Archive for the ‘MRI’ Category

Two Years after Diagnosis and MRI Tomorrow
November 12, 2012

From James:

Today marks the two-year anniversary of the original MRI revealing So Young’s brain tumor. It’s an interesting coincidence that we have another important MRI taking place tomorrow, this time to assess the effectiveness of the chemo after the tumor began growing again, this time rapidly on her brain stem.

Once again we want to thank everyone for your prayers and many ways of showing support. A couple of examples: My colleagues at the State Department generously donated money to pay for medical expenses, many of whom have never met So Young or the girls. Also, you may have read a few comments on the blog recently from Seattle. These are friends of Ann, a beloved friend of So Young’s with whom she shared Christ just after the diagnosis. Ann became a Christian, moved across the country, and found a new family of believers to whom she is now a blessing. They’ve been writing on the blog to tell So Young how the legacy she left with Ann has carried over as a blessing to them. It’s such a meaningful thing for So Young to hear. It shows her that her life has made a difference in the midst of suffering. Those are just two examples. There are many more.

I want to ask for your prayers for my coworker Jennifer, who has posted comments on this blog before and continues to show support and concern for So Young. She recently underwent serious back surgery and is recovering. She could really use your prayers as well.

I’ll tweet the results of So Young’s MRI tomorrow, possibly around 4 p.m. or so. Thanks again for everything!


Hope for the Exercise Intolerant(?)
January 23, 2012

From James:

This is our 100th post! Woo hoo!

We had another follow-up MRI today. We are having them every three months now, so we get a quarterly dose of drama. And of course when I say “we” I mean So Young, but I say that because it feels like we are both going through it. Here is So Young right before the MRI, illustrating how un-nervous/peaceful she was.

SY "Sleeping"

She’s a pro at this now, but I have to tell you, it is stressful every time. You wait for the doctor afterwards, and no matter how optimistic you started, you have this vague feeling that she has bad news.

That was not to be the case this time. The MRI “looks great,” according to our radiation oncologist, Dr. Kristin Redmond. Last time, as you may recall, there was a dramatic reduction in size, estimated to be roughly 30% or so. This time was less dramatic, perhaps to be measured in millimeters rather than centimeters, but nevertheless it continues to get smaller. So Young asked her to show us before and after images, and we agree that today’s tumor looks rather beat up compared to the plump, thriving version of July, just six months ago.

Dr. Redmond confirmed that So Young’s newly diagnosed hypothyroidism might be caused by the radiation, although she said that the timing is rather soon after radiation ended, so the tumor might be causing it. Either way, I don’t think it is a surprise, but it is a good thing that our family practice doctor, Peter Mendel, checked for it. So Young had a bunch of symptoms that would have been written off by a less attentive physician.

Dr. Redmond also said that “exercise intolerance” is a common symptom of hypothyroidism, which would explain So Young’s recent lack of desire to run. That is the funniest turn of phrase I’ve heard in a while. I might start using it myself!

The good news about hypothyroidism, if that is in fact an issue (it hasn’t been definitively diagnosed yet), is that to counteract it, you simply take a pill. Your energy level magically goes up, along with the other symptoms that were plaguing you, supposedly.

As I write, So Young is taking a “victory lap” (as she calls it) on the treadmill. She said she wants to try the Historic Half again this May. She’s going to “take it on faith,” she says. This is her first time running in a long while, and now I have to revise the FAQs again, since I corrected them last night to say she doesn’t run anymore.

So Young has really been enjoying some hymns as performed by Sufjan Stevens recently, and although he isn’t for everybody, she wanted me to post the lyrics from one here. It captures well how we felt on the drive home and have been feeling recently.

Come, Thou Fount of Every Blessing
by Robert Robinson

Come, Thou Fount of every blessing,
Tune my heart to sing Thy grace;
Streams of mercy, never ceasing,
Call for songs of loudest praise.
Teach me some melodious sonnet,
Sung by flaming tongues above.
Praise the mount! I’m fixed upon it,
Mount of Thy redeeming love.

Sorrowing I shall be in spirit,
Till released from flesh and sin,
Yet from what I do inherit,
Here Thy praises I’ll begin;
Here I raise my Ebenezer;
Here by Thy great help I’ve come;
And I hope, by Thy good pleasure,
Safely to arrive at home.

Jesus sought me when a stranger,
Wandering from the fold of God;
He, to rescue me from danger,
Interposed His precious blood;
How His kindness yet pursues me
Mortal tongue can never tell,
Clothed in flesh, till death shall loose me
I cannot proclaim it well.

