yet we say “Yay!” – intentionally.

The often quoted Psalm 23:4 reads, “Yea, though I walk through the valley of the shadow of death, I will fear no evil; For You (God) are with me.” But I challenge that a simple yea, or yes, is not enough. We want a Yay!, a deliberate celebration of bright victories in the dark moments. We want to cheer God when He shows up in the low times. We have to believe that these moments exist. And we must purposefully seek them out.

To be clear, this is not about James 1:2, “Count it all joy when you fall into various trials,” another often quoted scripture. We are not aiming to find joy with the trial (of course there may be some of that), rather we are looking to find joys in the trials. Most lessons have been revealed with time, not by questioning in the moment. Try not to dwell on what lesson God is teaching during a trial. Instead, be in the moment and train your brain to recognize the small joys throughout the journey.