I didn’t realize how much care we’d taken to make our 10-year Minneapolis house a home until we moved into our new house in Seattle. 1,700 miles from home while staring a metastatic melanoma diagnosis straight in the face is a sure-fire way to make everything feel a little out of whack.

Conversely, it wasn’t until my husband and I were sitting across from each other at a Pizza Ranch in Rochester, Minnesota, that I realized our mountainous suburb of Seattle had become more of a home than we’d realized.

This was and is the crux of it all.

This was and is the beautiful trust of it all.

Finding home isn’t always as easy as it seems.

But there is always a sense that it MUST be true, it HAS to be true…we’re WHERE we’re supposed to be.

If you’ve had the fortune of living in the same house for 20, 30, 40 years, count your blessings of stability and security. If you’ve moved, been displaced, found your way in a place far from everything you’ve ever known, you understand what I’m talking about.

From the moment the Minnesota Mayo doctor called me with with MRI results indicating 8-10 lesions on my husband’s liver while I was sealing grout at our new home in Seattle, there were questions of HOME. Should we get the biopsy done at Mayo where the original choroidal melanoma diagnosis was made 3 1/2 years ago, where my husband spent a week in the hospital with a gold plaque filled with radiation stitched to his eye, where liver lesions were found on CT and MRI scans 3 1/2 years later? Or should we get the biopsy done 1,700 miles away in Seattle, the place we now called home? Our choroidal melanoma doctor was adamant. We must get the liver biopsy done at Mayo. They are the best of the best. They’ve seen more of this incredibly rare form of melanoma than anyone on earth. So we had the biopsy at Mayo, we got the metastatic melanoma diagnosis at Mayo, we had an MRI of the brain at Mayo, and my husband had his first immunotherapy treatment at Mayo.

But questions of HOME lingered, even so.

The plan was to have that first immunotherapy treatment at Mayo, to come home and have the second immunotherapy treatment in Seattle three weeks later, then return to Mayo another three weeks later for a third treatment and more scans. After that? Well, we’d go from there.

So after our unplanned 10-day trip to Minnesota and Mayo Clinic, after we landed in Seattle, right after we got in the car to head back home, I made the call to Seattle Cancer Care Alliance so we could get an appointment set up for Seth.

11 days later, Seth and I were sitting in an office downtown Seattle, waiting to meet another new doctor. The journey had already been exhausting. Adding to the exhaustion was 2 1/2 hours and seven phone calls with insurance and Seattle Cancer Care Alliance the day before, and 45 minutes of me meeting with a financial rep from family services trying to figure out whether or not this Seattle Cancer Care Alliance was in-network with our insurance plan. Thank GOD, all that work was worth our effort. The Alliance is IN-network, thanks to a special network of University Physicians we have access to as part of our insurance plan.

Finding home isn’t always as easy as it seems.

This consultation with the Seattle doctor was required before Seth’s second immunotherapy treatment could even be scheduled. The doctor had reviewed the case, but had us provide a full review anyway. Seth explained the side effects he’d experienced since his first immunotherapy treatment – full-body itching, low-grade joint aching, fatigue, nausea and a bit of diarrhea setting in. Dr. V explained that with immunotherapy, the side effects are more unpredictable than traditional cancer treatments. He explained the things to watch for down the pike, and predicted that the worst of the side effects are still to come. Then there were what-next questions, what-if questions, and those dreaded questions about HOME. Dr. V from Seattle Cancer Care Alliance was going to call Dr. M from Mayo. There were questions and differences of opinion on what would be the best dosing, when would be best to run the next batch of scans, and what the next-best treatment options would be IF immunotherapy doesn’t work. We explained that we’d like to keep BOTH providers, Mayo AND Seattle Cancer Care Alliance. This wasn’t a usual nor preferred practice for Seattle, but the doctor thought it could work.

Six days later and just two days from what was supposed to be Seth’s second immunotherapy treatment in Seattle, I spent another FOUR HOURS on the phone with insurance, Mayo Clinic and Seattle Cancer Care Alliance trying to determine WHERE oh WHERE we’d be getting that treatment.

Finding home isn’t always as easy as it seems.

We finally got clarity. After all of the questions and uncertainty, insurance was dictating that we needed to CHOOSE one place or the other for treatment. We couldn’t go back and forth between Mayo Clinic in Minnesota and Seattle Cancer Care Alliance in Seattle as we’d hoped and planned. If we wanted to receive ANY immunotherapy treatments at home in Seattle, we’d need to CANCEL the authorization of six immunotherapy treatments at Mayo and re-authorize treatment for Seattle. One place or the other. One home base or the other. Not both.