O to grace how great a debtor
Daily I’m constrained to be!
Let Thy goodness, like a fetter,
Bind my wandering heart to Thee.
Prone to wander, Lord, I feel it,
Prone to leave the God I love;
Here’s my heart, O take and seal it,
Seal it for Thy courts above.

O that day when freed from sinning,
I shall see Thy lovely face;
Clothed then in blood washed linen
How I’ll sing Thy sovereign grace;
Come, my Lord, no longer tarry,
Take my ransomed soul away;
Send thine angels now to carry
Me to realms of endless day.

On a more somber note, we ask your prayers at the passing of my step-grandmother Marie Gage. Pray especially for my grandfather, Bill Gage, now in his mid-eighties.

Many thanks to all of you for your countless prayers.

MRI Tomorrow: 1-23
January 22, 2012

From James:

Tomorrow (1-23) is going to be another three-month follow-up MRI at Johns Hopkins. The MRI will be at 8:30 a.m., with a follow-up appointment at 12:30. Before the previous three-month MRI, the tumor had shrunk 30%. We are praying that it has gotten another 30% smaller at least.

In other health news, a few days ago, So Young was diagnosed preliminarily with hypothyroidism. My theory is that the radiation itself or the tumor caused this, or both. Radiation to the head and brain tumors are known to be causes in other patients. The good news is that we now have a probable explanation for her tiredness, muscle weakness, stiff joints, and (more worrisome) tingling extremities of late. We’re having a follow-up and accompanying blood tests to confirm that diagnosis on Tuesday.

Thanks everybody for your continued prayer and support! We couldn’t make it without you.

A Good and Perfect Gift
October 24, 2011

“Every good and perfect gift is from above, coming down from the Father of the heavenly lights, who does not change like shifting shadows.” — James 1:17

From James:

So Young’s brain tumor is shrinking! We had a follow-up MRI today that seems to show a significant reduction in its size, the first ever since the diagnosis almost a year ago. We pressed Dr. Redmond to quantify it, and she said that if she was forced to guess, she would say that it has been reduced in size by 30%. This is amazing to us. They have been telling us all along that it is unlikely that it would shrink because of the type of tumor (an astrocytoma). I asked Dr. Redmond again today, and she said that it is possible for them to shrink but atypical. The doctors have always said that if it stopped growing, we would be happy with that. But to shrink? And this much? We are flabbergasted. We have prayed for it to shrink but never really expected it to, and certainly not by 1/3 in three months! It seemed like too much to ask or expect.

So thank you for your prayers. And continue to pray! Pray audaciously. Ask that it will go away entirely and that So Young will be completely restored.

As a footnote, they are saying that these are preliminary results and that the official radiologist’s report will be released tomorrow. But this is the first time they have really made a big deal about that report. Even the technician was talking about it as soon as So Young got out of the MRI room. It seems as if they noticed something significant right away. Dr. Redmond then also looked at the MRI itself and confirmed what the preliminary report was saying. They said they will tell us if the final report is any different, but that seems unlikely.

So Young and I are overjoyed, as are the girls and all of our family and friends. I overheard and participated in some very joyous telephone calls today. It shows me just how much those who love us don’t just share in our sadness, but in our high points as well.

This miracle comes as a surprise to us, even as we realize that we have nothing to be surprised about. We asked. Our Father gave. So we won’t stop asking.

We won’t be back at Johns Hopkins until the cold month of January. We’ll be having three-month follow-ups for the next two years. At this rate, with the improvements we are seeing to So Young’s eyesight, she might be able to drive herself there!

Big Weekend for So Young
October 21, 2011

From James:

This is going to be a big weekend for So Young. On Saturday, she will be speaking at our church’s annual Women’s Fall Tea. She has been keenly focused on preparing for the event for the past few weeks, writing and revising her testimony, which is currently over 30 pages printed, which sounds like a lot until you consider that the font is 40 points! So Young is both excited and nervous. It’s a once-in-a-lifetime opportunity for her to tell her story to so many people. She’s praying, and hopes that you will pray, that God will use her testimony to make a difference in people’s lives and for his glory.

This Monday (October 24) is going to be another follow-up MRI and appointment at Johns Hopkins. The follow-ups are always stressful for So Young, although we are hopeful that the progress in her vision means that something good is happening. Again, we covet your prayers.

