Wednesday, April 30, 2014

Update

It's been 8 days since I had my second dose of chemotherapy and this cycle has been mostly predictable, which is a good thing.  The first week was rough as expected but I'm feeling much better today.  If the rest of the cycle follows suit, I'll feel good this week followed by a dip in energy early next week and then feeling decent by the time round 3 comes.  Good day or bad, I start each day by thanking God for all of the blessings in my life (of which there are many) and that sets the tone for the day.

Tiffany's sister Pascha was also in town to visit this past week.  It was nice to see her and I'm grateful that she spent time praying for my healing. 

I did have one issue last week where I felt like my heart was pounding and beating irregularly.  I woke up in the middle of the first night after chemo with a gasp and my heart was beating hard.  I fell back asleep but over the next couple of days it would come and go, especially when I was lying down.   On Friday morning, I decided ("was convinced") to call the doctor and they asked me to come in to get checked out.  I ended up spending most of the day there and at the hospital getting blood work, a chest x-ray, an EKG and an echocardiogram.  Everything came back fine, so they assume it was just the prednisone messing with me and to keep an eye on it.  I felt better by the end of the weekend, so I guess it's another one of the side effects during the first week I'll have to deal with.  

I mentioned in the last post that my hair was starting to fall out and that has been slowly continuing.  It's also still growing, but in a weird and splotchy way, so I have to keep shaving my face and head.

I may keep the shaved head after this is all over


One thing I've been noticing more this time around is the mental/ emotional effect of the chemo and/ or the other drugs I'm taking.  It's difficult to put into words, but in addition to the physical sickness I have the first week after chemo, there's definitely something else chemically or hormonally going on.  I feel emotionally "flat" for lack of a better term.  I'm not sad or depressed because I know in my mind that I have nothing to be sad or depressed about, but it's a very bland feeling where I don't feel happy and things that I know usually make me feel good don't.  Mentally I'm still in a good place and I know I am happy, but I don't feel happy.  It's like the feelings are blocked until about day 7 or 8.  So in addition to feeling better physically, it's such a relief to get back to normal emotionally after the first week.  I  know that one of my anti-nausea drugs is a serotonin blocker and another is a dopamine blocker, which are both "feel good" chemicals, but it usually lasts a few days after I stop taking those.  Whatever it is, I have a newfound empathy for people who suffer from depression.  It's a strange and unpleasant feeling when your mind and emotions are off like that. 

That's all for now.  33% done with the hard part, but who's counting...




Tuesday, April 22, 2014

One Down

Today was my appointment for the second cycle of chemo so I've now officially completed one round.  One down, five to go.  The timing worked out well as we were able to enjoy Easter with family on Sunday while I was feeling good.  It was just Tiffany and I this morning for the 8:00am appointment and the day started with the now familiar routine of vital signs and blood work.  My white blood counts were low last week, which was expected, so they needed to be above a certain level today. Otherwise I would have needed medication to stimulate white cell growth before getting chemo.  Thankfully they were back above the level they needed to be and the nurse proceeded with the regimen.  The whole process still took about 7 hours, but I felt like this time was easier.  Knowing what to expect made a huge difference so I wasn't worried about getting a reaction every time a new drug was added.  I spent most of the time reading and listening to music, although it's difficult to focus on reading with all of the drugs.

Cycle 2 in the shirt from my Spartan family, Al and Collette

I also feel like I have an idea of how the weeks themselves will play out during each cycle.  This takes some of the stress away and the fear of the unknown.  The first week is generally unpleasant, the second week is pretty good, and the third week is when I am the most tired until a few days before the end..  Since the chemo is cumulative, this pattern will get more intense and possibly change, but I'm thankful that I'm not going to feel how I do the first week for the entire 5 months.  The bad days really do make the good days so much better.

As I'm sitting here typing, I've been unconsciously feeling my newly grown beard and noticing the hair on my hands.  My hair is falling out.  It was fun while it lasted, but I'll be shaving it off with the rest of my hair tonight.  This is a part of the process that can be traumatic for a lot of people that go through it, but I'm okay with it.  I can understand why it's hard though.  Up until this point there was no way anyone would know I have cancer unless I told them (or they read this blog) because I still look normal.  Now my appearance will be broadcasting to the world that I am a cancer patient.  Personally, I look at it as a sign that the drugs are doing their job and the hair loss is just collateral damage.  Plus I have some cool new hats and sunglasses to wear.  Maybe my attitude will change after getting the stares and/or awkward comments from strangers, but those things are outside of my control.  I've dealt with minor disappointments in my life in the past by holding to the idea that "my circumstances do not determine my character; my character determines how I respond to my circumstances" and that's how I'm approaching this as well.  Full disclosure: I learned that after dealing with disappointments the wrong way early on.