Time had run out. Everyone had done the best they could to support us and follow the case hour by hour, but the truth was, Seth needed his treatment in 48 hours, and we still didn’t have clarity as to where it was going to happen. We needed to make a decision and FAST. Treatment was scheduled for Seattle, but we didn’t have insurance authorization. We had authorization for treatment at Mayo, but didn’t have any appointments scheduled.

I spoke with a nurse at Seattle Cancer Care Alliance. From their perspective, it was clear that time had finally run out. We’d need to fly and get this treatment at Mayo in Minnesota. Then after that, if we wanted to get ANY immunotherapy treatments here, at our new home in Seattle, we’d need to CANCEL the Mayo treatment authorization, get treatment re-authorized for Seattle, and the doctors HERE would need to be in the driver’s seat moving forward.

Finding home isn’t always as easy as it seems. Or maybe it’s more that HOME can be elusive because we’ll never be truly home till we’re in heaven.

Time was pressing on these questions of home. WHERE oh WHERE would we call home for this treatment due in 48 hours? WHERE oh WHERE would we call home for treatment of my husband’s metastatic melanoma? WHERE oh WHERE would we call home?

When we circled back to reason and reality, the answers about HOME were undeniable.

1. Our house is in Seattle.
2. Seth’s job is in Seattle, and our health insurance is through that job.
3. Our children are enrolled in school in Seattle.
4. We can’t predict Seth’s health moving forward. We need to secure a local provider rather than flying to Minnesota every time he needs care.

Home is in Seattle now.

This is where we are.

Home is where you are.

Perhaps HOME is the presence of the Lord, wherever you are?

Here we are.

We are here.

Do you know where you are?

I called Mayo with an update and made them aware of our urgent situation. It took an afternoon, overnight and into the next late-morning of researching on Mayo’s end to get orders placed and appointments secured.

Seth booked his flight to Minnesota the afternoon of the 10th. At 4:30 am on the 11th, I pulled out of our driveway and drove Seth to Seattle International Airport for a 6:30 am flight to Minnesota. I stayed here at home with the kids and my family who’s visiting from Minnesota. Seth was greeted by his brother, Jake, at the airport in Minnesota, who then drove him to Rochester for labs and an appointment with Dr. M at Mayo.

This is not our preferred course of action. We wanted to use both Mayo AND Seattle Cancer Care Alliance for treatment and testing related to Seth’s metastatic melanoma. But Dr. M understood, they suspected we’d need to transfer care to Seattle. This is home now.

Dr. M has spoken with the head of the Seattle Cancer Care Alliance. There are still slight differences of opinion as to WHEN follow-up scans should be run and WHAT KIND of follow-up scans should be run in the immediate future. There are still slight differences of opinion as to what the best contingency treatment options would be IF immunotherapy doesn’t work. Blood work revealed a level in the liver that was slightly elevated, slightly abnormal. Seth will need to return for more blood work next week to make sure it isn’t on the rise. ALL of this will be done and decided at home, in Seattle.

For now, right now as I type, Seth is wrapping up his second immunotherapy treatment at Mayo Clinic in Minnesota, with brother, Jake, by his side. Tomorrow, I’ll cancel the Mayo authorization for treatment, and we’ll begin the process of re-authorizing immunotherapy with Seattle Cancer Care Alliance.

Finding home isn’t always as easy as it seems.

Perhaps home is the presence of the Lord, the Abba Father’s Spirit, wherever you are.

Early yesterday morning, my friend, Tricia, drove 100 miles to meet me at Caribou Coffee across the street from Mayo’s Saint Mary’s Hospital. She hugged me with the longest hug I’ve had in a very long time, we chatted, had some tears and covered a whole wide range of topics in just one hour and thirty minutes. After I received the phone call from Mayo’s business office reminding me that my husband’s PET scan had been denied and that we needed to show up to the office and make a $7,500 payment before we had the procedure (which I am absolutely NOT going to do), Tricia handed me a a necklace from which hung the TINIEST of keys with the word HOPE on it. She chose a tiny key because she knows I don’t wear a lot of necklaces and agreed it would be understated. But this morning as I type each uncertain word out on the keyboard, I realize an even better reason for that tiny HOPE key necklace.

It’s okay to have the tiniest bit of hope.

Whether it springs forth in abundance or remains a tiny seed nested amongst a host of worries, HOPE is HOPE.

