Laurie-ann was diagonosed with inflammatory breast cancer stage 3B on August 16, 2019
We Copples have completed more than two thirds of our mission, teaching, and ministry work here in South Africa. We had a successful and busy home visit in eastern Ontario, a family visit in Toronto (where L-A's family is based), and a special time in Virginia with dear family friends (Williamsburg and Richmond). Shortly after we arrived back in SA, L-A began experiencing shooting pain in her left breast from the nipple to the chest wall. She could find no lumps. She went to her replacement GP to be treated for mastitis, and was given a large antibiotic injection, which did help, but not for long. At the same time, she was diagnosed for an unrelated illness (hidradenitis supertiva), which is a debilitating auto-inflammatory skin disease. This was confirmed by her new dermatologist in Paarl. That doctor was concerned about the inflamed breast, but that was not her area of expertise.
L-A returned to one of her wonderful GPs, who was concerned and booked her into the local MediClinic (private hospital) right away, so that ultrasounds could look at the breast and she could be on antibiotic drip and pain meds. This was done for four days, with a followup ultrasound. The technicians could find no lumps, just a "massive amount of inflammation." They were concerned about the size of the lymph nodes in L-A's left underarm. These responded a little to the antibiotics, and when checked again in a week, they grew again. On August 6th, Dr S discharged her due to financial reasons, and gave more meds. We were to followup very soon. The next course of action was to check for the possibility of a rare form of cancer. L-A heard that comment, and thought to follow up for info online, with her symptoms. She found breastcancer.org, which is a reputable site. Other sites were scary.
We called for an earlier appointment for August 13th - when Dr S performed core biopsies, using a laptop ultrasound. L-A prayed softly for Holy Spirit to fill the room, and after the doctor told her that she would hear a sound from the device, she imagined it would be a whirring sound. Instead it sounded like a staple gun, which L-A found hugely funny and she began to laugh. The picture she had in her mind was of him stapling posters to her chest. We love it when God brings joy into the room and brings peace into the situation. Then she was given more pain meds and sent to get a diagnostic mammogram. The techs were very gentle, even though it was difficult getting the side-scans of the left breast. But again, prayers were answered and they could accurately tell what was going on in all the images. Then we had the third ultrasound. This thing was growing FAST.
On August 16th, Dr S personally called with the diagnosis, and while we wanted to see him to talk options, it was important to get the treatment process right away, with staging imaging (to determine how far the cancer spread), meet the oncologist (who is based in the northern Cape Town suburb of CapeGate an hour away), an echocardiagram to see if L-A could handle the chemo treatment), port-insertion surgery and more. We began responding quickly, and appointments were laid out quickly. We are amazed how fast this timeline was moved up to get ahead of this cancer. We aren't sure how fast the Ontario system would have responded. Perhaps we are to be where we are - and continue with ministry.
We went away on a pre-arranged break to the West Coast to see the spring wildflowers, sea and a friend who lives in Yzerfontein. This was a perfect time away, not to draw as L-A had hoped, but to reflect, pray, be by the ocean and receive peace. We had trouble with our special travel medical insurance once they found out that the HS-boils claim was morphing into a bigger illness. We were asked to start a new claim for cancer - they wanted all diagnostic reports, doctors' notes etc. The doctor and oncologist both wrote letters pleading that L-A be allowed to stay for treatment. This was ignored. After more than two weeks of decision making, the case manager phoned Tony twice. First that they they would not support us staying for treatment. The second that L-A must leave within the week, without the first chemotherapy, and fly to Ottawa. Then she would have to present herself (even with no place to live, transport or carer) to the nearest hospital ER as a walk-in. This would put us back over a month of treatment (although the hospital doctors would have fast-tracked her somewhat due to xrays, ultrasounds, mammograms, doctors' notes and a perfectly new port surgery). Still, this would have been very traumatic. L-A insisted on having Tony stay due to so many unexpected loose ends. She would have had to travel on her own.
While Tony was trying to figure out a plan, L-A was inspired by Holy Spirit. She already had a dream the night before of gold falling at her feet. That meant to us, alternate funding. We would crowd fund, as soon as allowed by our Iris supervisors in Canada and South Africa. Both approved, although with the stipulation that any funds that would come through Iris Ministries Canada have to go to our ministry work/living expenses rather than medical costs. We still pay out more in ministry than comes through IMC, so that's not a problem. We set up the campaign poster, which is further down this page. We went ahead with the first haircut (the middle picture of L-A above), arranged a wig, and the first chemotherapy treatment on September 5th. L-A didn't have too many side effects other than tiredness and nausea, but the side effects are cumulative. Later on, neuropathy in the right thigh, and sharp pains were added to the nausea and exhaustion. Hair loss began to incur in mid-September, so we had the supplied chemo hat (see above picture on the right), as well as a few more hats. The wig arrived on 25th September. We ordered a few more hats, (although our friend Michelle knit three more hats, which arrived in early November from Canada.
So Holy Spirit's inspiration came with a beautiful compromise: we could stay in South Africa for the chemo treatments, and followup imaging and then return to Canada in early April (the plans changed later due to covid-19). We would have half the process in SA, and half in Canada. We would need cooperation from doctors on both sides of the Atlantic. We shared with Dr S, who was compassionate and willing to work with our Canadian GP, who will likely refer us to an Ottawa surgeon and oncology team (maybe Ottawa Civic or Ottawa General Hospital)? If so, Dr S and this surgeon could work well together, and the transfer of care would go well. This projection is exactly what is happening. We are staying until early April, rather than until the length of our visa in early November. We also have found a willing Ottawa surgeon already and we are making that option available. L-A sees him on April 22nd.
L-A is continuing to work with light children's ministry, writing, art workshops, her colouring book and website work. Tony does do the bulk of everything else with help of others. So both of us need prayer - not just for healing, and ministry but also daily life as Canadian missionary-expats in South Africa.
On November 8th, Dr. Laura S examined L-A before her 4th chemo session. She was amazed at the reduction in the lymph node in the left underarm, although there was still some swelling. But the tumour itself shrank 60%!!! She kept saying that she couldn't believe this was the same person from Hanlie's notes! This was more than just chemo, this is God accelerating the process. Our prayers were being answered. We need to continue to pray, for this and finances. Dr. Hanlie T was very happy with L-A's progress during the December 2nd visit and wanted L-A to go on a companion drug called Perjeta. She explained that chemo alone will get the job of killing/shrinking the cancer cells done. However, it's like a bakkie (pick-up truck). Taxol with Herceptin is like a Mercedes, and Taxol, Perjeta and Herceptin is a Rolls Royce. A Rolls is a good metaphor, since it's a very expensive injection - out of our league! We're happy with the "Mercedes" as expensive as that is. Perjeta is R81,000 per full dose - roughly the cost of Tony's car in 2017. Herceptin is R9,132 per dose).