We’ll be sure to update the blog early next week. I’ll tweet something on Monday afternoon after we get the MRI results. I’m hoping for a boring tweet!

Also, there is another issue of The Irregular Prophet in the works, if we can only get our editor-in-chief to wrap it up! Middle school can be so demanding.

Gifts Beyond Measure
July 25, 2011

From James:

“Be joyful in hope, patient in affliction, faithful in prayer.” – Romans 12:12

“Taste and see that the LORD is good; blessed is the man who takes refuge in him.” – Psalm 34:8

Today we received tremendous news from Johns Hopkins. So Young’s brain tumor is no longer “lit up” on the MRI. This means that it does not have evidence of fast-growing cells anymore. Dr. Kristen Redmond, our radiation oncologist, described the MRI as “perfect” and said that the white area on the tumor is “diminished significantly, if not gone.” It turns out that the previous MRI showed a short-term side effect of the radiation that was more an indication of tumor cells being destroyed than new tumor cells growing. The tumor has not gotten smaller and is not expected to, at least from the perspective of the doctors. Also, we continue to pray that So Young’s eyesight will be restored.

So Young has a Grade 2 astrocytoma, and that type of tumor can become fast-growing (Grade 3 or 4), but hers has not. We got a taste of what it might feel like if such a thing were to happen. But more than anything, today we also got a taste of God’s goodness.

Early on, many people dropped everything to drive So Young to Baltimore. Still more people provided meals for us, for almost 8 months straight. Now they have given up food and sleep to pray for us. That is the most tangible and significant gift they could have given: faithfulness, trust in God, self-sacrifice, prayer, and hope. You really bore a great burden with us. We would be lying if we said we were never afraid, but we felt protected and confident all along because of you, our family.

So many good things happened this week. Over fifty people fasted and prayed. Wednesday was So Young’s birthday, and her friends lavished her with love and honor. A couple who has already been so kind to us offered (unsolicited, a surprise to us) to let us use their beach house later in the summer, free of charge. Those are just a few examples from this week among many. And I don’t know why, but I honestly felt like all the good things meant that something bad was going to happen, like God was cushioning the blow for bad news. He was not. He was preparing us for more blessings.

Isn’t that just like God? He isn’t only merciful, holding back punishment from us, born his enemies. He is abundantly gracious, lavishing gifts beyond measure on his adopted children.

How do we respond? How are we going to live our lives differently after God has given us so much? These are questions that So Young and I have been asking ourselves since this all started. We don’t have concrete answers yet, but we know that we want to pour out the same love we have received.

I don’t know that we will be able to keep up.

MRI Tomorrow
July 24, 2011

From James:

The MRI tomorrow could turn out one of three ways, as I see it: good, bad, or inconclusive. (Kind of obvious, right?) An inconclusive or bad MRI that is “lit up” about the same as the previous image (or more) would probably result in another needle biopsy to determine whether there are Grade 3 or 4 cells in the tumor, indicating fast-growing cells (“malignancy” — although I’d characterize anything that damages your brain as malignant). A good MRI would be one in which the white area in the image has diminished or no longer exists. This would almost certainly mean that the brain tumor is deteriorating. I can’t say that this is exactly how the professionals at Johns Hopkins would evaluate the situation, but it is my guess.

People skipped meals and prayed for us all week. As I write this entry, people are praying “round the clock” for So Young. Instead of skipping meals, many are skipping sleep to pray at 12 a.m., 1 a.m., 2 a.m., etc. The prayers started at 5 p.m. today and will end around the time we find out the results tomorrow. Over fifty people (55 last I heard) have been involved in fasting and praying for So Young. I’m sure many more are praying that didn’t formally sign up to do so. This is truly a great gift to us.

I won’t post anything on the blog until I get home tomorrow afternoon, but I will likely tweet a status update after the doctor talks to us about the results of the MRI. Click here to view my tweets. So Young will get the MRI at around 9:40 a.m. The appointment with the radiation oncologist to discuss the results will start around 11 a.m. and will probably last less than an hour.

God bless you! Thanks for your prayers. What a great family you are.


The Girls and Their Cousin (Olivia, Left) Show Off a Turtle They Found Behind the House Earlier this Week


Follow-up MRI and Appointment: Hopeful and Afraid
June 13, 2011

From James:

We received inconclusive news from the doctor about So Young’s brain tumor today. Part of the tumor might have become fast growing. Then again, that same part of the tumor might be succumbing to the radiation treatment. Dr. Redmond believes it is probably the latter, but there is enough uncertainty that she is presenting So Young’s case before Johns Hopkins’s tumor board again next Monday. If they believe it might be fast-growing, they will probably recommend another needle biopsy to verify, but Dr. Redmond believes that they will agree with her assessment that it probably isn’t fast-growing.

