Praise God from whom all blessings flow!

JENNIFER IS IN REMISSION!!!

She and Matt went in to Vandy this morning for a few appointments and received this wonderful news. Remission means there are no traceable blasts in her marrow. She texted, "I'm officially cancer-free!"

The blessings are raining down from Heaven!

Thank you, Lord, for your protection and provision. Thank you for being a Father we can trust in, no matter what the outcome. Thank You for holding our hands through the mountaintops and the valleys of life. Thank you for this exciting news! As in all things, let it be used for Your glory. You alone are worthy of all our praise and adoration!

The Vandy Verse:
(The Song of Moses)

I will sing to the Lord, because He is worthy of great honor...
The Lord gives me strength and makes me sing; he has saved me.
He is my God, and I will praise him.
He is the God of my fathers, and I will honor him.
The Lord is a warrior; the Lord is his name...
Your right hand, Lord, is amazingly strong.
Lord, your right hand broke the enemy to pieces.
In your great victory you destroyed those who were against you...
Are there any gods like you, Lord?
There are no gods like you.
You are wonderfully holy,
amazingly powerful,
a worker of miracles,
You reached out with your right hand,
and the earth swallowed our enemies.
You keep your loving promise
and lead the people you have saved.
With your strength you will guide them to your holy place...
You will lead your people and place them on your very own mountain,
the place that you, Lord, made for yourself to live,
the temple, Lord, that your hands have made.
The Lord will be king forever!

-Taken from Exodus, Chapter 15.

Match Day!

"Hey! Guess what?! ...They found me a match! It's a 10 out of 10 match! It's a perfect match! They've contacted the donor, and they have two more potential matches. ...I didn't ask, she just said I have a donor! Isn't it wonderful??! ...Hopefully my bone marrow is in remission, which we will find out tomorrow. We are praying that it is. If it is, next week they'll consolidate me. Then one more consolidation, and then they'll prep me for the transplant. ...It's a 100 day procedure, and they'll watch me real close. Then, maybe, after two years I'll be back to normal! ...I told Mom and Billie and Lauren, and Matt listened in with me on speaker phone. ...He's right here beside me. ...That'd be great Dad! ...Yeh, and watch football and just have a good time! ...Ok. Thanks Dad! ...Bye!"

That was Jennifer's conversation with Dad that I recorded in real time. As you can see, we have lots we're celebrating here in Nashville!

TURKEY STRUT UPDATE: For out-of-town participants (or, out-of-town non-participants that just want a t-shirt), please send registration forms and payments to:

Mrs. Chris Potts
1202 East South Street
Kosciusko, MS 39090

*See "Strut Yo' Stuff" post for more information. Please feel free to email me at laurenmccool11@gmail.com if you are having trouble viewing any of the information. The deadline for registration WITH a t-shirt is next Friday, November 4th. We don't want you to miss out!

Prayerful Ponderings:
Please pray for her donor. Pray that the biopsy reveals a remission. Praise the Lord!

The Vandy Verse:
Psalm 103 (King James Version)

¹Bless the LORD, O my soul: and all that is within me, bless his holy name.

²Bless the LORD, O my soul, and forget not all his benefits:

 ³Who forgiveth all thine iniquities; who healeth all thy diseases;
 ⁴Who redeemeth thy life from destruction; who crowneth thee with loving kindness and tender mercies;
 ⁵Who satisfieth thy mouth with good things; so that thy youth is renewed like the eagle's.
 ⁶The LORD executeth righteousness and judgment for all that are oppressed.
 ⁷He made known his ways unto Moses, his acts unto the children of Israel.
 ⁸The LORD is merciful and gracious, slow to anger, and plenteous in mercy.
 ⁹He will not always chide: neither will he keep his anger for ever.
 ¹⁰He hath not dealt with us after our sins; nor rewarded us according to our iniquities.
 ¹¹For as the heaven is high above the earth, so great is his mercy toward them that fear him.
 ¹²As far as the east is from the west, so far hath he removed our transgressions from us.
 ¹³Like as a father pitieth his children, so the LORD pitieth them that fear him.
 ¹⁴For he knoweth our frame; he remembereth that we are dust.
 ¹⁵As for man, his days are as grass: as a flower of the field, so he flourisheth.
 ¹⁶For the wind passeth over it, and it is gone; and the place thereof shall know it no more.
 ¹⁷But the mercy of the LORD is from everlasting to everlasting upon them that fear him, and his righteousness unto children's children;
 ¹⁸To such as keep his covenant, and to those that remember his commandments to do them.
 ¹⁹The LORD hath prepared his throne in the heavens; and his kingdom ruleth over all.
 ²⁰Bless the LORD, ye his angels, that excel in strength, that do his commandments, hearkening unto the voice of his word.
 ²¹Bless ye the LORD, all ye his hosts; ye ministers of his, that do his pleasure.
 ²²Bless the LORD, all his works in all places of his dominion: bless the LORD, O my soul.