The following chemo was December 23rd, where L-A was given a three week dose again, which will be weekly from January 13th on. It turned out to be better in the long run due to car problems that would have prevented L-A receiving chemo. However, the combination of so much Taxol, and the Neulastin injection gave L-A severe bone pain for two days - Christmas eve and Christmas day. Thankfully this wore off before preparing to have a Canadian Christmas-style dinner for the family of one of the girls we love and disciple. The following two chemo treatments were shorter with no neulastin shot, since Dr. K decided that L-A didn't need the extra boost for the white blood cells. The combination of extra Taxol and neulastin was causing the increase of bone pain. The last chemo was February 10th, when L-A rang the chemo bell! Unfortunately though, L-A had more reaction to the last Taxol cycles than she did the earlier ones; the nausea, tiredness, peripheral neuropathy and exhaustion returned, but we are managing. L-A continued with unexpected herceptin injections, right up to March 20th. We were to return to Canada not too long after that. It didn't matter. We tried multiple times to recover cancelled flights and found ourselves stuck. But it's okay, we have a place to stay through a 21 day lockdown and beyond.
Next were more herceptin injections at R9,132 every three weeks, including the lockdown (since it's an essential service). We were to begin to receive these (we think) in Ottawa General Hospital oncology ward, but with the corona virus, most everything is cancelled or seriously postponed. L-A's Ottawa surgeon told her that she must continue treatments set up by the South African oncologist, which basically is herceptin injections, and in sometime in May or June, a flush of her port.
But before corona virus struck South Africa, we were given wonderful news from March 11th's PET scan: no tumour found, lower back S1 deteriorizing, rib issue on right, gallstones. “No convincing evidence of residual local disease. No evidence of nodal disease; a possible skeletal metastasis in the 6th left rib cannot be excluded.” This means the cancer tumour has disappeared! While there is still damage from the cancer, the cancer itself is gone!!! Praise God. He did that!" Our next needs are to cover the coming herceptin injections while we remain in South Africa, follow-up surgical/oncologist appointments, since L-A reported breast pain again around April 20th. And then... surgery.
May 2020 Surgery
L-A was to see her Ottawa surgeon for assessment April 22nd). We aren't sure when the re-booked appointment will be after we return to Canada, but we are in touch with the surgeon. L-A is now to see her South African surgeon to assess new lumps on her breast. Ironically the date of this appointment is the same as when she would see the Canadian surgeon! Dr. S said that the lumps likely are the cancer showing itself again, but also it could be reacting against the herceptin. While he recommends L-A has surgery, but with coronavirus restrictions, all 'elective' surgeries are postponed. We still have time, although it's actually much better to have surgery sooner. Dr. S called the next day that L-A needs to have mastectomy surgery as soon as possible (even in the midst of covid-19). This would be a radical single mastectomy, since the other breast is fine. We are waiting on an estimate and date. The costs would include: facility fees for operation and hospital stay (Mediclinic hospital), surgical fees, and anesthesiologist. We would also need certain post-mastectomy supplies such as a mastectomy pillow and drainage bags. We don't know how much these would cost but they are essential.
May 6th update: We received an estimate for the surgical fees (R7,400), 3 day hospital stay/ 2 hour operation (R61,5206), and anesthetic (R5206). We estimate that the cost of the operation not including blood work, x-rays or added things would be between $6,000 - $7,500 Cdn. (The operation was more than that, but the estimate was still helpful). We ordered two nice cloth drainage bags, but still need a pillow. The surgery was on May 12th at Mediclinic Worcester hospital. We had a covid-19 test at Pathcare on May 7th as a precaution (L-A tested negative for the virus). May 11th: We have had an outpouring of funds towards the surgery and aftercare. We received more than enough, just over $12,000 just for this stage of the cancer journey! (Later, we received another $5,000) We are amazed and thankful. We don't have all the figures yet from the hospital, surgeon and Pathcare lab, but based on the previous hospital stay, pathology and surgical care, and taking into effect the low value of the rand to Canadian dollar, the cost is approx. R106,711 or $8,098. It may be a bit higher but we aren't worried. We have what we need.
May 16th update: L-A was discharged from Worcester Mediclinic Hospital, with lessons on dealing with drainage, wound care and physiotherapy. She had four days of excellent care from her surgeon, anesthetist, and all medical staff. She is currently still in pain, and managing with pain meds when needed most. The surgery was a radical mastectomy, where anxillary lymph nodes were taken (not sure how many), the breast, fatty tissue, and skin all the way to the chest wall. The bandages need to be changed every five days, and we were advised to have that nursing task done at Dr Smith's/Dr Botha's office, rather than Tony struggling with it. While Dr. Smith said that he tried to get as much tissue and skin as possible, there is no 100% guarantee that he got all the cancer. Inflammatory breast cancer is a very sneaky disease. But we need to remember the God part of this. L-A believes that she will NOT die of cancer and that it's not her time yet. But we are thankful to God, and to those who have partnered with him to help L-A not die prematurely. Thank you so much!
May 20th update: L-A and Tony visited the surgeon, who wanted to look at the incision sites and ask about pain reactions (it continues to be very painful, so L-A is taking oxycodone and Tylenol to cope). The sites look clean and are healing. The sites are draining well into the tubes and cup, although the liquid is still too much for us to remove the 'drains' yet. But the pathology report came through from the lab. There were excellent margins in the breast tissue for the cancer (we got it all out!) and all nine lymph nodes that were removed from L-A's left underarm are negative from cancer! This apparently is rare for inflammatory breast cancer. Dr. S is calling both a miracle. We will see what the oncologists' reactions are. They will likely feel the same way. We are rejoicing. Although L-A is so very tired and healing in three incision sites (breast, underarm and leg) takes a lot of energy. This is where we are thankful for people praying for us, and for good rest. Even oxycodone is not sufficient to take out the pain, but that will get better very soon.
May 25th update: L-A had her herceptin injection and saw Dr K, who is a favourite. She repeated her surgeon's excitement and the results of having an excellent margin for the cancer (so it is all out of her). This is incredibly rare for this kind of cancer, so she is hopeful. Radiation was not mentioned, although we will likely have it, if Dr H says it's needed as a precaution. Dr K also marvelled at the financial miracle, which makes all the care possible. L-A also had an appointment with Marzanne JV Rensburg, who specializes in prosthetics and manual lymph drainage. L-A likely needs both. On May 23rd, she had an accident of her drain tube falling out, and went to the local ER for help. They couldn't help her but suggested just cleaning the wound and bandaging it before calling the surgeon. L-A is to see him on the 26th. There is considerable swelling in her underarm area, so this may be a good time to deal with that! We are waiting on a quote from Marzanne for a prosthetic and the bras. On May 26th, Dr S and his nurse took needles and syringes to drain the built up fluid, and he prescribed an antibiotic. The mole pathology came back from the lab. It was nasty but it's harmless, thank God. L-A's blood pressure dropped quickly as they drained the fluid, so she was allowed to rest for ten minutes or so. She is to return for a follow-up on June 3rd. We may not need a lymph drainage specialist after all (the needles were the third option).
June 8th update: The recovery of the mole removal is fine and the fluid taken from L-A was sent to the lab for testing. It is also benign. However, the fluid keeps coming, and the second drainage was even more than the first. L-A's prothesist specialist is also a therapist in lymph node drainage, and she told us that there is one like her in Paarl named Este. If this fluid keeps coming we will go to her. L-A next sees Dr S on June 22 (or his colleague Dr. Botha on June 12) for drainage or post-surgical assessment). We tried to find this MLD therapist but we can't find where she works or her proper contact details. All we found was a spa salon, which would be closed until lockdown level 2. That doesn't bode well for this treatment! Meanwhile, we'll keep going to the surgeon for drainage as needed.