 I hope this post is coherent because I'm a little "foggy" tonight but I wanted to write.  I'll end with something that my good friend's dad told me after church on Sunday that I wanted to share: "Every setback is just a setup for a comeback."  That is the truth. 

It's all about perspective, so like this song says I'm doin' alright.


Sunday, April 13, 2014

Gratitude, Not Attitude

I'm almost finished with week 2 of cycle 1 of chemo and I can say that this week has been much better than the first.  The first week, while it certainly could have been worse, was tough as I just felt sick, tired and gross every day.  It's not like anything I've ever experienced, so the closest description I've come up with so far is like a combination of having a hangover and food poisoning at the same time ("oh, like a weekend in Tiajuana!" said my friend Pat.)  Of course when anyone asked how I was doing I would say "good" but I guess it's all relative.  My definition of "good' was "not throwing up" which I'm still thankful for.  All of the anti nausea drugs worked well, although they made me cloudy so I tried to stop taking them as soon as I could.  I've also started getting acupuncture treatments every week, which I've really enjoyed.  Recent clinical studies have shown what the Chinese have known for centuries, that acupuncture can aid in treating a variety of conditions including, in my case, boosting immune function and helping with chemotherapy side effects.  While obviously not a replacement for modern medicine, it's useful as a complimentary therapy.  At a minimum, it's the most relaxing hour of my week.  And no, the needles don't hurt. :)

So I started feeling a little better on Tuesday of last week, exactly one week after chemo started. Coincidentally, this was also the day I had somewhat of a revelation.  This experience is teaching me to appreciate life differently, to value each day more because the next 40-50 years aren't guaranteed.  That peace and happiness aren't things to try to accomplish for the future, but things that exist right now.  And at the root of those things is gratitude.  Our culture is built around discontent and always wanting more.  Marketers figured out a long time ago that they can create "need" and drive us to consume more and more so that it will never be enough.  Because of that, it's hard to step back and truly appreciate everything that we have.  It's easier and maybe more natural to focus on the things we lack, to compare ourselves with our perceptions of other people.  I heard it said once that we should never compare ourselves with other people, because it can only result in us feeling either prideful or inferior, and neither of those are positive.

I decided that I would focus on being grateful throughout this experience. Regardless of how I'm feeling or the circumstances around me, I have a lot to be thankful for.  The Bible says in 1 Thessalonians 5:16-18: "Rejoice always, pray continually, give thanks in all circumstances; for this is God's will for you in Christ Jesus."  All circumstances, not just the mountaintops.  I've tried to do this on some level in the past and it really does work.  When I would be running a long endurance race or mountain race, I would start praying in my head and thanking God for every possible thing in my life to take the focus off of the physical pain.  It really made the time go by faster.  I've also heard of people getting over major depression by volunteering to serve others in need.  I suppose it works in the same way by taking the focus off of self and providing perspective.

Being thankful while carrying a 60 pound sandbag up Mt. Killington

Being thankful crawling through the mud with Al (who is wearing shorts by the way)

Here are just some of the things I'm thankful for right now:  I'm thankful that we're having a boy in September!  I'm thankful that my last round of chemo is in July and I'll be recovering when he's born.  I'm thankful for my beautiful wife and daughters.  I'm thankful for my supportive family, church family, friends and coworkers. I'm thankful for good benefits at work.  I'm thankful that the weather is turning here and I can be outside in the fresh air.  I'm thankful for dark chocolate.  I'm thankful for modern medicine and my medical team and also that this isn't a death sentence like it was 50 years ago.


That's just a small sample.  But if you're reading this and you're going through a trial I would encourage you to try it too.  Surely you have things to be thankful for and meditating on those things can release a healing chemical reaction in your body, mind and spirit.