I Say a Little Prayer for You...

The moment she wakes up,
She's gotta go for her check-up.
(I say a little prayer for you.)
She has no hair now.
She's wonderin' what hat to wear now.
(I say a little prayer for you.)

(Refrain)
Forever, forever, you'll stay in my heart.

And I will love you, 

Forever, forever. We never will part. 

Oh how I'll love you...

Together, together that's how it must be.

To live without you, 

Would only mean heartbreak for me.

She goes to the nurse here.
She's got a big needle, Oh dear!
(I say a little prayer for you.)
As straight as an arrow,
It drills down deep in her marrow.
(I say a little prayer for you.)

(Refrain)

And now at this juncture,
She'll go for her lumbar puncture.
(I say a little prayer for you.)
They'll send in the chemo.
The blast count will register zero.
(I say a little prayer for you.)

Forever, forever, you'll stay in my heart.

And I will love you, 

Forever, forever. We never will part. 

Oh how I'll love you...

Together, together that's how it must be.

To live without you, 

Would only mean heartbreak for me.

(Written by Jennifer, Matt and Lauren)


Prayerful Ponderings:
Jen did go for her bloodwork today. There are no cancerous cells in her blood, and we are prayerful that this is mirroring what is going on in her marrow - i.e., that her cancer will no longer be detectable in her bone marrow. She will go in early tomorrow morning for the biopsy and lumbar puncture. Things are still going well here at home, and, after some nausea this weekend, her appetite is back with a vengeance! Please pray that Jen tolerates the procedure well, that there will be no adverse side effects, and that God will guide the proceduralists tomorrow. Pray she will be found to be in remission and that she will be able to begin consolidation as early as next Monday. Also, pray that she will continue to be infection-free! (And, as you can tell from the parody above, keeping her sense of humor and laughter are proving to be wonderful medicine!)

The Vandy Verse:
I praise the Lord because He advises me. Even at night, I feel His leading. I keep the Lord before me always. Because He is close by my side, I will not be hurt. So I rejoice and am glad. Even my body has hope... You will teach me how to live a holy life. Being with You will fill me with joy; at your right hand I will find pleasure forever. Psalm 16:7-11

Washed anyone else's feet lately?

(Written Tuesday evening, October 18th)

So I would imagine this is what a mother hen feels like when she has all of her chicks in her nest. Yes, I know Jennifer is not my 'chick' but it is a comforting, safe feeling having her here at my 'home away from home,' Jenny and Matt's house in Nashville. It's nice being able to look over and see her resting on the couch versus driving 20 to 40 minutes (depending on traffic), parking in a garage, gathering all the laundry, food, etc. from the car that has to go to her room, stagger to the lobby with the mound of 'stuff,' ride eleven floors up, punch the security button to the bone marrow unit, wash down with sanitizer... and all this just to lay eyes on her! 

As I was saying, Jenny's resting easy here at home enjoying movies, naps, an array of t.v. channels (in the hospital there were only about 12, most of them being versions of ESPN- who knew there were so many!), spending time with Traveler the dog, visiting with Mom, our aunt Billie Jean, Matt, and me, and eating the most delicious meals! Today Billie and I weathered the FREEZING rain to visit the amazing Nashville Farmer's Market and snag some fresh veggies. That place is phenomenal! As I write, Mom and Billie are in the kitchen preparing some different dishes from our farmstand finds that Jen has requested, Traveler is tip-tapping around Jennifer's feet, and Matt has just come bounding in the door from an 8-hour long test! What a blessing to see this house come alive with Jennifer's presence!

I've been thinking a lot today about the outpouring of love and support from family and friends that has manifested itself in the kindest acts of service over the course of the last month. To name a few....

