A Liver Biopsy

The dogs were pooped after playing with their Christmas toys

When I was young, I loved a good rain storm.  I would watch with fascination as the rain dripped down the window, each drop pushing the previous drop down the glass.  I loved riding in the car and hearing the rain pound on the metal of the car.  It was a symphony to my young ears.
On our way to school each morning we passed over the train tracks and under an overpass bridge for the highway.  We loved to throw our hands in the air and shout "WEEEEEE" as we went up over the tracks and under the bridge.  It was like a daily theme park ride for 3 young siblings.
I especially loved this ride when it was raining.  I would listen to the rain pounding on the roof of the car as we crossed the tracks.  It felt as if we were being launched directly into the source on the rain before we came down again and under the overpass.  The rain would abruptly stop as we drove under the cover of the bridge and the stark silence that it provided from the pounding rain was always profound to me.  I would hold my breath as we passed under the bridge to thoroughly enjoy the silence before we drove back into the pounding rain.
For me, that was heaven.
These past few weeks have reminded me of that kind of serenity.  I feel like I have been holding my breath and enjoying the silence that has existed in our lives before the rain begins again.  We had a most enjoyable Christmas.  I got Willie what I consider to be the best gift of all time.  In November, when we thought he would be getting the transplant, I was struggling to think of a small gift that would be meaningful that I could give Willie for Christmas in the hospital.  I wracked my brain for weeks when I had a stroke of genius:  I would get our dog DNA tested so we can finally know what breed she is!  I did a lot of Internet research on the matter until I found a company that can test the dog's saliva to determine breed.  I sent away for the kit and when it arrived, Kona and I had a show-down with the cheek swabbing.  She wanted nothing to do with the long Q-tip I shoved in her mouth, but in the end, I won and send back the kit with her DNA in it.
I got the results of her test in the end of November and could hardly keep it secret for a full month.  As Christmas approached, I thought I would explode from anticipation of him opening his gift.  On Christmas Eve we went to Willie's parents house for hours devours and opening presents.  It was a battle between me and our 10 year old nephew to see who was more antsy to open gifts. 
I scarfed my food and asked if I could give Willie his gift right then. 
I simply couldn't wait another minute. 
I had printed off the results of Kona's test and put them in a folder then wrapped in brightly colored Santa paper.  I had written on it "To: Willie  The BEST gift ever!!!!"
Attached to the top of the gift was a smaller present that I instructed him to open first.  He removed the paper to reveal a wooden ornament of a dog that looks like Kona.  Above the dog is engraved "Icelandic Sheepdog" and below it reads "Kona 2012."
"Is that what she is?" he said to me, holding the ornament in the air as he admired it.
"Don't ruin it for yourself!" I shouted "Keep opening."
He removed the paper with the speed of a snail, knowing full well that it was making me crazy.  He pulled out the folder and looked at the pictures.
"She's a sheepdog?" he said.  It was almost a statement, but had a hint of question that revealed the years of wondering and researching he has done to find out what breed she is.  We've had Kona for 3 years and she came to us from a friend that found her in a park.  She is a beautiful dog that doesn't resemble one specific breed that we could tell.  Willie had spent hours looking through a giant book of breeds entitled "The Dog Bible" and we had held many a conversation on guesses of her genetic make up.
Neither of us EVER guessed sheepdog.
The test showed that one of her parents was a pure bread Icelandic Sheepdog and the other was a mixed breed with varieties of terrier, shepherd, and chow chow.  As we have read more about the sheepdog it is clear that she gets a lot of her personality traits from that side of her make up.  He is definitely a herder of things and people and enjoys most to herd the neighbors cats back into their yard.
"Is it the best gift ever?" I asked Willie as we finished looking at the report.  I was still breathless with excitement that wouldn't wear off for the rest of the night.
"Yeah," he said, casually "It's pretty good."
I laughed as he got up to find Kona and tell her that she is a sheepdog.  That is the moment I was looking forward to from the time I had the idea to get her tested.  I couldn't wait to hear what he would say to our dog!  He gathered Kona close to him and patted her belly as he told her of her origins. 
She was unimpressed.
Later that night I was lying in bed with Kona when Willie came in.
"There's my girls," he said, lying on the bed and resting his head on Kona's belly.
"Kona," he said to her "did you know you're a sheep dog?
She responded by letting out a loud sigh.
"You're a little herder," he continued "and you like the cold.  That's why you always wear this fur coat."
He grabbed a handful of her loose fur and held it up for her to see.
She opened her eyes just enough to inform us that she was too busy sleeping to entertain our conversation.
He layed back on her belly and rested his hand on my leg.
"Merry Christmas Baby." He said, smiling at me.
"Merry Christmas!" I said and took a picture with my heart.
We were so spoiled for Christmas and I feel overwhelming blessed. I made Willie a book of messages and pictures from his friends and family to take with us to the hospital and he made me a book of pictures from our life together so far.