(If you aren’t interested in the medical details, skip the next paragraph.)

Brain tumor MRIs are usually performed “with contrast,” meaning with an injected agent that can cause part or all of a tumor to appear more white in the image. My understanding is that the whiter all or part of a brain tumor looks in the image, the more likely that part of the tumor is suffused with many blood vessels and therefore faster growing. However, radiation itself can also cause parts of an otherwise slow-growing tumor to appear whiter, even though the cells themselves are still slow-growing. Three months ago, Dr. Redmond saw a small spot like this on So Young’s tumor and said it was not a cause for concern. But now the spot is perhaps twice as big and much whiter. She said this could mean that something is going on within the tumor vascularly as it deteriorates, but it could also indicate faster-growing cells. She said it was rare for tumors to become fast-growing “this soon.” Still, she wants a larger panel of experts (the tumor board) to offer their opinion as well.

So Young was very upset when she heard this news. She despaired that she might lose her life, and understandably so. I prayed for her and encouraged her not to assume the worst, since the worst probably isn’t true anyway, and we can’t know the future. Her point of view has improved considerably throughout the day, largely because of the prayers and encouragement of friends and family. She feels confident now that we will see a good outcome.

We have many earthly reasons to be hopeful. Her fatigue has improved. Her appetite is better. Her eyesight hasn’t deteriorated more. All of that is true. But as Kenji has said, these are ordinary hopes. We have a more extraordinary hope, no matter what happens, and that is our hope in Christ. He is very familiar with what So Young is going through. He shared our sufferings on this earth, even unto death. Because of Christ, So Young is confident of a very long life as well, here or with him — it doesn’t matter to her.

Remember early on, when I wrote that driving to and from Johns Hopkins was like going to church? We would sing hymns all along the way. Today it was something different. Maybe a different kind of church? Lacrae was blasting in the car, the bass pumping. Imagine a nerdy white guy like me and a Korean lady “bustin’ rhymes” as they say (or do they say that?) the length of 95. At first So Young cried on the way back, but pretty soon her demeanor changed. She was ready to fight.

First Follow-up Appointment and MRI
March 21, 2011

“Have I not commanded you? Be strong and courageous. Do not be afraid; do not be discouraged, for the LORD your God will be with you wherever you go.” (Joshua 1:9)

From James:

Short Version: Another long day in Baltimore — our first in 6 weeks. Today’s MRI showed no tumor growth, which is good news.

Long Version:

Today was our first MRI and follow-up after radiation treatment ended on February 2. It was an all-day affair. We departed at 7 a.m. and arrived home at around 5 p.m. The MRI appointment was in the morning, and the actual meeting with the radiation oncologist was at 1:30 p.m.

The MRI was as routine as such a thing can be, with So Young falling asleep on the table, which is probably the best thing you can do during an MRI, because it facilitates sitting still.

We had some time to kill between the MRI and the consultation, so we took the museum tour of Johns Hopkins. There is an area under the hospital’s famous Dome that contains various portraits of benefactors and famous doctors, along with a bust and portrait of Johns Hopkins himself and a 10′ tall statue of Jesus.

People write prayers or thoughts in two books in front of Jesus. We wrote our prayers as well. The sculpture is about to be covered up for renovations, so we were lucky to see it. It is surrounded with scaffolding right now. I had to take this shot from beneath it, behind the scaffolding — hence the cut off hands.

Jesus at Johns Hopkins

Here is the inscription on the pedestal. (“COME unto ME all ye that are weary and heavy laden and I will give you REST.”)


 Ever wonder what Johns Hopkins (the man) looked like? Grouchy.

Johns Hopkins (the Man)

We later ventured to a different part of the hospital (the Blaylock Building) to see the portrait of Vivien Thomas, an African-American heart surgeon and unsung hero at Hopkins who was crucial in discovering new surgical techniques for treating “Blue Baby Syndrome.” So Young and I are watching a DVD that Ellen let us borrow that tells his story — Something the Lord Made. Seeing all of these monuments made us all the more convinced that we picked the right hospital for So Young.