~friends and aunts keeping Jen and Matt's house squeaky clean, doing laundry and 'honey do' projects, caring for Traveler, and preparing meals.

~throngs of cards, phone calls, emails, care packages, drawings, visits, meals, sweet goodies, caps, scarves, Clorox wipes, and water! Amazing!

~friends giving us rides to and from Nashville.

~the run/walk benefit for Jennifer, simply- WOW!

~one aunt canceling her trip to Ireland to be here for 3 weeks! She also taught Traveler how to be leashed for his walk without going nuts and breaking furniture. The other aunt slaving away in the kitchen to prepare gourmet and neutropenic (a medical term indicating Jennifer has to have meals specially prepared) dishes and cleaning out and reorganizing the entire kitchen to be more Jen-friendly!

~doctors and nurses going above and beyond to see that Jen is being cared for in the best possible manner- we are blown away, to say the least!

And these are only a few! To sit back and contemplate all these sacrificial acts of service is extremely humbling. That this many people care about someone you love so deeply is truly moving. How we have been blessed by these wonderful people who have allowed themselves to be used as vessels in the Father's hands through which He has poured out His grace, mercy and love. It is my opinion that we, the human race, are at our best when we take on the heart of a servant because it is then that we are most closely mirroring our Savior, the ultimate Servant. 

When I think of all the acts of Jesus' service chronicled in the Bible, my favorite has to be on the night before his death when He washed the feet of his disciples. To understand the magnitude of what He did that night, we have to understand the times in which He did it. Right now, my feet are pretty clean. I took a shower and slipped on socks and have been walking around in shoes all day. Now, contrast that with the feet of Andrew or Thomas or Matthew on the Thursday night of the famous Last Supper. Dirt roads, sandaled feet and long walks...Pleasant feet, they do not make. In Jesus' day, when guests arrived at the hosts' home, the lowliest of the servants was chosen to do the considerably dirtiest of jobs. Can you imagine your boss walking up to you and saying, "Yeh, uh, we're gonna need you to be washing everyone's feet that walks through the door today,"? I don't think they could process my two-week's notice fast enough! To sum up this particular household servant's job in a word: demeaning. 

Now, back to the Upper Room where the Master of the Universe, the King of kings and Lord of lords, the Alpha and the Omega, the Prince of Peace, and the Darling of Heaven, is bended low on His knees meticulously, LOVINGLY washing the filthy feet of his sometimes faithful followers. When He reaches Peter, Peter will have none of it! "No, Lord, you will never wash my feet." Jesus answered, "If I don't wash your feet, you are not one of my people." Peter quickly changes his tune, "Lord, then wash not only my feet, but wash my hands and my head, too!" Don't you just love outspoken, impulsive Peter! (Reminds me of someone...) For me, it would have been a somewhat easier task to wash ol' Peter's feet. Yes, in a few short hours, Peter will flat-out deny that he even knows Jesus much less that he is one of his dearest friends. But take a closer look at this fisherman who left all that he knew to follow this man who made him an offer he couldn't refuse...

-When asked about the identity of Jesus, he boldly proclaimed that Jesus was the Christ, the Son of the Living God. (Side note: Peter claimed Jesus was the Christ when making such a claim was anything but 'cool.') 

-He was one of three of Jesus' disciples on the mountaintop when Jesus was transfigured and heard the voice of the Father boom from heaven, "This is my Son, whom I have chosen. Listen to him!" He then begged Jesus to let him, literally, set up shop and never leave that mountain-top experience. 

-He was often found jumping out of boats just to be near Jesus. Cases in point: Peter steps off the boat one night to WALK to Jesus who's also WALKING around out there on the water. After Jesus' resurrection, Peter doesn't even take the time to take off his cloak before jumping into the water, off the boat he and the other disciples are fishing from, to swim ashore to see and be with Jesus.

-It is believed that Peter was the disciple, the only one in fact, who drew his sword to defend Jesus when the crowd, wielding clubs and swords, arrived to arrest Jesus. 

-Again, Peter was the only one who bothered to come back (all the others had run away in fear) and head over to Caiaphus' house to find out Jesus' fate before the Jewish Sanhedrin. 

-He was a part of the "Inner Three," one of Jesus' closest friends, along with James and John. 