Thursday, April 3, 2014

Chemo Cycle 1

Before starting chemotherapy on 4/1, Tiffany and I wanted to get away for one last weekend to just relax and be together.  The prior four weeks had been busy and stressful in addition to the unknown ahead, so we were really looking forward to it.  We spent the weekend at Church Landing in Meredith, NH in a room overlooking (frozen) Lake Winnipesaukee courtesy of some unexpected generosity from friends.  We are also appreciative of our parents who split up the weekend watching the girls.  While it was supposed to be a cancer free weekend I'll admit the topic may have still come up a few times, but we had an amazing time.  Tiffany wrote more about it here.   We came home on Sunday refreshed and ready for the next step in the journey. 

Monday night we had a small gathering with family and friends which was really nice.  It felt kind of like a send off even though I'm not going anywhere.  Everyone enjoyed pizza and cupcakes, lots of hugs and a nice prayer and then it was time to get home to get a good night's sleep.  Tiffany asked me again that night if I was nervous about the next day and I really wasn't.  I'm not trying to sound overly tough because trust me I deal with anxiety and fear like everyone else.  The only explanation for the peace I felt is the amount of prayer that has been and is still being sent up for me.  The verse I shared in the last post, Phillipians 4:7 mentions this as "the peace of God, which transcends all understanding."  I slept great that night and then we were up early on Tuesday to get to the Lahey Clinic by 8:00am.


Tiffany, my mom and I arrived at the office and were taken back soon after.  I chose the recliner in the far corner of the infusion therapy room, which is basically a room filled with big reclining chairs separated by curtains.  Each little station has it's own TV, along with pillows and blankets to make you comfortable.  I brought my bag filled with books and electronics to pass the time over the next 8 hours.  My nurse for the day, Shelley, came over and introduced herself.  I started with some Tylenol and then she "plugged" me into the IV through my port.  I was shocked at how much this hurt and she gave me some numbing cream to prep the area for the next time I came back.  Next came the Benadryl through the IV followed by one of the anti-nausea drugs, Aloxi and a steroid.  After that came the Rituxan, which would take 4 hours to deliver for this first time.  I quickly felt drowsy from the Benadryl and then cold, so I was given a couple blankets and just sat back.    I felt a little weird, almost like when you know you're about to be sick but it hasn't come on yet, but nothing major. During the morning, I met with Dr. D'Silva, the nurse navigator, the social worker, and the nutritionist who all came over to talk.  Everything went fine for the next couple hours and Tiffany and my mom left to go get lunch.  The clinic provided lunch and snacks during the day and I was able to eat with no problems. I tried to read a little (finally almost finishing "The Last Pick" by Dave McGillivray) and mostly just dosed in and out.


The next two drugs were "push" drugs, where the nurse injects the syringe directly into the IV (versus having a bag with a slow drip).  Those went in quickly and were followed by another anti nausea drug called Emend. The last one was another slow drip one but it would only take an hour.  Once that one was finished we were cleared to go as I would be taking the Prednisone at home for the next 5 days on my own.  I felt ok, although I had the sense of being pumped full of chemicals.  Once we got home, I was pretty tired so I took a nap and then had dinner.  I still felt a little cloudy the rest of the night, although the Prednisone can make you hyper, so I took an Adivan and an anti nausea pill before bed to be able to sleep that first night.  The rest of the time I'll be taking the Prednisone in the morning.

The last two days have been OK.  I've been taking all my medicine to deal with the side effects religiously and so far so good.  I've also been drinking my green drink every morning and night (made with all organic kale, spinach, celery, cucumbers, parsley, apples, ginger root, lime juice and lemon juice), drinking lots of distilled water and making sure I get enough protein (chocolate almond milk and organic grass fed whey protein shakes.)  Feeding my body right is going to be more important than ever these next few months, so I've also been avoiding processed foods and sugar (mostly - I may have had a few Cadbury mini eggs that came with our dinner last night :) )  The most annoying part was getting these nasty hiccups every time I ate yesterday, I think 5 or 6 different times.  I heard it may be from the Zofran, which is the anti nausea drug, so it's still a trade off that I'll take.  Today has been better though.  I even went for a 30 minute walk this morning since it's warming up somewhat here.  Supposedly days 7-14 are the "nadir" or low point at least energy wise, so we'll have to see what that looks like and then I'll start quickly losing my hair around day 15 they said.  I'll be ready with a new Patriots hat from my mother in law and a nice new Red Sox hat that came in the mail yesterday (thanks Robin!)  That's all for now and thank you for your continued support!