June 15th update: L-A saw Dr. Botha on June 12th and he would not drain her. He said that the swelling was actually back fat that has infiltrated the area. The area is still sore because it is healing, but the liquids are from whereever and not the incision site. He believes it would be better to have area liposuction of that fat, which would leave the area fat-free. Then the underarm and breast area can heal properly. We called on June 15th for the office to get a quote for the liposuction (it would be done by a plastic surgeon colleague). They will send the details. We still see Dr. Smith on June 22nd for his assessment. There hasn't been a drain problem since, there is no leakage. We are thankful for the prayer that contributed to this, as well as Dr. Botha said, that's it, no more. L-A also had encouragement and a herceptin injection at CapeGate. L-A will next go on July 9th to see her main oncologist, Dr H, a herceptin injection and a flush of her port. We hope to see Marzanne with the prosthetic and bra on the 9th as well.
July 2nd update: L-A saw Este Mellet for MLD therapy in her arm and side. She is to treat more than just the area, and also help strengthen L-A's entire lymphatic system. Part of this is by a certain type of massage, and helping with compression garments. L-A tried to order these on Amazon, but either they weren't the right size or it would not take delivery to South Africa. Best to try and have them made here. Este suggested that L-A ask her prothetist Marzanne for help with a compression bra and sleeves, to be made for her. L-A was also given a list of changing her lifestyle in different ways - sterilizing nail cutters, limiting hot tub experiences (!!!) using only natural lotions and moisturizers, due to having less lymphatic strength to deal with infections and well, junk in a lot of different things we put on our skin! L-A next sees Estee on July 7th, two days before seeing Marzanne, the oncologist, having herceptin and having the chemo port flushed. What a week.
July 7th update: Este taught L-A more MLD exercises and went through the physio exercises that L-A was given in hospital. She circled the ones that still should be done. After examination, Este was shocked at L-A's lower legs, which have swollen with fluid for years, perhaps since 2014 or so. L-A has lymphedema stage 3 in her legs, as well as lymphedema under the left arm. Este is ordering compression bandages. Compression garments may be next. L-A's next appointment with Este is on July 9th, before we head to CapeGate to see the prosthetics lady Marzanne (who also does MLD), then L-A's oncologist, then a herceptin injection and flush of her chemo port (which should have been done back in May).
July 9th update: Este continued with grounding L-A in her MLD exercises/therapy, and then continued further treatment on her arm. She then bandaged L-A up with two kinds of bandages. She also advised to continue to put gauze in the incision skin fold to make sure the area stays dry (with no plasters on top, which causes skin damage). The bandages only stayed on for an hour, when L-A saw her oncologist, Dr. H. She hadn't seen her since March. Dr. H was very, very happy with the healing on the surgical sites, and the news of good margins for the cancer in the breast and no cancer in the lymph nodes that were taken. She wasn't surprised about the lymphedema, but was more concerned about what came next under her care: radiation therapy. Ouch. We hoped to avoid that. Dr. H doesn't want to take chances, since inflammatory cancer can stay in microscopic form in the area (I didn't get to tell her about the lump in the right breast). She is going to arrange a quote, and to get a bed in a radiation room, either on the ground floor of CapeGate or in Somerset West. It depends on if the bed can take my weight. Ouch as to the unknown cost. The radiation therapy will likely be in 16 sessions). Then L-A had a herceptin injection and a flush of her chemo port. She was told the chemo port must be flushed every three months, so the next flush is October 1st.
L-A then met with Marzanne, and tried on her new mastectomy bra with the prosthetic. It fit beautifully! Marzanne measured L-A for compression sleeves and ordered them as well as gauntlets (for the hands) and a lymphedema bra. This is the bra that L-A can wear every day, and the mastectomy bra/prosthetic can be wornr when she goes out. The compression bandages were re-wrapped (although Marzanne's wrap was tighter than Este's!). L-A paid a 50% down payment on the bra/compression garments, so they could be ordered ASAP. The compression garments were made to order, so it needed the down payment (Marzanne later emailed and said the manufacturer is charging us another $54 Cdn. We said that was fine).
July 14th update: The financial person at CapeGate Oncology emailed the financial quote from the radiation people (who are in a different Cape Town suburb). The cost is just a bit over R800,000 ($7,000). They plan to give us a discount, although we will have other related expenses, as well as continuing injections and lympedema related therapy. We will begin another fundraising campaign.
July 21 update: L-A was treated with more MLD on her chest and her legs. Este ordered one Mobiderm set of Leg compression - enough for one leg, or two lower legs (which we prefer right now). Este taught Tony how to do the massages, and he took a video of the wrapping, so that he could study and do it. He learned a LOT. Cost was mostly for the Mobiderm set, but it was at wholesale cost and necessary for now (approx $268). The arm sleeves are still coming separately from Marzanne. L-A and Tony are to manage the compression and MLD and return without the bandages on for the appointment on July 24.
July 24 update (compression): Este taught Tony more MLD massages, and more practice on bandaging for BOTH legs. They need to be in compression almost all the time, apart from a shower/moisturize every few days. Once the legs start slimming from losing the excess lymphatic fluid, L-A will be a lot more mobile. She is already walking around the house without her walker. The next step is for special velcro wraps around smaller legs. Thankfully L-A's upper legs are more normal and don't need compression. They do still need lymphatic massage. The legs are to stay in compression until the morning of the next appointment (could be July 28) During the same day, L-A's new radiologist doctor, Tessa, called to set up a time for the preliminary scan at the hospital that is near CapeGate Oncology. Tony is going to arrange one of L-A's pairs of sandals to be modified so that she can wear them with the bandages on. At this point, she cannot leave the house, but she's walking around without her walker at home.
July 28, 2020 update: L-A was due to be at CG Mediclinic for the initial scan and didn't yet have her modified sandals. So we took off the bandages. We were amazed to find that the swelling had gone down considerably on L-A's lower left calf! We will continue with good skin care, MLD massage and compression. L-A can't handle the legs and chest bandaged overnight but is slowly getting used to the bandages. The next session is on July 29th.
July 29, 2020 update: Este was excited that the swelling has dramatically gone down in her left leg and somewhat in her right leg and chest. L-A was given more physiotherapy exercises that would help her movement and independence apart from Tony. We may move to a first floor (read 2nd floor to North Americans) flat in central Worcester, but it is a walk up flat without an elevator. Tony will view the unit and stairs to see if it's suitable. We are hopeful, since we must move out of our current home before October 1st. Meanwhile, L-A now has walking exercises every hour, with getting up every half hour to keep moving as much as possible. This is also good for the compression bandages to force more lymph fluid that is stuck in the wrong places. We are sure that some of this problem was worsened by the journey through chemotherapy, although it did not initially cause it.
RADIATION THERAPY
Starting July 28, 2020! The first scan was at CapeGate Mediclinic hospital x-ray department. Radiologist Tessa was gentle in taking a CT scan of L-A's chest and did three little tatoos on her, to help with the coming radiation treatments (to get the radiation gun on target? These 16 radiation treatments will be given on CapeGate Oncology's ground floor. CG Chemo floor finance folk helped us with getting the funds from L-A's Visa card to the radiation department, which saved us R8,000! (We get discounts if we pre-pay in full) We still don't have all the funds yet, but we have a month to pay. The first session scan was just under R3,000. Radiation looks like it will be at least R76,000, with discounts on the sessions and first scan. The sessions should begin in early August, and Tessa was informed we will be away 24-27 August, so we have to work around these days.