-He was the man whom Christ built His church upon, in essence, the first preacher. 

Peter and Jesus were buds, great friends, tight as ticks as some say.

But then, Jesus arrives at the feet of the one and only Judas Iscariot. The first time you really see this guy he's complaining about a woman who has 'wasted' perfume to annoint Jesus. If that's not a window into his heart and where his loyalties really lie, I don't know what is. At the time of the scrub down, he's the one who has sold out to the political and religious leaders of the day and been looking for ways to hand Jesus over to them to be killed - all for a mere 30 silver pieces. With 'friends' like Judas, who needs enemies?

Re-reading the story, time and again it's not when Jesus washes Peter's feet that moves me. It's when he bends over Judas and, just like the other 11, he gently, carefully washes the feet of his betrayer. In a matter of moments, Judas will hurry from the room to do "the thing that he will do (and) do it quickly," to turn Jesus over to the religious leaders who can't wait to get their bloodthirsty hands on him. Judas leads them right to Jesus, who, at this point in the night, is praying in the Garden of Gethsemane. He is arrested and the rest, they say, is history- or should I say HIS-Story. And isn't it a marvelous one. 

Throughout the Gospel books, it's interesting to note that Jesus not only serves His closest friends and casual acquaintances, but that He also serves one who despises Him and all that He stands for. As Christians we are called to be like Jesus, called to have the hearts of servants. Trouble is, we don't get to choose whom we will serve. God just says- SERVE.

So thinking on all the ways it has been a pleasure, a delight, and a joy to serve Jennifer and Matt down this bumpy road, I got to thinkin' I'm only half-way mirroring Christ. I am called not only to serve my friends, those whom I love, but my enemies, or those whom I have a harder time loving, as well. Great enjoyment can be found in serving a friend, so it's sort of a win-win, right? But serving an enemy, now that's where the rubber meets the road... Therein lies the challenge - the challenge of turning from my sinful way, taking up my cross, making the sacrifice, and serving one who would rather have nothing to do with me (and I them) or, worst case scenario, rather do me harm than good. Sounds like a win-lose. And to the blind eye it is. But when my motive for serving is to bring glory to my Father above and not for the praise of men, then I will find my reward. And it is heavenly. 

O Lord, thank You for the parts of us that are like You, for it is not by anything we can muster. The only good things in us are those things which are from You. Let us not come up short in serving. Let us serve, with glad hearts, our friends AND our enemies. And may we be found to be more like Christ with each act of service to which we yield ourselves. That we may hear You say, on the day of Judgement, "Well done, my good and faithful servant. You have been faithful with a few things; I will put you in charge of many things. Come and share your Master's happiness!"


(Written Thursday night, October 20th)

Prayerful Ponderings:
Please pray that Jennifer will continue to rest easy here at home. It was a gorgeous day here in Nashville, and she and I got the chance to walk around the neighborhood for a little while. Pray that she will continue to gain her strength back. She will have bloodwork done next Tuesday. We are praying that all her blood count levels will have returned to normal and that there will be no cancer found in her blood. On Wednesday, she will undergo a bone marrow biopsy- to determine if she is in remission or not- and a lumbar puncture- a test to see if there's any cancer in her central nervous system. Also, with the lumbar puncture, they will inject chemotherapy into her central nervous system which will circulate through her brain. Please pray for a positive outcome. Pray for Jen's mental, emotional, and spiritual state as she faces the week and all it will hold. Pray for Matt as he holds her hand each step of the way. Pray for wisdom for the doctors. It is our hope and prayer that next week will find her in remission and that the doctors will be able to begin consolidation therapy on Friday of next week. Of course, all of this is tentative but will help to serve as a timeline for the coming week. Pray, ultimately, that God will be given all the glory, honor and praise. He is worthy.

The Vandy Verse:
Jesus answered, "I tell you the truth, if you have faith and do not doubt, you will be able to do what I did to this tree and even more. You will be able to say to this mountain, 'Go, fall into the sea.' And if you have faith, it will happen. If you believe, you will get anything you ask for in prayer." Matthew 21:21-22

Strut Yo' Stuff!

We are so very excited about the 1st annual Turkey Strut in honor of and to benefit Jenny! When I gave her the news that kind members of the Kosciusko community wanted to do this for her, she was absolutely thrilled and deeply touched. 