Christmas and Camo
 

Great minds think alike!
I was shocked when I opened my last gift from him to find a Kindle Fire HD.  It was totally unexpected.  I hadn't asked for it and didn't know I wanted one, but after using it for a day now I have fallen deeply and totally in love with it.
It was the best Christmas ever and the most meaningful one I've ever celebrated.  It was wonderful this year to reflect on the meaning of the season and feel the personal impact that the birth of our Savior has in our lives.  That is truly the BEST gift ever and one that I am deeply grateful for.
We came back to Stanford yesterday for lab work and to meet with the transplant doctor.  Willie's liver numbers have been a concern for the past month as they have been elevated.  We had been warned that if they had not decreased enough, they would have to do a liver biopsy to rule out any serious liver damage.  The thought of a liver biopsy gave us both a lot of anxiety so we became vigilant with his diet and supplements for the past two weeks to hopefully drop those numbers.
The anxiety in the dr.s office was tangible as we waited for the results from his blood work.
A man entered the room wearing jeans and a black, long sleeved tee shirt.
"Are you Mr. Beavers?" he asked, extending his hand as Willie nodded his head.
"I'm Dr. Lowsky," she said, smiling "I am filling in for Dr. Laport today."
He pulled up a stool and sat down.  He was in his late 40's with short brown hair and an athletic build that made me think that the decor of his office features pictures of himself standing on various mountains he has climbed.
He crossed his legs, revealing a pair of brown sketchers and leaned toward us
"Your labs look good, but your liver is still inflamed so we're going to go ahead with the biopsy."
Willie and I both gasped.  We had convinced ourselves we could pull those numbers down ourselves.
"What is his ALT number today?" I asked
"It's better, but not low enough," the Dr. replied "He dropped from 290 to 210, which is significant, but normal levels are below 60 so we need to make sure that isn't something else going on."
He explained that the CT showed fat deposits in Willie's liver which can account for poor function and can be a result of receiving multiple rounds of chemo.
"We will still go forward with the transplant, we just need to get a look at the liver tissue by doing the biopsy before we go into the transplant."
He stared sternly at Willie to silence any debate.
"Look buddy," he said, leaning forward on his stool "the transplant is going to be a grunt.  You're not going to eat, you're not going to drink, you are going to have blisters in all 26 feets of your digestive track and you will have blood oozing out your mouth.  You are going to be in a lot of pain, but you don't need to worry about any of that because we will put you on a pain pump and you'll have IV's and feeding tubes."
I sat there in shock.  He certainly wasn't sugar coating anything.  I looked over at Willie to gauge his reaction.  He was staring straight ahead, his eyes showing no emotion.
"We've heard all this," Willie said flatly "I've handled everything well so far so we're hoping things will go well."
I wanted to stand an applaud my husband for his optimism, but the Dr quickly squashed it.
"Even in the most mild of cases, the patients still get oozing sores."
This time he stared sternly at both of us to see if we would challenge him.
I wanted to tell him that we have talked with several people who have gotten transplants and haven't gotten the mouth sores.  We have been warned for months about the mucositis that can occur.  The radiation kills all the rapidly dividing cells in the body which means all the mucosal lining in the mouth and digestive track is destroyed.   This can result in painful mouth sores and digestive distress.  Some people become so inflamed that they can't even swallow for weeks.  We have heard all the gruesome details and prefer to remain optimistic that it will not be too awful for Willie. 
Your prayers for smooth sailing will help!
"You're going to be fine," he said, lightening the mood "You'll get the transplant and be cured.  Two years from now this will just be a part of your story."
He leaned back and observed us both.
"Do you have any kids?"
"Not yet," Willie replied "they're frozen right now."
This has become our programmed response since Willie got cancer.  It makes me smile every time I hear it.
The Dr looked confused and concerned "You have them fro.....OHHHHH!" He threw his head back and laughed as he realized what Willie had said.
"That's clever, I've never heard that before." 
He looked at us differently this time, with a heighten level of respect for thinking of such a clever line.
"You're going to have a bright future, you'll kick this cancer and have yourself some frozen babies."
We all laughed as she stood and shook our hands, although I think we'll thaw the babies first!
"Well he was certainly blunt." I said, as soon as the door closed behind the Dr.
"I liked him." Willie said.
I was just about to ask him why when the door opened and the transplant nurse walked in.
"What did you think of Dr. Lowsky?" she asked, after we exchanged formalities.
"He doesn't sugar coat anything!" I said.
She smiled "No he doesn't.  Did he say that transplant was going to be a grunt?  He's famous for using that term."
She laughed as we confirmed that he had indeed used his catch phrase.

Waiting with Will's wedding ring...again.
This time with the Kindle though!

The nurse gave us instructions for the biopsy and we left the cancer clinic.  We spent the night and reported bright and early this morning to the outpatient surgery center.  The surgeon met with us to explain the procedure.  He would give Willie some light anasthesia then insert a line in the vein in his neck.  He would feed that line down to the Liver and clip off a few samples.  It sounded gruesome, at best, but a pretty simple procedure.
"How does this compare to a bone marrow biopsy?" Willie asked the surgeon
"Have you had a bone marrow biopsy before?" He asked Willie, raising his eyebrows in question.
"Only about 6 of them." Willie said casually.
The surgeon laughed and slapped Willie on the shoulder "This is going to be cake then.  If you've done that then this will be nothing!"
I liked him.  He told us that his cousin received a bone marrow transplant 4 years ago from the same dr. Willie has. 
"I'm a huge fan of Dr. Laport," he said as he was leaving "my cousin is doing fantastic and you will do the same.  You're in good hands."
There seemed to be a running theme this trip of people assuring us things will be fine.  We already feel that way, but it's nice to be validated.
The liver biopsy went well.  He was done in 30 minutes and wheeled back to the staging room.  He was groggy from the anaesthetic, but said it had been fine and he hadn't felt anything.  We will have results from the biopsy hopefully by tomorrow, but it seems as though there is nothing that could come up to delay the transplant.
(Knock on wood!)
As we drove home it hit me that we will be leaving in 2.5 short days.  A mild panic ensued as I thought of all the things I need to do.  I realized that I have been able to complete most of the things on my list during this time the transplant has been delayed. 
What a blessing that turned out to be!
We are so happy to have had this time to spend at home with our family and friends before going back into the fire.  We are grateful to all of you who have kept us in your thoughts and prayers and feel so blessed by the outpouring of love we have received.  These next few month will probably be the most challenging we will ever face, but we are confident that we will come out of it with better health, stronger faith, and be better looking!
Happy New Year to all!  See you next year!