Radiation Sessions: The first was August 13th at 11:20 am. The schedule after that is all over the place in timings, but we plan to arrange transport on the days that Tony is working on other things (likely the free Dischem bus that connect Worcester folk with CapeGate Oncology). The following appointments were and are for August 14, August 17-21 (stinging pain began Aug 20), August 28, August 31, September 1-3, and September 7-9. (There is a herceptin injection on the 10th)
September 1 update: L-A saw Dr. Koetze, who told her that she's doing very well through radiation treatment. Side effects are not that bad, with stinging pain during the weeks with more than three treatments in a row, stretchy skin, thickening of the flesh being radiated, but no 'sunburn' on the actual skin. Maizena (cornstarch) has been helpful to alleviate discomfort. L-A has been very tired, in a cumulative way. It's good that we had the Mossel Bay break so that treatments were not all in a row. L-A asked for more Lyrica in a stronger dose, but she's already at the limit. We will manage with what we have as well as Gen-Payne, soluable Panado and CBD oil at night. L-A next sees the doctor September 8th, after the 13th radiation session. L-A will also see Marzanne on the 8th, because the leg wraps and lymphedema bra are in! Marzanne will also bring a special glue that will help the arm sleeves to stay up L-A's arms.
September 7th update: L-A had radiation, then saw her main oncologist, who is pleased at her progress, although advised to use antibiotic ointment in the skin fold where the surgery scar is, since it's getting infected again. Radiation sickness of the extreme exhaustion and some nausea may occur for another 3 weeks after the radiation sessions are over. She shared that she shortened the sessions from 16 to 15 to protect L-A's heart. L-A also met with Marzanne, who showed Tony and L-A how to roll on the arm sleeves, and leg wraps, and to how exactly they work. There was a surprise second payment for the leg wraps.
September 9th update: The radiation machine is still broken, and will be repaired for the 10th or 11th, but L-A can't make those times due to a hiccup in Tony's health. He had to go to have his left lung drained for a pleural effusion. His hospital stay was only one night, and we are waiting for the lab results on the 3 litres drained from his lung. Meanwhile L-A had her herceptin injection and was given a schedule for the remaining three injections and oncologist appointments. The two remaining radiation appointments were rescheduled for September 14th and beyond.
September 16th update: Dr. H spoke with L-A after her 15th radiation session and explained why she would need more sessions, at least one. It had to do with the unintended break the week before. If there is too much of a break, more sessions are needed to achieve the required result. L-A and the doctor chose to end at 16, partly since 16 were paid for. Dr H examined L-A's scar skin fold and was pleased at the result of Tony's nursing - the infection was nearly gone. After the 16th session, L-A was told to be gentle with herself for at least two weeks and continue using Maizena cornstarch on her chest. After two weeks, she's allowed to shower normally. It takes two weeks for the skin to return to normal, and about three to four to begin to feel normal (to recover from the weakness and exhaustion). But otherwise, all is well. If the cancer isn't dead by now... but we strongly believe it was killed when L-A's breast was removed. Tony took L-A to lunch at Cafe Hugo to celebrate, but since she's not allowed to wear her prosthetic, she gave Tony an unsure smile when he photographed her as is.
L-A returned to one of her wonderful GPs, who was concerned and booked her into the local MediClinic (private hospital) right away, so that ultrasounds could look at the breast and she could be on antibiotic drip and pain meds. This was done for four days, with a followup ultrasound. The technicians could find no lumps, just a "massive amount of inflammation." They were concerned about the size of the lymph nodes in L-A's left underarm. These responded a little to the antibiotics, and when checked again in a week, they grew again. On August 6th, Dr S discharged her due to financial reasons, and gave more meds. We were to followup very soon. The next course of action was to check for the possibility of a rare form of cancer. L-A heard that comment, and thought to follow up for info online, with her symptoms. She found breastcancer.org, which is a reputable site. Other sites were scary.
We called for an earlier appointment for August 13th - when Dr S performed core biopsies, using a laptop ultrasound. L-A prayed softly for Holy Spirit to fill the room, and after the doctor told her that she would hear a sound from the device, she imagined it would be a whirring sound. Instead it sounded like a staple gun, which L-A found hugely funny and she began to laugh. The picture she had in her mind was of him stapling posters to her chest. We love it when God brings joy into the room and brings peace into the situation. Then she was given more pain meds and sent to get a diagnostic mammogram. The techs were very gentle, even though it was difficult getting the side-scans of the left breast. But again, prayers were answered and they could accurately tell what was going on in all the images. Then we had the third ultrasound. This thing was growing FAST.
On August 16th, Dr S personally called with the diagnosis, and while we wanted to see him to talk options, it was important to get the treatment process right away, with staging imaging (to determine how far the cancer spread), meet the oncologist (who is based in the northern Cape Town suburb of CapeGate an hour away), an echocardiagram to see if L-A could handle the chemo treatment), port-insertion surgery and more. We began responding quickly, and appointments were laid out quickly. We are amazed how fast this timeline was moved up to get ahead of this cancer. We aren't sure how fast the Ontario system would have responded. Perhaps we are to be where we are - and continue with ministry.
We went away on a pre-arranged break to the West Coast to see the spring wildflowers, sea and a friend who lives in Yzerfontein. This was a perfect time away, not to draw as L-A had hoped, but to reflect, pray, be by the ocean and receive peace. We had trouble with our special travel medical insurance once they found out that the HS-boils claim was morphing into a bigger illness. We were asked to start a new claim for cancer - they wanted all diagnostic reports, doctors' notes etc. The doctor and oncologist both wrote letters pleading that L-A be allowed to stay for treatment. This was ignored. After more than two weeks of decision making, the case manager phoned Tony twice. First that they they would not support us staying for treatment. The second that L-A must leave within the week, without the first chemotherapy, and fly to Ottawa. Then she would have to present herself (even with no place to live, transport or carer) to the nearest hospital ER as a walk-in. This would put us back over a month of treatment (although the hospital doctors would have fast-tracked her somewhat due to xrays, ultrasounds, mammograms, doctors' notes and a perfectly new port surgery). Still, this would have been very traumatic. L-A insisted on having Tony stay due to so many unexpected loose ends. She would have had to travel on her own.
While Tony was trying to figure out a plan, L-A was inspired by Holy Spirit. She already had a dream the night before of gold falling at her feet. That meant to us, alternate funding. We would crowd fund, as soon as allowed by our Iris supervisors in Canada and South Africa. Both approved, although with the stipulation that any funds that would come through Iris Ministries Canada have to go to our ministry work/living expenses rather than medical costs. We still pay out more in ministry than comes through IMC, so that's not a problem. We set up the campaign poster, which is further down this page. We went ahead with the first haircut (the middle picture of L-A above), arranged a wig, and the first chemotherapy treatment on September 5th. L-A didn't have too many side effects other than tiredness and nausea, but the side effects are cumulative. Later on, neuropathy in the right thigh, and sharp pains were added to the nausea and exhaustion. Hair loss began to incur in mid-September, so we had the supplied chemo hat (see above picture on the right), as well as a few more hats. The wig arrived on 25th September. We ordered a few more hats, (although our friend Michelle knit three more hats, which arrived in early November from Canada.