The Turkey Strut is a 5K run/walk that will begin at 8:00 am on Thanksgiving morning, with registration beginning at 7:15 am. The entry fee is $20, which includes a 'Turkey Strut' t-shirt if your pre-register before November 4th. The race will start and finish at the First Presbyterian Church. You can register at First Presbyterian Church, M&F Bank, Claude Julian's and Spot Cash Tire & Appliance. Sponsoring the race are M&F Bank, Ivey Mechanical, JC Cheek, Breezy 101, Claude Julian's and Spot Cash Tire & Appliance. *If you are unable to participate in the run/walk but would still like a t-shirt, you may fill out a registration form indicating FOR T-SHIRT ONLY and attach $10. All proceeds from the race will be donated to the Jennifer Fowler Sample Fund. 


Below is the link to the flyer detailing the event, and the link to the t-shirt design is just below it. If you have any trouble viewing either one, please email me at laurenmccool11@gmail.com. I think it promises to be a fun morning and what a special way to kick off Thanksgiving Day gathered with family and friends remembering all we have to be thankful for. 


*Another trick, try copying and pasting the link into your web browser to pull each one up. 


Race Flyer
https://docs.google.com/leaf?id=15haUySRcn4Vpl1jK6zG4MRUygn64-3aOHqI9xY9k38rnC63qEd6m6J-sHxxB&hl=en

T-shirt Design 
https://docs.google.com/viewer?a=v&pid=explorer&chrome=true&srcid=1kIvph3W_UchgcBpGF-jHAwdeXpXjoO-waWwQndb18As-W-ZekOUoRomMnVbY&hl=en

And the 2011 homecoming queen is...

I cannot think of better news to post with this morning, after a week off, than: 

JENNIFER IS COMING HOME!!

Last night was like Christmas Eve, and I could hardly sleep from the anticipation of having Jenny back. After riding a small roller coaster for the last several days, her numbers are now on the climb and the doctors feel comfortable about sending her home. She was excited this morning when I spoke with her, albeit a tad apprehensive about the transition, naturally. Please pray that the transition will be a smooth one, that she will be able to get some much needed rest, and that her body, mind and soul will be strengthened and restored during her week and a half long stay. After a week and a half of respite, she'll go back to the hospital for a week of consolidation therapy. The goal of consolidation therapy is to achieve a deeper level of remission. The therapy is about five days, with a seven day stay in the hospital all total. 

A Hymn of Thanksgiving, A Psalm of David

Lord, I will thank you with all my heart...

I will bow down facing your holy Temple,

and I will thank you for your love and loyalty.

You have made your name and your word

greater than anything.

On the day I called to you, you answered me.

You made me strong and brave...

Though the Lord is supreme,

he takes care of those who are humble...

Lord, you do everything for me.

Lord, your love continues forever.

Do not leave us, whom you made. 

Psalm 138

Praise the Lord. 

Medical Synopsis

From Matt:

