Perplexed but not Driven to Despair

"But we have this treasure in jars of clay, to show that the surpassing power belongs to God and not on us. We are afflicted in every way, crushed; perplexed, but not driven to despair; persecuted, but not destroyed; always carrying in the body the death of Jesus, so that the life of Jesus may be manifested in our bodies." 

2 Corinthians 4: 7-10

                January 2019 was an intense month for the Winkelmeiers! Influenza A struck the members of our home with a vengeance and it got to me, Dave, first. Last year I had gotten it three times, Type A twice and Type B once. If there was a Type C, I was bound to get it. All the members of the family got it as well last year and everyone recovered with no major hiccups. However, this year, Angela seemed to be hit the hardest and went from having the Flu to having a long bout with walking pneumonia. The Doc gave her 2 rounds of antibiotics and things seems to clear up except this little nagging cough that occasionally gave excretion. We assumed that she was still battling pneumonia. She also had some chest pressure and feeling a little more fatigued in the evening, which is common when someone is sick. 

                On the evening of April 16, 2019, we were doing life like normal. I was driving Eden back and forth to Jiu Jitsu and she was hanging out at the house with the kids and a couple extra girls to watch while their parents were getting training to be foster parents. Angela is always helping others and that night was no exception!! She was working hard to keep up with them while I did yard work. I came in from doing yard work and noticed her coughing and holding her chest. She said her chest hurt her more that evening than times before. She just looked more tired and fatigued. Grant it she pushed herself at the gym that day and had, what she called, “a good workout”. To me a good workout is painful. It always is bad when I walk out of a gym and I’m hurting. Angela is often sore because she works out at the gym five days a week and that includes running 4-5 miles on the treadmill and other intense cardio. We attributed that some of the soreness she was experiencing in her chest to her workouts because she’s intense and often sore. That night was different though. She was bent over and looked really concerned, which got me concerned!! I told her that she needed to have a chest X-Ray done soon.

                Two days later she had her late afternoon appointment to get the X-Ray at Metro Imaging. After the appointment she called me with some concern in voice. She told me that the Radiologist said that she had an “abnormality” in her right lung and suggested that she get a CT Scan to get a better Idea of what’s going on in there. Like I mentioned, it was late in the afternoon I told her to let her doctor look at it in the morning and he would tell her what to it is. I’ve been through hundreds of X-rays and know that an abnormality is a vague term that could mean many different things. We still had in our heads that she was still dealing with pneumonia and pneumonia shows up as abnormal on an X-ray. I’ve been there done that. After she left Metro Imagining I told her to call her doctor on his cell to let him know and she did. He’s also was a friend of hers, dating back a few decades and who is great Christian man. He reassures her that it could be anything and reminded her that she had been sick with pneumonia and the influenza. Of course, our minds are still concerned, but continued to trust God with it. He’s the one in charge and on His throne.

                Friday, April 19, 2019, my 8-year anniversary for my lung transplant, will have a totally new

The left side of the picture is actually the right side. 

The tumor is pushing her heart over to the left.

Both lungs should look like the side with the cursor. 

memory associated with it from now on. I went to work as usual while Angela and the kids were still in bed, around 8:15am. I got settled into my desk when I got a call from Angela at 8:30. I teased her for sleeping in and we talked courtesies for a few seconds before she said that her doctor called her few minutes ago to tell her that her abnormality was actually a large mass of 14.5 centimeters on her right lung and that she needed CT Scan ASAP along with bloodwork.  His office went to action and arranged for the bloodwork to be done that afternoon and the CT scan on Monday afternoon. Our hearts were fainting inside us with unbelief. Shock, surreal-ness and fear struck hard at hearing this news. Of course, I dash home to be with her, tell our close family and friends and pray, pray, and pray to Jesus.

                After processing, or trying to, Angela decides to go to the gym to run on the treadmill to process it. It’s a happy place for her to release stress. I tried to talk her out of it, but she persisted. I don't think I would be comfortable with a grapefruit size mass bouncing around in my chest. She ran about 4.5 miles that day!!! She came back from the gym smiling and satisfied. We did more praying and she got her bloodwork done which came back perfect!

                Over the weekend, it took everything we had to keep our minds focused and not deterred by fear. We went along our normal weekend activity and went to the CT Scan at 3pm on Monday, April 22, 2019. The call from the doctor with the results came late in the evening we thought that we were going hear from him in the morning.  At 9:38pm, the phone rang, and Angela answered it with nostrils flared and taking deep breathes. My heart also raced as she put the doctor on speaker phone. There was little small talk because we wanted the facts and that was it. Unfortunately, the news was much worse than we could have imagined. Not only did Angela have the large mass in her right lung that was pushing against her heart in such a way that it could eventually affect the circulation of blood throughout her body, she has 4 other spots in her body that were detected. Angela and I can’t believe what we’re hearing. Dizziness from the adrenaline took over. The doctor goes on to explained that the other small masses are 1-2 centimeters in diameter, and she has one on the T3 vertebrae along her spine that's embedded in the bone, a mass on her liver, and one small mass on each lung. Needless to say that we got off the phone with he doctor with more questions than he could possibly begin to answer. One of the most comforting parts of the journey is that he asked if he could pray with us before getting off the phone. He took us to Jesus because Angela had a problem he could not fix. However, he and his office staff started moving like a fine tuned machine and God used their urgency and assertiveness to get a biopsy scheduled for her in less than 36 hours. The doctor asked me what hospital I wanted her at and I promptly replied, “Siteman Cancer Treatment Center at Barnes-Jewish”, which he was happy with the selection as well. He said that he would speak with an oncologist there and get the ball rolling.