So Holy Spirit's inspiration came with a beautiful compromise: we could stay in South Africa for the chemo treatments, and followup imaging and then return to Canada in early April (the plans changed later due to covid-19). We would have half the process in SA, and half in Canada. We would need cooperation from doctors on both sides of the Atlantic. We shared with Dr S, who was compassionate and willing to work with our Canadian GP, who will likely refer us to an Ottawa surgeon and oncology team (maybe Ottawa Civic or Ottawa General Hospital)? If so, Dr S and this surgeon could work well together, and the transfer of care would go well. This projection is exactly what is happening. We are staying until early April, rather than until the length of our visa in early November. We also have found a willing Ottawa surgeon already and we are making that option available. L-A sees him on April 22nd.
L-A is continuing to work with light children's ministry, writing, art workshops, her colouring book and website work. Tony does do the bulk of everything else with help of others. So both of us need prayer - not just for healing, and ministry but also daily life as Canadian missionary-expats in South Africa.
On November 8th, Dr. Laura S examined L-A before her 4th chemo session. She was amazed at the reduction in the lymph node in the left underarm, although there was still some swelling. But the tumour itself shrank 60%!!! She kept saying that she couldn't believe this was the same person from Hanlie's notes! This was more than just chemo, this is God accelerating the process. Our prayers were being answered. We need to continue to pray, for this and finances. Dr. Hanlie T was very happy with L-A's progress during the December 2nd visit and wanted L-A to go on a companion drug called Perjeta. She explained that chemo alone will get the job of killing/shrinking the cancer cells done. However, it's like a bakkie (pick-up truck). Taxol with Herceptin is like a Mercedes, and Taxol, Perjeta and Herceptin is a Rolls Royce. A Rolls is a good metaphor, since it's a very expensive injection - out of our league! We're happy with the "Mercedes" as expensive as that is. Perjeta is R81,000 per full dose - roughly the cost of Tony's car in 2017. Herceptin is R9,132 per dose).
The following chemo was December 23rd, where L-A was given a three week dose again, which will be weekly from January 13th on. It turned out to be better in the long run due to car problems that would have prevented L-A receiving chemo. However, the combination of so much Taxol, and the Neulastin injection gave L-A severe bone pain for two days - Christmas eve and Christmas day. Thankfully this wore off before preparing to have a Canadian Christmas-style dinner for the family of one of the girls we love and disciple. The following two chemo treatments were shorter with no neulastin shot, since Dr. K decided that L-A didn't need the extra boost for the white blood cells. The combination of extra Taxol and neulastin was causing the increase of bone pain. The last chemo was February 10th, when L-A rang the chemo bell! Unfortunately though, L-A had more reaction to the last Taxol cycles than she did the earlier ones; the nausea, tiredness, peripheral neuropathy and exhaustion returned, but we are managing. L-A continued with unexpected herceptin injections, right up to March 20th. We were to return to Canada not too long after that. It didn't matter. We tried multiple times to recover cancelled flights and found ourselves stuck. But it's okay, we have a place to stay through a 21 day lockdown and beyond.
Next were more herceptin injections at R9,132 every three weeks, including the lockdown (since it's an essential service). We were to begin to receive these (we think) in Ottawa General Hospital oncology ward, but with the corona virus, most everything is cancelled or seriously postponed. L-A's Ottawa surgeon told her that she must continue treatments set up by the South African oncologist, which basically is herceptin injections, and in sometime in May or June, a flush of her port.
But before corona virus struck South Africa, we were given wonderful news from March 11th's PET scan: no tumour found, lower back S1 deteriorizing, rib issue on right, gallstones. “No convincing evidence of residual local disease. No evidence of nodal disease; a possible skeletal metastasis in the 6th left rib cannot be excluded.” This means the cancer tumour has disappeared! While there is still damage from the cancer, the cancer itself is gone!!! Praise God. He did that!" Our next needs are to cover the coming herceptin injections while we remain in South Africa, follow-up surgical/oncologist appointments, since L-A reported breast pain again around April 20th. And then... surgery.
May 2020 Surgery
L-A was to see her Ottawa surgeon for assessment April 22nd). We aren't sure when the re-booked appointment will be after we return to Canada, but we are in touch with the surgeon. L-A is now to see her South African surgeon to assess new lumps on her breast. Ironically the date of this appointment is the same as when she would see the Canadian surgeon! Dr. S said that the lumps likely are the cancer showing itself again, but also it could be reacting against the herceptin. While he recommends L-A has surgery, but with coronavirus restrictions, all 'elective' surgeries are postponed. We still have time, although it's actually much better to have surgery sooner. Dr. S called the next day that L-A needs to have mastectomy surgery as soon as possible (even in the midst of covid-19). This would be a radical single mastectomy, since the other breast is fine. We are waiting on an estimate and date. The costs would include: facility fees for operation and hospital stay (Mediclinic hospital), surgical fees, and anesthesiologist. We would also need certain post-mastectomy supplies such as a mastectomy pillow and drainage bags. We don't know how much these would cost but they are essential.
May 6th update: We received an estimate for the surgical fees (R7,400), 3 day hospital stay/ 2 hour operation (R61,5206), and anesthetic (R5206). We estimate that the cost of the operation not including blood work, x-rays or added things would be between $6,000 - $7,500 Cdn. (The operation was more than that, but the estimate was still helpful). We ordered two nice cloth drainage bags, but still need a pillow. The surgery was on May 12th at Mediclinic Worcester hospital. We had a covid-19 test at Pathcare on May 7th as a precaution (L-A tested negative for the virus). May 11th: We have had an outpouring of funds towards the surgery and aftercare. We received more than enough, just over $12,000 just for this stage of the cancer journey! (Later, we received another $5,000) We are amazed and thankful. We don't have all the figures yet from the hospital, surgeon and Pathcare lab, but based on the previous hospital stay, pathology and surgical care, and taking into effect the low value of the rand to Canadian dollar, the cost is approx. R106,711 or $8,098. It may be a bit higher but we aren't worried. We have what we need.
May 16th update: L-A was discharged from Worcester Mediclinic Hospital, with lessons on dealing with drainage, wound care and physiotherapy. She had four days of excellent care from her surgeon, anesthetist, and all medical staff. She is currently still in pain, and managing with pain meds when needed most. The surgery was a radical mastectomy, where anxillary lymph nodes were taken (not sure how many), the breast, fatty tissue, and skin all the way to the chest wall. The bandages need to be changed every five days, and we were advised to have that nursing task done at Dr Smith's/Dr Botha's office, rather than Tony struggling with it. While Dr. Smith said that he tried to get as much tissue and skin as possible, there is no 100% guarantee that he got all the cancer. Inflammatory breast cancer is a very sneaky disease. But we need to remember the God part of this. L-A believes that she will NOT die of cancer and that it's not her time yet. But we are thankful to God, and to those who have partnered with him to help L-A not die prematurely. Thank you so much!