I wish I was a super-happy, super-hopeful, happy-hopeful, beyond-hopeful kind of person that sprung forth with “everything’s going to be okay” language around every turn. Honestly, I’ve wished for that kind of personality, that kind of perspective, more than I’d care to admit. Christian and American culture has tried to convince me that it’s totally in my power to decide how much hope, how much positivity I have about life’s circumstances. Believe me, if I could turn on a switch and become super happy, super hopeful, happy hopeful, beyond hopeful at a moment’s notice? I would.

But try as I may, God made me a certain way.

I’m the woman whose once-upon-a-time very serious career aspiration was to be a psychologist. I can listen to your stories and your burdens ALL DAY LONG. Bring me your tears, your pain, the things that have hurt you most. Bring me your impossible circumstances, your most unlikely of hopes, your NOT understanding why this or that happened or didn’t happen. I can handle it all. It doesn’t bother me that your life has been complicated, twisting, turning, filled with a whole bunch of things that were hard, don’t make sense or have tested your faith beyond measure. I believe, with all my heart, that there’s purpose for our pain, that beauty and glory are waiting to shine through our stories. I believe that life’s challenges are meant to strengthen us, fortify us, prepare us for an eternity of peace, hope and the Greatest of Loves. I believe the best stories are those in which everything imaginable falls apart, but then there is that flicker of hope, that light of hope, that tiniest key to life, HOPE.

When my husband, Seth, and I walked through Door B yesterday, plopped on the exam room couch, and waited for the oncology doctor to arrive, I must admit that I had the tiniest bit of HOPE for the news we were about to receive. Seth had a MRI of the brain the afternoon before to make sure the cancer hadn’t spread to his brain. To be honest, I was pretty worried. The only physical symptom Seth’s had through all of this is headaches, bad headaches that have required him to take Tylenol almost every day for the past two months. He thought it was just stress, but now that we’d found out the melanoma had spread to his liver, they’d ordered the brain MRI, and said they wouldn’t be surprised if the metastatic liver lesions were “the tip of the iceberg,” there was legitimate reason to fear.

So when Dr. M arrived and announced “the brain scan was clear,” the tiniest bit of HOPE turned to a swelling, overwhelming HOPE. I didn’t believe what I was hearing. I’d been worried, and so had Seth. This was one HUGE blessing, one very big RELIEF. If nothing else good came from yesterday, this huge hit of HOPE overpowered everything.

Dr. M went on to describe immunotherapy treatment in more detail than we’d ever heard. The goal, in layman’s terms, is to “turn on the immune system,” rev it up, and “get all the good guys on this thing.” Immunotherapy has proven to be effective on metastatic melanoma when the originating tumor is choroidal melanoma (eye cancer). With Seth’s very rare version of melanoma, there is at least a 30-40% chance that immunotherapy will “shrink the tumors immediately.” If immunotherapy isn’t working the way they want it to, they will try other more conventional treatments. And then there was the list of potential side effects, questions we maybe didn’t want to ask, treatment in Seattle three weeks from now, treatment and tests at Mayo in Minnesota six weeks from now, more treatments, and the reminder that this is “an unusual version of an unusual tumor.”

HOPE.

Whether it’s bursting and swelling out of us; whether it’s super hopeful, happy hopeful or beyond hopeful; or whether it’s the tiniest of hopes, HOPE is HOPE.

From here on out, I place no judgement on the amount of hope I have vs. the amount of hope Seth has vs. the amount of hope our kids have vs. the amount of hope Seth’s parents have vs. the amount of hope my parent’s have vs. the amount of hope pastors have vs. the amount of hope our friends, family and colleagues have.

HOPE is HOPE.

That is what I will embrace today. That is what I proclaim today. That is what feels right and seems right today.

HOPE is HOPE.

It doesn’t really matter how much you have, how loudly you yell it from the streets, or how quietly you guard it inside your heart.

HOPE is HOPE.

So I had hope, a swelling of hope and a bit more guarded and exhausted sort of hope, when we arrived for Seth’s first immunotherapy treatment at Mayo Clinic yesterday afternoon. Nurse Bert was helpful, hopeful. She’s been working in oncology for 35 years, many of those years alongside Dr. M. She reminded us that he is a world renowned physician, sounded genuinely excited about how much HOPE immunotherapy has brought to the world of cancer, and had a fierce, but friendly positivity to her that made you believe, yet again, that there was TRULY HOPE, even amidst these darkest of circumstances.