Warning: this song is extremely hard and aggressive. The message is positive, a take on Psalm 23, but it's delivered angrily, a kind of righteous indignation.  It's called Fearless and it really speaks to me to know that God is with me during this time and the tone fires me up for this fight.  I know that probably most of my readers would approve of the content but object to the style, so I want to be respectful of that.  




Saturday, March 29, 2014

Second Opinion

Thursday was the big day where we had our appointment at Mass General with Dr. Abramson for a second opinion on the diagnosis and treatment plan.  We have no lack of confidence in Dr. D'Silva and the team from the Lahey Clinic, but second (and sometimes third or more) opinions are important to get when you're dealing with cancer, especially types that offer a number of different treatment options.  Dr. D'Silva himself actually arranged for this visit which says a lot about him.  Dr. Abramson is the director of the Lymphoma Center as well as a professor at Harvard Medical School, so I was anxious to get his assessment.  My entourage for this appointment consisted of Tiffany, my parents, and my older brother John.  It was a cozy ride down to Boston but we made good time and found our way to the Lymphoma Center and checked in.  I learned that we would be seeing Dr. Abramson's fellow, Dr. Oser first, which was fine with me; the more lymphoma specialists the merrier.


We were called in exactly on time and piled into one of the treatment rooms.  After the nurse took my vital signs and asked the standard questions, she gave me a paper that listed my care team from Mass General. This listed all of the doctors and nurses I would have access to.  It made me feel good to have another whole team of experts that would be available to me.  Soon after, Dr. Oser came in and introduced himself to everyone.  He had reviewed my case and spent most of the time talking about the most recent pathology report from Mass General.  The biopsy was reviewed by the pathologists there after I received my initial diagnosis and there were some differences.  While the initial results indicated follicular lymphoma with an aggressive type similar to diffuse large B cell lymphoma, the latest pathology showed it to be straight follicular lymphoma, which is a slow growing type.  Apparently I am right in the middle as far as slow growing vs aggressive, but it's amazing to think that I've had this for years.  After about 30 minutes or so, Dr. Oser left with my discs to go review the CT and PET scan results with Dr. Abramson.


Another 30 minutes later, they both returned and Dr. Abramson introduced himself to everyone.  He started from the beginning, educating or reeducating us on what exactly lymphoma is at the cellular level, all of the different types, and then my specific type.  He explained that for slow growing or indolent lymphomas, if it is "behaving itself" or not causing any symptoms, they prefer to leave it alone until treatment is necessary because earlier treatment doesn't have any impact on overall lifespan.  In my case, even though I don't have any outward symptoms, the fact that there is so much of it encroaching on my organs means I need treatment.  He reiterated that this type was not categorized as curable, but treatable, meaning it usually returns at some point down the road (although personally I don't have to accept that right now.)  However, there have been significant advancements in lymphoma treatments very recently with even more expected in the near future.  "There's a lot of work happening for Joe," he said.

Next we talked about treatment options.  This was the part where we learned some new information.  He talked about my current planned chemotherapy regimen, R-CHOP, as well as another that has seen recent success, R-CVP, and a newer regimen called R-Bendamustine that was only FDA approved in 2008.  He also told us that I qualify for a current clinical trial for a drug called Lenalidomide, which has seen some early success in treating lymphoma.  It's a non-chemo drug, so it would be less toxic, however there is no long term data on it and if I even if joined the trial, there would only be a 50% chance that I would get it (the other half are given R-CHOP) and I'd have to drive into Boston for the treatment vs. getting it in Derry.  Given all of the options available, his recommendation was that I go with the existing plan of the R-CHOP since it's a proven treatment with over 40 years of data behind it.  I'm young enough to tolerate it and according to him, if it comes back there is a better likelihood for advanced treatments in the future that would come with less unknown risk.  He also strongly recommended "maintenance therapy" of getting just the Rituximab every 2 months for 2 years after the R-CHOP ends, which has shown to extend remission time.  Rituximab won't cause any of the chemo side effects as it is just an antibody that targets cancer cells to help our immune system kill them naturally.  We all agreed with his conclusions.


We spent the next few minutes asking some other questions, including "the" question of what could have caused this.  He confirmed what we had already been told, that it's a random genetic mutation and nothing I did caused it.  He also told us that it's not hereditary, so I couldn't blame my parents or pass it on to my children.  At that point he had spent around an hour with us and we were satisfied that we had all of the information we needed.  He gave us his card and said to contact him any time if we have questions or want to come back for another appointment.  We left feeling even more informed than we already were and more at peace with the current plan.  We were also very impressed with Dr. Abramson and grateful to have access to him in the future.  So now we're down to three more days until chemo starts and I'm ready to get on with it.