May 20th update: L-A and Tony visited the surgeon, who wanted to look at the incision sites and ask about pain reactions (it continues to be very painful, so L-A is taking oxycodone and Tylenol to cope). The sites look clean and are healing. The sites are draining well into the tubes and cup, although the liquid is still too much for us to remove the 'drains' yet. But the pathology report came through from the lab. There were excellent margins in the breast tissue for the cancer (we got it all out!) and all nine lymph nodes that were removed from L-A's left underarm are negative from cancer! This apparently is rare for inflammatory breast cancer. Dr. S is calling both a miracle. We will see what the oncologists' reactions are. They will likely feel the same way. We are rejoicing. Although L-A is so very tired and healing in three incision sites (breast, underarm and leg) takes a lot of energy. This is where we are thankful for people praying for us, and for good rest. Even oxycodone is not sufficient to take out the pain, but that will get better very soon.
May 25th update: L-A had her herceptin injection and saw Dr K, who is a favourite. She repeated her surgeon's excitement and the results of having an excellent margin for the cancer (so it is all out of her). This is incredibly rare for this kind of cancer, so she is hopeful. Radiation was not mentioned, although we will likely have it, if Dr H says it's needed as a precaution. Dr K also marvelled at the financial miracle, which makes all the care possible. L-A also had an appointment with Marzanne JV Rensburg, who specializes in prosthetics and manual lymph drainage. L-A likely needs both. On May 23rd, she had an accident of her drain tube falling out, and went to the local ER for help. They couldn't help her but suggested just cleaning the wound and bandaging it before calling the surgeon. L-A is to see him on the 26th. There is considerable swelling in her underarm area, so this may be a good time to deal with that! We are waiting on a quote from Marzanne for a prosthetic and the bras. On May 26th, Dr S and his nurse took needles and syringes to drain the built up fluid, and he prescribed an antibiotic. The mole pathology came back from the lab. It was nasty but it's harmless, thank God. L-A's blood pressure dropped quickly as they drained the fluid, so she was allowed to rest for ten minutes or so. She is to return for a follow-up on June 3rd. We may not need a lymph drainage specialist after all (the needles were the third option).
June 8th update: The recovery of the mole removal is fine and the fluid taken from L-A was sent to the lab for testing. It is also benign. However, the fluid keeps coming, and the second drainage was even more than the first. L-A's prothesist specialist is also a therapist in lymph node drainage, and she told us that there is one like her in Paarl named Este. If this fluid keeps coming we will go to her. L-A next sees Dr S on June 22 (or his colleague Dr. Botha on June 12) for drainage or post-surgical assessment). We tried to find this MLD therapist but we can't find where she works or her proper contact details. All we found was a spa salon, which would be closed until lockdown level 2. That doesn't bode well for this treatment! Meanwhile, we'll keep going to the surgeon for drainage as needed.
June 15th update: L-A saw Dr. Botha on June 12th and he would not drain her. He said that the swelling was actually back fat that has infiltrated the area. The area is still sore because it is healing, but the liquids are from whereever and not the incision site. He believes it would be better to have area liposuction of that fat, which would leave the area fat-free. Then the underarm and breast area can heal properly. We called on June 15th for the office to get a quote for the liposuction (it would be done by a plastic surgeon colleague). They will send the details. We still see Dr. Smith on June 22nd for his assessment. There hasn't been a drain problem since, there is no leakage. We are thankful for the prayer that contributed to this, as well as Dr. Botha said, that's it, no more. L-A also had encouragement and a herceptin injection at CapeGate. L-A will next go on July 9th to see her main oncologist, Dr H, a herceptin injection and a flush of her port. We hope to see Marzanne with the prosthetic and bra on the 9th as well.
July 2nd update: L-A saw Este Mellet for MLD therapy in her arm and side. She is to treat more than just the area, and also help strengthen L-A's entire lymphatic system. Part of this is by a certain type of massage, and helping with compression garments. L-A tried to order these on Amazon, but either they weren't the right size or it would not take delivery to South Africa. Best to try and have them made here. Este suggested that L-A ask her prothetist Marzanne for help with a compression bra and sleeves, to be made for her. L-A was also given a list of changing her lifestyle in different ways - sterilizing nail cutters, limiting hot tub experiences (!!!) using only natural lotions and moisturizers, due to having less lymphatic strength to deal with infections and well, junk in a lot of different things we put on our skin! L-A next sees Estee on July 7th, two days before seeing Marzanne, the oncologist, having herceptin and having the chemo port flushed. What a week.
July 7th update: Este taught L-A more MLD exercises and went through the physio exercises that L-A was given in hospital. She circled the ones that still should be done. After examination, Este was shocked at L-A's lower legs, which have swollen with fluid for years, perhaps since 2014 or so. L-A has lymphedema stage 3 in her legs, as well as lymphedema under the left arm. Este is ordering compression bandages. Compression garments may be next. L-A's next appointment with Este is on July 9th, before we head to CapeGate to see the prosthetics lady Marzanne (who also does MLD), then L-A's oncologist, then a herceptin injection and flush of her chemo port (which should have been done back in May).
July 9th update: Este continued with grounding L-A in her MLD exercises/therapy, and then continued further treatment on her arm. She then bandaged L-A up with two kinds of bandages. She also advised to continue to put gauze in the incision skin fold to make sure the area stays dry (with no plasters on top, which causes skin damage). The bandages only stayed on for an hour, when L-A saw her oncologist, Dr. H. She hadn't seen her since March. Dr. H was very, very happy with the healing on the surgical sites, and the news of good margins for the cancer in the breast and no cancer in the lymph nodes that were taken. She wasn't surprised about the lymphedema, but was more concerned about what came next under her care: radiation therapy. Ouch. We hoped to avoid that. Dr. H doesn't want to take chances, since inflammatory cancer can stay in microscopic form in the area (I didn't get to tell her about the lump in the right breast). She is going to arrange a quote, and to get a bed in a radiation room, either on the ground floor of CapeGate or in Somerset West. It depends on if the bed can take my weight. Ouch as to the unknown cost. The radiation therapy will likely be in 16 sessions). Then L-A had a herceptin injection and a flush of her chemo port. She was told the chemo port must be flushed every three months, so the next flush is October 1st.
L-A then met with Marzanne, and tried on her new mastectomy bra with the prosthetic. It fit beautifully! Marzanne measured L-A for compression sleeves and ordered them as well as gauntlets (for the hands) and a lymphedema bra. This is the bra that L-A can wear every day, and the mastectomy bra/prosthetic can be wornr when she goes out. The compression bandages were re-wrapped (although Marzanne's wrap was tighter than Este's!). L-A paid a 50% down payment on the bra/compression garments, so they could be ordered ASAP. The compression garments were made to order, so it needed the down payment (Marzanne later emailed and said the manufacturer is charging us another $54 Cdn. We said that was fine).
July 14th update: The financial person at CapeGate Oncology emailed the financial quote from the radiation people (who are in a different Cape Town suburb). The cost is just a bit over R800,000 ($7,000). They plan to give us a discount, although we will have other related expenses, as well as continuing injections and lympedema related therapy. We will begin another fundraising campaign.