                There wasn’t much sleep for me that night as I held Angela in my arms until she slipped off. While, I spent most of the night watching her breathe as I prayed that God would give it to me instead. She managed to sleep 5 hours and woke up refreshed and with a great attitude. Of course, things were still on our minds as we made phone calls to our close friends and family. We kept the normal daily routine other than me staying home to keep an eye on her and help her with the kids. I did have to see my pulmonary specialist for some annual Lung Transplant check-up. Unfortunately, my lungs had really taken a beating this year from a nasty virus I’ve never had. My lung function is down to 30% from 36%, I’ve lost 30 pound in 16 months with no real explanation and I’ve been having shortness of breath in normal daily activities like getting dressed. I was assuming that with all my health issues with lung rejection that I would at some point have something happen to put me back on the transplant list. I think we were all kind of preparing for that in our minds, but never did we think Angela would have something like this!! She has always been the eat well, take supplements, and exercise kind of person. She’s never smoked, done drugs or anything that would be potentially harmful to her body. She always has her seatbelt on reminding, everyone else to get them on.

5 hours in the ER. 

                The biopsy was scheduled for Wednesday morning at 8:30am. We got our hustle on and delivered our 2 little guys over to the babysitter and pulled in at Barnes St. Peters right on time. The weather totally carried the mood that morning with this persistent drizzle and a cold chill. The biopsy went smoothly and Angela, as the doctor report, did great. He did have a heavy expression of concern on his face as he spoke with me privately. He told that he strongly believes tumor was cancerous as he formed a shaped his hand like he was holding a ball. My heart continued to sink even deeper because this  is coming from a radiologist whose hundreds of these, if not thousands. I didn’t want to tell Angela about my conversation, but I think she needed to here it.  As the radiologist was making his rounds to check on her in recovery area, I asked him in front of her why he believed it was cancer and he explained that is could have been a variety of things, but this mass had characteristics he’s seen before in cancer. Once again, our hearts sank even further. We were becoming more and more perplexed but not driven to despair!!

                On our way back to pick up the kids, Angela’s doctor called to inform us that he spoke with an oncologist at Siteman who agreed with our doctor that we needed to move quickly and get Angela admitted into the hospital immediately. This was not foreseen by us and again threw us into panic and fear. We had to figure things out for where our boys would stay before we could go down to Barnes-Jewish emergency room to be evaluated and admitted. God had that worked out already and our friend who had the boys already was able to take them for a couple of days. Our baby has to be watched by a qualified foster-parent and she was just what we needed in our time of need. God continued to show himself in the valley of the shadow of death. He was showing himself in even the small details throughout this journey. We started at 8:30am and by 10pm she was admitted and settled in a room.

                Thursday was a day of a few more test and waiting to be moved over the oncology floor. By that evening she had a new room with an incredible view of Forest Park which made it easier. We think it was sent from God to comfort us. Her parents also came in early from vacation as well as her sister, Amanda, who lives in Perry, MO. Friday was a rough day as she started off with a PET scan and had to have the hard talk with the Dr. Brian Van Tines who is overseeing her case! He came in with an urgency in his voice and told us that Angela was in SERIOUS trouble, which I think we already knew. It’s just a hard hit to your faith when a professional tells you that your illness is very serious. Angela was crying and shaking her head in unbelief as her sister held her. My brain took over as it went into “business mode” as I had to fight off the feelings of shock and unbelief as fear oozed its icy way through my veins. Dr. Van Tines is one of leading sarcoma specialist in the world and is the Director of the Sarcoma department at Siteman. He doesn’t mince words and is straight to the point. He said that he believes that the cancer inside Angela is Leiomyosarcoma (LMS). He was seriously concerned that the mass in her right lung was pushing against her heart in such a way that it could cause obstruction of the major veins. He also had serious concerns about the tumor on her spine and how it was compromising the integrity of the strength of her vertebra. He then went through what he believed was the course of action. Dr. Van Tines said that he ordered that she have a Port Catheter placed in the right chest area to have easier access to her circulatory system and that she was going to start chemotherapy immediately which would span for 4 days while she was in the hospital. He also proceeded to tell us of all the horrible side effects that were to come. It was overwhelming, to say the least!! The nurses were sent into a frantic pace after he left the floor to catch a flight out of the city. We were left puzzled and confused. But there was a resolve in our hearts that God had given us favor by getting treatment from the best doctor!!

                The next four days of chemo were rough on Angela. The side effects started immediately. Nausea, neurotoxicity and fatigue crashed her world. The drugs were making it hard for her to even

Fatigue and Nausea after 4 days of Chemo

think straight. Saturday, the day after her first treatment was the worst. She had retained so much fluid that her appearance was definitely altered. Each day was its own set of challenges. She did not get the port as soon as we would have liked. She had to have several IV lines started in her arms which left them bruised and sore until they placed port in chest on Monday morning and she received her last chemo treatment that evening. Tuesday was a day of rest and recovery before they had a surgical procedure on her spine. The procedure and the experience of it is something we may share later. It was successfully completed, and she was released from the hospital on Thursday evening. 

                Our lives have been forever turned upside-down, as you can see, but we know God is in complete control. We are hearing from him in new ways as we walk through this. Your prayers are greatly appreciated. OUR GOD REIGNS!! HE IS KING!! HE IS OUR ROCK!! The storm has come and we are standing on Him as our foundation. ---Dave