Phil 4:6,7 – “Do not be anxious about anything, but in every situation, by prayer and petition, with Thanksgiving, present your requests to God.  And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.”

Relevant verse from this song: "..couldn't believe, it could happen to me, I guess we're all one phone call from our knees..."

Tuesday, March 25, 2014

Chemo Class

Yesterday we had an appointment back at the Lahey Clinic for what they call a "Chemo Teaching Session" where we would learn all about my upcoming treatment and have an opportunity to ask questions.  As usual, I brought my entourage: Tiffany, my parents, and my mother-in-law.  Now I have to admit that this is the part of the process that has me the most concerned so far, specifically how my body is going to react to the chemotherapy .  As soon as I found out the regimen that I would be taking, I started doing research on my own and seeking out others who had gone through it.  There is a lot of information out there on reputable websites (www.lls.org, www.cancer.org, www.livestrong.org. www.chemocare.com) as well as a lot of less than reputable sites.  I've also been fortunate enough to connect with a few lymphoma survivors who have shared their experiences with me and offered advice and encouragement.  Some who are friends of friends as well as through the Leukemia and Lymphoma Society's First Connection program.  My favorite, non-scary piece of advice so far came from a friend of my cousin's, Holly, who said she would imagine the long day of chemo as if it were a spa session.  I never would have thought of that, but hey, it's worth a try.

So back to the teaching session, we were led into a conference room and joined by Colleen, the nurse practitioner, and Katie, the nurse navigator.  Katie's role is basically to be a single point of contact for me and my family to answer questions as well as coordinate all aspects of my care.  We were all ready to take notes, however she had already put together a very comprehensive binder of information which she handed me as I sat down.  They first discussed the schedule; I would be coming in every three weeks beginning on April 1st for the chemo and then coming back the day after every time for a quick shot of Neulasta, which stimulates white blood cell production in the bone marrow.

The binder

Next we learned about what the treatment itself will look like.  Basically I will be a walking (hopefully) pharmacy.  I will start taking a drug called Allopurinol a couple days before the first treatment, which will essentially prevent the dead cancer cells from damaging my kidneys due to the size of my tumor.  On the day of treatment, I'll start with an anti-nausea /anti-anxiety drug before I leave.  Once I arrive, I'll be connected to an IV through the port in my chest and get 5 more drugs before the chemo even starts.  These consist of an antihistamine, a pain reliever, 2 more anti-nauseas (seeing a theme here), and a steroid.  After that, I'll begin the 6+ hour process of getting my chemo drugs, R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin (apparently the brand name starts with an 'H'), Vincristine (Oncovin), and Prednisone (which I'll be taking by a pill for the first 5 days of every cycle.)  Once I'm all loaded up, I'll be able to go home although there's a slight chance the first cycle may be done inpatient.  I will also have 2 more prescriptions for more anti-nausea drugs to have on hand at home (definitely a theme.)  

We then learned about each chemo drug individually as far as their purpose as well as side effects.  I will be highly toxic for the first 48 hours so I'll have to be very careful during that time (they gave me a sign to hang in the bathroom that says "48 hours after chemo - FLUSH TWICE!!" with a picture of a toilet on it. Thanks.)  After that it varies by the person, but I could have to deal with fatigue, weakness, nausea (got pills for that though), mouth sores (I'll get to rinse my mouth with a delicious mix of baking soda, salt, and water three times a day to try to avoid these), constipation, and irritability, along with the expected hair loss (I'm in the market for some hats right now.)  Days 7-10 of each cycle will be what they call the nadir, or low point, of my blood counts and immune function, so I'll be at high risk for infection and will have to be extra careful during these days as well.  One thing that they kept reiterating was to call the office immediately if the side effects weren't manageable and that the goal was to make sure I made it through as comfortably as possible, which made us all feel good.

We had a chance to ask some questions and then the session was over.  Knowledge is power, and we all left with a greater understanding of what to expect as well as a better comfort level overall.  One week until cycle 1 starts and I am anxious to get it started (so it can be finished.)  Next on the schedule is the second opinion with Dr. Abramson at Mass General on Thursday and then Tiffany and I are taking a little weekend away before treatment starts while our parents watch the kids.