July 21 update: L-A was treated with more MLD on her chest and her legs. Este ordered one Mobiderm set of Leg compression - enough for one leg, or two lower legs (which we prefer right now). Este taught Tony how to do the massages, and he took a video of the wrapping, so that he could study and do it. He learned a LOT. Cost was mostly for the Mobiderm set, but it was at wholesale cost and necessary for now (approx $268). The arm sleeves are still coming separately from Marzanne. L-A and Tony are to manage the compression and MLD and return without the bandages on for the appointment on July 24.
July 24 update (compression): Este taught Tony more MLD massages, and more practice on bandaging for BOTH legs. They need to be in compression almost all the time, apart from a shower/moisturize every few days. Once the legs start slimming from losing the excess lymphatic fluid, L-A will be a lot more mobile. She is already walking around the house without her walker. The next step is for special velcro wraps around smaller legs. Thankfully L-A's upper legs are more normal and don't need compression. They do still need lymphatic massage. The legs are to stay in compression until the morning of the next appointment (could be July 28) During the same day, L-A's new radiologist doctor, Tessa, called to set up a time for the preliminary scan at the hospital that is near CapeGate Oncology. Tony is going to arrange one of L-A's pairs of sandals to be modified so that she can wear them with the bandages on. At this point, she cannot leave the house, but she's walking around without her walker at home.
July 28, 2020 update: L-A was due to be at CG Mediclinic for the initial scan and didn't yet have her modified sandals. So we took off the bandages. We were amazed to find that the swelling had gone down considerably on L-A's lower left calf! We will continue with good skin care, MLD massage and compression. L-A can't handle the legs and chest bandaged overnight but is slowly getting used to the bandages. The next session is on July 29th.
July 29, 2020 update: Este was excited that the swelling has dramatically gone down in her left leg and somewhat in her right leg and chest. L-A was given more physiotherapy exercises that would help her movement and independence apart from Tony. We may move to a first floor (read 2nd floor to North Americans) flat in central Worcester, but it is a walk up flat without an elevator. Tony will view the unit and stairs to see if it's suitable. We are hopeful, since we must move out of our current home before October 1st. Meanwhile, L-A now has walking exercises every hour, with getting up every half hour to keep moving as much as possible. This is also good for the compression bandages to force more lymph fluid that is stuck in the wrong places. We are sure that some of this problem was worsened by the journey through chemotherapy, although it did not initially cause it.
RADIATION THERAPY
Starting July 28, 2020! The first scan was at CapeGate Mediclinic hospital x-ray department. Radiologist Tessa was gentle in taking a CT scan of L-A's chest and did three little tatoos on her, to help with the coming radiation treatments (to get the radiation gun on target? These 16 radiation treatments will be given on CapeGate Oncology's ground floor. CG Chemo floor finance folk helped us with getting the funds from L-A's Visa card to the radiation department, which saved us R8,000! (We get discounts if we pre-pay in full) We still don't have all the funds yet, but we have a month to pay. The first session scan was just under R3,000. Radiation looks like it will be at least R76,000, with discounts on the sessions and first scan. The sessions should begin in early August, and Tessa was informed we will be away 24-27 August, so we have to work around these days.
Radiation Sessions: The first was August 13th at 11:20 am. The schedule after that is all over the place in timings, but we plan to arrange transport on the days that Tony is working on other things (likely the free Dischem bus that connect Worcester folk with CapeGate Oncology). The following appointments were and are for August 14, August 17-21 (stinging pain began Aug 20), August 28, August 31, September 1-3, and September 7-9. (There is a herceptin injection on the 10th)
September 1 update: L-A saw Dr. Koetze, who told her that she's doing very well through radiation treatment. Side effects are not that bad, with stinging pain during the weeks with more than three treatments in a row, stretchy skin, thickening of the flesh being radiated, but no 'sunburn' on the actual skin. Maizena (cornstarch) has been helpful to alleviate discomfort. L-A has been very tired, in a cumulative way. It's good that we had the Mossel Bay break so that treatments were not all in a row. L-A asked for more Lyrica in a stronger dose, but she's already at the limit. We will manage with what we have as well as Gen-Payne, soluable Panado and CBD oil at night. L-A next sees the doctor September 8th, after the 13th radiation session. L-A will also see Marzanne on the 8th, because the leg wraps and lymphedema bra are in! Marzanne will also bring a special glue that will help the arm sleeves to stay up L-A's arms.
September 7th update: L-A had radiation, then saw her main oncologist, who is pleased at her progress, although advised to use antibiotic ointment in the skin fold where the surgery scar is, since it's getting infected again. Radiation sickness of the extreme exhaustion and some nausea may occur for another 3 weeks after the radiation sessions are over. She shared that she shortened the sessions from 16 to 15 to protect L-A's heart. L-A also met with Marzanne, who showed Tony and L-A how to roll on the arm sleeves, and leg wraps, and to how exactly they work. There was a surprise second payment for the leg wraps.
September 9th update: The radiation machine is still broken, and will be repaired for the 10th or 11th, but L-A can't make those times due to a hiccup in Tony's health. He had to go to have his left lung drained for a pleural effusion. His hospital stay was only one night, and we are waiting for the lab results on the 3 litres drained from his lung. Meanwhile L-A had her herceptin injection and was given a schedule for the remaining three injections and oncologist appointments. The two remaining radiation appointments were rescheduled for September 14th and beyond.
September 16th update: Dr. H spoke with L-A after her 15th radiation session and explained why she would need more sessions, at least one. It had to do with the unintended break the week before. If there is too much of a break, more sessions are needed to achieve the required result. L-A and the doctor chose to end at 16, partly since 16 were paid for. Dr H examined L-A's scar skin fold and was pleased at the result of Tony's nursing - the infection was nearly gone. After the 16th session, L-A was told to be gentle with herself for at least two weeks and continue using Maizena cornstarch on her chest. After two weeks, she's allowed to shower normally. It takes two weeks for the skin to return to normal, and about three to four to begin to feel normal (to recover from the weakness and exhaustion). But otherwise, all is well. If the cancer isn't dead by now... but we strongly believe it was killed when L-A's breast was removed. Tony took L-A to lunch at Cafe Hugo to celebrate, but since she's not allowed to wear her prosthetic, she gave Tony an unsure smile when he photographed her as is.
Current Needs: We now need to pay for three more herceptin injections, oncology consultancies, facility fees, medications, supplements, MLD therapy, physiotherapy and compression therapy. On the wish list is possible liposuction in the underarm and surgery to take away the scar tissue on the arm. Surgery to take the chemo port out can wait as well. We now need to flush the port out once every three months. The radiation treatments are now paid for, but the compression therapy is not (yet).
We may have to re-think about area liposuction of the area, which would greatly relieve pressure in the two surgical sites. Both Dr S and Este would like to see the wounds heal first before liposuction is seriously considered. Some of the swelling is lymphedema.
Newsletters
So if you would like to be added to our ministry newsletters (note whether for prayer and general update), please email us at laurie-ann@coppleswesterncape.ca
If you would like to be added to the health updates, please email Laurie-Ann at laurie-ann@coppleswesterncape.ca
Help us financially (to help in radiation treatments for breast cancer aftercare or also for our ministry if you feel so led) Most of the costs have been chemo-related but the mastectomy was well over $9,000, more than we expected, but people gave far more than expected. This was like loaves and fishes :) The rest of the funds are coming in slowly, but we are thankful for anything to help clear medical debt.