The following will serve as a clinical summary of what has happened thus far:  On Tuesday, September 13, 2011, Jennifer was seen in primary care clinic at Vanderbilt Internal Medicine regarding some leg swelling, shortness of breath, and skin/soft tissue issues she was having.  Routine blood work returned from the clinic visit later that afternoon when Jennifer was at work that indicated she had acute leukemia.  She was severely anemic in addition.  I called Jennifer at approximately 5pm that afternoon once I became aware of the lab abnormalities and asked her to leave work to present to the ER for a much needed blood transfusion.
Upon arrival to the ED, she was promptly seen in the ER by hematology who made us aware that she had acute leukemia but were not sure exactly which type.  At this point, Jennifer was placed in a room on the 8th floor where she stayed for the rest of the night.
The following day, Wednesday, September 14, 2011,  she underwent a bone marrow biopsy to help determine the type of leukemia she had as well as get specifics about the cells that would help determine the best course of treatment.  Intravenous fluids and allopurinol (a medicine to assist with clearing away cellular breakdown products as they react with chemo) were started.  She also underwent a breast biopsy of a mass that was discovered earlier in the week.  Finally, she was transferred to the bone marrow unit on the 11th floor.
On Friday, September 16, 2011, the final results from the bone marrow biopsy had returned with the diagnosis of biphenotypic leukemia as her specific type of acute leukemia (in previous posts referred to as mixed lineage leukemia, but more accurately referred to as biphenotypic).  This is a rare type of acute leukemia (less than 5% of all acute leukemia) and the specific subtype of biphenotypic leukemia that she has (T myeloid) makes it even more rare.  The biphenotypic portion of the name simply refers to her leukemia as being a combination of both ALL and AML within the same malignant cell.  All of this taken together means that there are not any clinical trials or research that might inform our physicians' decisions.  That is not to say, however, that they are unsure of what to do for her.  As one of the more senior physicians put it, “she’s got leukemia, we can treat that.”
Later that day, she began on a regimen of cytarabine, idarubacin, prednisone, and vincristine to begin treating her leukemia - this represents day 0 of treatment.  This is part of the induction phase of chemotherapy.  The way leukemia is typically treated is first giving induction chemotherapy to knock the malignant cells down low enough in the bone marrow such that our tests are no longer able to detect them.  We know, based on medicine’s long history of treating this illness, that if no therapy is offered beyond induction chemotherapy, the leukemia would return.  This is because malignant cells remain in the marrow despite our tests not being able to find them, i.e. they are below the test’s limit of detection.
After induction chemotherapy, depending on the type of leukemia, either a day 14 bone marrow biopsy is performed (for AML) or a day 30 marrow is performed (for ALL).  If no cells are seen, the patient is determined to be in clinical remission and the next phase of therapy, which is consolidation chemotherapy, may begin.  This consists of 2 to 5 sessions of chemo intended to drive the malignant cells count even lower in the marrow (and possibly even kill it for good depending on the specific type of leukemia).
After beginning induction chemotherapy on Friday, September 16, 2011, she was ready for her day 14 bone marrow biopsy on Friday, September 30, 2011.  This biopsy was rather controversial amongst the hematologists as there has been no research to show that this is the correct day to assess whether or not chemotherapy has been effective given her specific type of acute leukemia (biphenotypic).  Remeber, we check a day 14 marrow for AML and a day 30 marrow for ALL to check to make sure the chemo has been effective, but in Jennifer’s case, she has a combination of the two types and so no one was really sure when was the appropriate time to check.
Despite this area of controversy, a day 14 marrow (14 days are the beginning of induction chemo) was done which showed very few cells of any type within the marrow which is what one expects in the setting of chemo.  There were, however, still malignant cells present within the marrow.  Specifically, 7.5% of the cells seen in the marrow were cancerous at day 14, whereas on day 0 they had been at 95%.  We can therefore say that Jennifer has responded to the chemo that had already been given but were not sure if we should have expected there to be no cancer there or anything in between.  We were ecstatic about the results, despite the uncertainty.
Given that Jennifer’s bone marrow wasn’t totally free of cancer, her doctors decided to give a little more induction chemotherapy by adding on a different medication called PEG asparaginase with plans to reassess her chemo response with a day 30 bone marrow biopsy (roughly, could be anywhere from day 30 to 40).  This would mean that her next bone marrow biopsy would be scheduled for anywhere from Monday, October 17 to Wednesday, October 26.  We are in dire need of prayers that her marrow will be free of cancer at this point and she will be determined to be in a state of remission, so that we may begin consolidation chemotherapy.
On Monday, October 3, 2011, our hematologists met and determined that once Jennifer achieves a remission, she would need to undergo a bone marrow transplant.  We also need prayers that there will be a donor for Jennifer and that this procedure goes well.  The previous Saturday, October 1, 2011, we found out that neither Lauren nor Lindsey were matches for Jennifer’s bone marrow.
Jennifer has had two fevers during this hospitalization which have no doubt been related to her suppressed immune symptoms and bacterial infection of her IV line.  She has been treated with antibiotics since her first fever, and thankfully, these have resolved for now.
So as of today, October 10, 2011, day 24, Jennifer has received all of her induction chemotherapy and her immune system is starting to return.  The major cell of the immune system that we monitor is called the neutraphil.  We want her neutraphil count to be at least 500 prior to her discharge.  It had been 0 for the past 4 weeks as a results of chemo and her cancer.  Today it is 60.  Please pray that her counts continue to rise and that we don’t see a return of her malignant cells in her blood stream.  We are anxiously awaiting her day 30 bone marrow biopsy so that we can determine when she can begin consolidation chemo.