OK, so enough about the tourism.  (Like I said, we had time to kill.) We finally had the follow-up with the radiation oncologist, Dr. Kristen Redmond. First, we consulted with one of the residents, who asked questions about her current condition and performed basic tests of her neurological function (touch your nose, etc.). He danced around a bit about the new MRI, so as we waited for Dr. Redmond, So Young started to get nervous, but the news was good.

The brain tumor does not appear to have grown. It is the same size it was in the original MRI taken in November. It didn’t shrink, either, which I suppose would be the ideal outcome, but we still have several months for that to occur. They normally do not shrink. There are a few areas that “lit up” on the MRI, which would usually indicate fast-growing (“malignant”) cells, but Dr. Redmond said that that is expected so close to radiation and isn’t necessarily indicative of bad cells. Overall, Dr. Redmond summarized the situation this way: “It is as good as can be expected.” We will return again in June for another MRI/follow-up combo.

We can expect to go every three months for the next two years, and then every 6 months for years 3 – 5. After that, the MRIs will become annual events.

With regard to So Young’s symptoms:

  • Her eyesight may be unchanged or may have improved. Today she said she saw Dr. Redmond’s face for the first time. She has lost most of the light sensitivity that she had before, so no more sunglasses indoors.
  • She has some difficulty with short-term memory, which is normal for radiation patients.
  • She is more tired than before, but that could be caused by a lot of things, including proximity the radiation treatment and the anti-seizure medications she is on.
  • No headaches. No visual or aural hallucinations, which she was having pre-radiation and during the early radiation days.
  • Mild balance issues.

Thanks to everyone for your continued prayers and well-wishes, in person and virtual. We are so grateful for all of you and wish we could repay you for making such a difference in our lives. We send you our love as we continue on this race.

Here’s a picture of So Young before her first marathon. (She’s the one on the left…:-) ) She isn’t letting me post any recent images of her. Isn’t she beautiful? So glad to be hers. I know many are glad to know and love her, too.

So Young

Anticipating Monday and Typical Kindnesses
March 20, 2011

From James:

So Young’s first follow-up appointment and MRI after radiation treatment takes place tomorrow. I would say that we are waiting for this appointment eagerly, but it is with mixed emotions. The doctor has already told us that the tumor will likely look “angry” on the MRI, so it probably won’t be encouraging to look at, although of course it might also have retreated by that time.

Meanwhile, So Young has increased her dose of steroids to 2 mg after weaning to 1 mg, and now she is not experiencing headaches in the morning, with seems to prove that the headaches were the result of radiation-induced swelling. She is sleeping a lot more these days, almost to excess, as she was starting to do in the weeks preceding radiation treatment. I suspect that it is caused by the tumor itself. Some types of brain tumors are known to cause tiredness. Hers is in the thalamus, which affects the sleep cycle. And then there is the fact that she just recently got blasted with radiation, which can be tiring.

Yesterday was a typical Saturday at the Gage household — typical primarily in the kindness we received. Dad, Ka-loon and Sam (from church), and Ricky (our neighbor) came over to fix a falling fence in the backyard, which turned out to be a project within a project within a project that won’t be entirely complete for a few more weeks. Dad was the foreman for the job, always more than up to the task (he was made for this kind of stuff). Everybody gave many more hours than they probably anticipated but seemed glad to help.

While they labored away, we went to So Me and Jeremy’s house for Jacob’s 100 day celebration, a Korean tradition, and had tasty Korean food. Later, So Young watched Jacob and Nathanael while their parents went on a date.

Just before we left for the party, we discovered that the minivan was not operational. After a failed attempt to jump it, we almost had it towed, but the tow truck driver got it running again, so I was able to drive it to the repair shop. It could be as simple as a necessary tune-up.

In the evening, Justin and Lauren drove all the way from Arlington with a delicious, home cooked dinner for us. We invited them to stay and help us eat the meal they prepared. We have done this a couple of times with people who brought food, and the reaction we get is priceless. It’s an awkward suggestion. The (understandable) reaction is sort of like this: “You want us to eat the food we brought for you?” But it turned out well, allowing us to get to know this delightful couple much better than we otherwise would.

We talked a lot about our years at Ambassador Bible Church, which will be 14 this summer. So Young and I later reflected that we saw ourselves in them, as a young couple just starting out.  We didn’t know how things would turn out then — three kids, a lot of ups and downs, best friends even now. We still don’t know how things will turn out in a lot of ways, but we know that despite all the change, good and bad — like Lindsay prayed last night before bedtime — “God is good, all the time.” Yesterday was still more proof.