"In the middle of the storm, I am holding on to you..."



Sunday, March 23, 2014

Support

Supported.  Encouraged.  Blessed.  Surrounded.  Overwhelmed.  Loved.  These are all words I've used to describe the outpouring of support we've received since learning about my diagnosis.  Even while we were still in shock and disbelief, family and friends began mobilizing with acts of service and kindness.  Every prayer, every card, every online message, even every Facebook "like" gives us strength and peace to get through this.  But life goes on while we deal with this, including the annoying parts, and that is where our community has been so incredible.


Tiffany has been amazing, of course.  Despite not feeling 100% because of the pregnancy, she has put my needs above her own and taken on all of the work with the house and kids when I've been unable to help. And then there's my mother in law.  The timing of her moving to NH couldn't have come at a more critical time.  She is always a great help, but she has literally been a Godsend.  She is here almost every day cleaning, cooking, helping with the girls and watching them when we have to go to appointments.  I worry less about Tiffany during this time knowing that she has her mom here.   You can read Tiffany's response to the outpouring of support on her blog here.

No, they're not sisters.  :)
I'm fortunate to have most of my family close by.  From the very first CT scan when we learned something may be wrong, my parents have been at our side, even cancelling their vacation to be with us for appointments and in the hospital.  "Mama Pit bull" and my sister "Mini Pit bull" have been strong advocates to make sure I am getting the best care.  My dad welcomed me to "the club that no one ever wants to be a part of" and has a unique understanding of what's going on in my mind.   When we discovered that we had a mold problem in our house when I was in the hospital (because, of course), he, my brother and my brother in law were here ripping out the ceiling in my bathroom and putting a new one in.  We've also received so much love and encouragement from family afar (Connecticut, Maryland, Virginia, North Carolina, South Carolina, Florida, Georgia, Texas, Missouri, Kansas, did I miss any family?)

The Family
Words can't express how grateful we are for our church family.  Shiloh Community Church. If you live near me and you don't have a church, you should go there.  That's all I'll say about that.  The first night when we got the bad news from the enhanced CT scan, our pastor was at our house to pray with us and offer encouragement.  When I was in the hospital after the biopsy, a group of people descended on our house and spent an entire day deep cleaning it.  When our refrigerator broke down when I was in the hospital (because again, of course), they were there to help.  Shoveling my driveway when it snowed.  Signing up to bring meals to us. Making arrangements to have the mold issue professionally treated.  Sending me books.  Sending me encouraging words and scriptures (including an engraved dog tag necklace to constantly remind me of my faith.)  And not least of all, continuously praying, which has given me a different level of strength and peace that I would not have on my own.



Thank you Jack and Judy Hartman
When a friend is dealing with a significant issue, it can be hard to know what to do or say.  Our friends have also been amazing during this time to say the least.  They've visited me and provided so much encouragement over the past few weeks despite their own busy lives.  One of Tiffany's friends who lives far from us had ice cream delivered to our door one night (I didn't even know you could do that, which is probably a good thing.)  Even friends who I haven't seen since high school and even elementary school have reached out to offer support, which is just awesome.  I have tried to live my life and treat people a certain way, and although I've made mistakes along the way, it means so much to see that so many people care.  This experience has humbled me and will make me a more selfless and compassionate person.

I can't forget my coworkers.  I guess it's really true that "Fidelity Cares" (inside joke.)  My team bought me a nice leather bag filled with comfort items that will help during the chemotherapy and not to mention has graciously picked up my work without blinking an eye.  Coworkers that I didn't think even liked me have reached out with encouragement.  :)  One coworker and friend even created the below picture.  I am truly moved at that gesture and by all of the people who have made it their profile picture on Facebook.  You guys make me want to fight even harder.

So while a simple "thank you" will never be enough, know how much we appreciate everything.  And even though we still have a tough road ahead, we've already been changed for the better.

Matthew 25:34-40 “Then the King will say to those on his right, ‘Come, you who are blessed by my Father; take your inheritance, the kingdom prepared for you since the creation of the world. For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in,  I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.’  “Then the righteous will answer him, ‘Lord, when did we see you hungry and feed you, or thirsty and give you something to drink?  When did we see you a stranger and invite you in, or needing clothes and clothe you? When did we see you sick or in prison and go to visit you?’  “The King will reply, ‘Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.’

I like the message of this song about how we don't have to carry our burdens alone.