The nurse prepared Seth for the infusion. Bag one. Bag two.

The tiniest of hopes. A swelling of hope.

HOPE is HOPE.

When we stood in the sanctuary and said our vows to Pastor Darrell, Pastor Grandpa Selmer and a church full of friends and relatives 20 years ago, we hadn’t a clue about what better or worse, richer or poorer, or sickness and health would look like in real married life. That’s amazing grace, for sure.

So when things started to get really hard in the summer of 2004, just six years into our marriage, we pressed into those vows and learned what it looks like to love in the midst of significant life trials. Trial after trial, we made it through. 15 years in, our marriage started showing signs of fatigue, but we kept pressing on, leaned into God and each other, and made it through.

Then came a major career change and three mission trips for me, an eye cancer diagnosis and treatment for Seth, and a lung transplant for my dad. We had lice in our household four times over the course of two years, and I landed in the ER due to a panic attack I thought was a heart attack. Seth was impacted by a massive corporate reorganization, which was followed by a great job offer and a huge cross-country move from Minneapolis to Seattle for our family of five.

But our next adventure was coming.

In early March 2018, I began contacting Mayo Clinic in Rochester, Minnesota, as Seth was due for his regular eye cancer follow-up appointments, and we needed to get them on the calendar ASAP.

After a long wait to get in, Seth found himself back at Mayo for three days of eye cancer follow-up appointments on May 30th, 31st and June 1st, 2018. On May 30th, while Seth was sitting at Mayo with his parents, I was at our new house in the suburbs of Seattle for one last walk through with our realtor and the construction manager before we were scheduled to close and receive keys on June 4th.

So that afternoon of May 30th, right after I’d completed the final walk through our new house, I received a call with good news and bad news from Seth. For better or for worse. For richer and poorer. In sickness and in health. Mayo tests indicated that Seth’s eye was doing well, but the CT scan revealed a lesion on his liver. They needed him come back for a MRI on day three, June 1st.

On June 4th, our new house closed and we received keys. It should have been a joyous day, but it was filled with questions and unknowns.

On June 6th, while I was on my hands and knees sealing the grout in our new house, I received a phone call from Mayo. The MRI revealed 8-10 hemorrhagic lesions on Seth’s liver, approximately 1 cm in diameter. They suspected it could be metastasis of the choroidal melanoma diagnosed and treated 3 1/2 years ago. They needed a biopsy within 1-2 weeks, no later.

I literally felt sick.

I called Seth to share the news, we brainstormed a game plan for how you’re supposed to continue putting your all into a new job WHILE moving into a new house WHILE dealing with a significant medical concern WHILE being 1,700 miles away from friends, family and the treatment center of choice. And then Seth reminded me in his normal, but unusually optimistic tone that “This is just another adventure for us.” I tried calling Seth’s parents, but they were on the road, on their way from Minnesota to help us move into our new house in Seattle. I called my mom. Then I heard back from Seth’s parents and shared the news with them.

While Seth’s primary doctor at Mayo was out on vacation for a handful of days, there was debate as to whether we could get the biopsy done in Seattle or whether we would need to fly back to Mayo. But when Seth’s doctor returned, he was adamant that the biopsy be done at Mayo since they’ve seen more of this than anyone else in the country. So by Friday morning, June 8th, our flights were booked to Minnesota for a biopsy and an appointment with medical oncology, “just in case.”

That night, I frantically began packing loads of belongings from our two-bedroom town home into my car. There was no way we were going to stay another night in that stuffy, dark, two-bedroom town home. The lease was going to expire soon anyway. I was bound and determined that we’d start sleeping at our new house THAT NIGHT, even though we didn’t have beds yet. We had the keys. That’s all we needed. We shared the medical news with the kids, had a massive family crying session in that town home, and drove over to the house for our first night’s stay.

On Monday, June 11th, at 9:00 am, the moving truck and three movers arrived at our new house in the suburbs of Seattle. All of our belongings had been in storage for six months, as we’d lived extremely minimally in a two-bedroom town home while our house was being built. This was all part of the relocation package Seth received when he accepted the job in Seattle, but this was all feeling very odd and unsettling, not to mention incredibly difficult to know HOW to FEEL with a major medical concern looming in the background.

Monday we moved in. Tuesday we tried to get as much unpacked as we could. The living room, kitchen and kids rooms were first priority for functional, practical living. By Wednesday, June 13th, at 1:30 pm, we were at the airport making our way to Mayo Clinic in Minnesota for Seth’s biopsy.

Two days of me, Seth and my mom at Mayo and a slough of changes and unknowns, we got in with a world-renowned oncology doctor who was supposed to have his Friday afternoon of June 15th off. We had had an answer.

The “biopsy shows melanoma. We are dealing with a misbehaved tumor,” said Dr. M. On one hand, “there’s not a lot of trouble” in the liver, but this could be the “tip of the iceberg.” “Looks like we need to get busy,” he said. “We don’t have great treatments for this, but we have treatments that work.”

Dr. M asked us what our plans were for this coming week. “Well, we were scheduled to fly home tomorrow (Saturday, June 16th), but we want to get moving on this ASAP, so we can stay if that’s what you determine is best,” I said, though the truth was I didn’t want this to be happening in any way, shape or form.

Dr. M got on it. While we were still sitting there, he placed orders for a MRI of the brain, more blood work, a full-body PET scan, another mid-week medical oncology appointment with him, and a first treatment at Mayo.

Dr. M gave us a brochure about Metastatic Melanoma and told us to read it at our leisure when we could process more effectively. He explained that this is a metastasis of the incredibly rare choroidal melanoma Seth had 3 1/2 years ago (diagnosed in 6 in 1 million people every year). He went on to describe three treatment options, then quickly concluded they’ve had the best success with immunotherapy, a new arm of cancer treatment in which they turn on the immune system to fight the cancer. Immunotherapy tries to break control and turn tables on the cancer. Seth is healthy and strong, so this is the best treatment option.

Treatment is every three weeks. Typically, they do 2-3 rounds of treatment and then repeat imaging to determine the efficacy. For Seth, they will do two rounds of treatment and then repeat imaging.

Dr. M gave the scheduler a list of appointments that needed to be made ASAP. We returned to the waiting room and shared the updates with my mom. As we made our way back to central Minnesota where my parents live, we called Seth’s parents who are in Seattle caring for our kids and provided them with updates. A few hours later, we made individual calls to our three children, sharing the news at a level that was developmentally appropriate for each one.

So here we are. In central Minnesota for two days with my parents, then back to Mayo in southern Minnesota for another week. We just moved into our new house in Seattle, Washington, FIVE days ago. Our kids are there, 1,700 miles away, with my in-laws. And our 20th wedding anniversary is in ELEVEN days. We will be at Mayo Clinic for tests and treatments at least FIVE of the next ELEVEN days leading up to our anniversary. What more can I say?

Right now, I don’t claim to know anything about the world, how it works, and WHY things happen the way they happen. But if I had to say what it is that I know for sure, I’d say that we can make all the plans we want, but it is God who establishes and ordains our steps. I have no idea in heaven or on earth as to WHY God would allow this to happen after ALL we’ve been through the past 14 years. I am having a difficult time processing all the WHY GOD questions. I DON’T. UNDERSTAND. This doesn’t feel good, and it doesn’t feel like it’s coming from a God who is good. But I also spent the past 14 years developing a sturdy faith, so the Lord keeps spinning me in circles back to Him. I must trust, even when I can’t see, even when I have NO CLUE as to why this is happening.

And then I circle back to the vows.

For better, for worse.

For richer, for poorer.

In sickness and in health.

We hadn’t a clue 20 years ago, but here we are. We’re still kicking. The show must go on. This is what we vowed. This is what we promised. This is the truth.

So we ask for prayers to lift us up during this trial. For us and for our three children. We ask for the high-skilled, world-renowned doctors at Mayo and in Seattle. We ask for clarity as we journey this trial and determine each next-best step. We ask for our new home to become a place of refuge. We ask for new friends to come alongside us in Seattle. We ask for old friends and family to support us while we’re here in Minnesota and when we return to Seattle.  We ask for peace and positivity along the way. We ask for stomach aches to be eased, and tears to be shed and then wiped away with the softest of tissues. We ask for support in whatever way, shape or form we need. Coming off of a 9 1/2 month layoff, moving to a city that has a sky-high cost of living, then moving immediately into a major medical crisis is not easy on the finances. We ask for your friendship, your love, your care. We ask for your patience and understanding as we return calls, texts, and messages…or maybe we’re NOT able to return them at all. We ask that you bathe our marriage, our children, and our family in all the prayer you can muster. We ask that we will come through this. We ask these things with deepest humility, with deepest regard for each human being who knows us and has seen us through 20 years of marriage.

If I could’ve written my own story, I wouldn’t have written it this way.

But so begins our next adventure.

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