UPDATE on fundraising: As of September 16th, we have raised $54,639 Canadian! We will have spent as of September 12th: $55,480. We're in the red by $841 right now, we need more funds very soon to pay for the following: 3 more herceptin injections, given every three weeks (approx $740 each dose), oncology consults, facility fees, MLD/compression Therapy, pain meds, and supplements, What is on the possible list is area liposuction under the arm (as suggested by Dr. Botha), or more possible other surgery (removing the scars and the chemo port), but these can wait. The next herceptin visit is on October 1st at CapeGate, and two more radiation appointments are to come September 14th and 15th (to be confirmed).
While we no longer have health insurance, the insurance company we had came through with a lump sum payment at the end of 2019. They covered the early diagnostic treatments from late July and all of August 2019! This includes a surgery and the hospital stay but not the surgeon or any chemotherapy. That was good news. Months later, we had the PET scan, and L-A's oncologist was delighted to tell us the results of the PET/CT scan. There is NO TRACE of any "residual disease." (However, the scans did not pick up the cancer seeds that re-grew. We sent the results to Ottawa General Hospital Cancer Care so they will be ready for L-A's return. There was a following herceptin injection on March 20th, when we attempted to re-book our cancelled flights to Canada, which had been cancelled again by Lufthanza. We are now on lockdown in our rented house, and the landlords gave us a reprieve to stay until late September 2020. We found an apartment in the centre of town that we can stay in as long as we need to. It's managed by the same landlords we currently have. We move September 1st. We will need to extend our visas. We would like to return for family reasons in May 2021.
As for the donations, everything is noted for income tax purposes, including our donor's gifts, and the insurance company payout for costs incurred in August (the testing period). Just a note that the medical costs we have already paid from late July 2019 to now include: two - 4 day Hospital stays with the meds, GP doctor's visits, surgeon visits (hospital and in office), medications (many), five ultrasounds, two mammograms, three sets of xrays, port-insertion surgery, anesthesia (2 operations, biopsies), day hospital fees, surgical fees, biopsy fees, lab-work/blood-work fees (last blood work March 4th), swabs for more lab-work, oncologist fees, the chemotherapy meds/consumable meds fees for four A/C cycles, 12 cycles of Taxol (ending Feb 10), Herceptin (last injection September 10th), port flushes, one prosthetic, one mastectomy bra, one lymphedema bra, two compression arm sleeves, compression leg wraps, compression therapy supplies, covid-19 test, cancer clinic fees, cardiologist fees (echo-cardiogram), surgical fees (port, mastectomy), two wigs, 9 cancer hats, 2 drain bags, pain and nausea meds, Lyrica, Panado, MyPaid Forte pain meds, CBD oil, re-usable ice packs and more. We also had doctor follow-ups, oncologist consultations, medications, a PET scan, 16 radiation treatments, a preliminary scan (at CapeGate Mediclinic), compression bandages, arm sleeves and leg wraps, and more post chemo-herceptin injections on March 20th, April 8th, April 29th, May 25th, June 15th, July 9th, 30th, August 20th, September 9th. The next injection is on October 1st, with another to follow three weeks later (October 22nd, then the LAST ONE on November 12th). L-A also has had MLD appointments in Paarl on July 7, 9, 21st, 24th, 29th, August 4th, 12th and September 22nd.
Thanks so much to those who have helped us financially (for chemotherapy, PET/CT scans, bloodwork/pathology, supplements, meds and herceptin injections) (first names only): Ellen, Bev, Luanne, Minx, Mella, Claire, James, Kathy, Cindy, Diane, Gaets, Don, Miriam, Koliah, Samantha, Terri, Cathleen, WC, Dave, David, Henry, Jennifer, Keith, Tanya, Harry, Stewart, Christine, Richard, Susan, Dennis & Lee, Carolyn, Johan & Marie, Melissa, Phil & Maureen, Elaine, Chris, Alma, Rob, Karen, Deborah, Dave, Laila, Myriam, Anthony, Pat, Beth, Neesa, Sandy, Worcester Primary School grade ones, Peter, Rob, Suzette, Karen, Sarah, Pat, Beth, Anthony, Gary, BHCC, Maureen, GMCM, George, Dave, Peter, David, Deborah, Joel, Patricia, Helen, Brandon, Alison, Richard, Jiri, and anon.
Then other special people helped us with surgery, surgical aftercare, MLD/compression therapy for lymphedema, and herceptin injections: Dianne, Dale and Linda, Morris, Jane, Norm and Audrey, Sheila, Cate, Miriam, Gord and Heather, Summer, Jake and Helene, David, Chad, Archie, Doug and Michele, Pastor Richard and Terry, Rev. Fred, Wayne, Sarah, Rosemary, Helen, Fr John, Carol, Don, Dave, Rudolph, Rev. Sally and Ed, Dave, Cheri, Anthony, Fr Neil, Zoe, Nikki, Jennifer, Merilee, Sydney, Miriam, Laila, Peter, Denys, Michelle, Eternal Hope Anglican Church, George, Yvonne, Ethel, Francis, Mary, Bob, Mella, Richard and Margaret! A few on this list have generously given twice or more; some very sacrificially. We are so, so thankful for your kindness and loving hands reached out to help carry us through.
Still other special people have been reaching out and helping us with the 16 radiation treatments, multiple lymphedema treatments, 7 more herceptin injections and pain meds/anti-inflammatories. These include: Chris, Alma, Jake + Helene, Luanne, Steve, Tara, Dianne, Renate, Terry, Minx, Deborah, Ansa, Myriam John, Lisa, Terry and Ellen, Juliet, friends in BHCC, Gaylene, Helene/Jake, and more to come as people respond to our campaign! May the Lord bless each person deeply with love and peace. We pray and decree over each one that they will prosper due to their kindness and love. We are so thankful.
We even have received hefty discounts from surgeon Arnold Smith (port/radical mastectomy surgery), Pathcare (lab work) and Mediclinic hospital (hospital stay) because we pay as early as possible! We also get a discount on the prosthetic, mastectomy bras, compression garments and for the radiation therapy as well. L-A's radiologists also offered at ten percent discount. We will take that gratefully.
Here's how you can give financially:
DIRECT GIVING TO THE COPPLES (For Medical expenses, NO TAX RECEIPT)
Canadians can contribute via our regular Canadian banking account by e-Transfer to tonycopple@gmail.com
South Africans can contribute via Tony's South African account. via EFT to: FNB (First National Bank) Account Number 62757609494, Branch Code 200407 Account holder: Mr Anthony C Copple.
Anyone can contribute via Tony's Paypal via this link: https://www.paypal.me/WaystogrowinGod
MISSION GIVING TO THE COPPLES - This option is available until we leave for Canada, which may be in October, 2020 or May 2021
(Online Tax receipt through Canada Helps for Canadians, IMC Tax receipt sent later for those donating directly through Iris Ministries Canada office)
Due to Canadian charity laws, our ministry (or 'work') funds from Iris Ministries Canada has to be kept separate. IMC is not a sponsor of L-A's medical needs. IMC is however, the sending agency of the work we do.
Iris Ministries Canada online portal at Canada Helps - please scroll down to South Africa-Tony & Laurie-Ann Copple
https://www.canadahelps.org/en/dn/2555
If you are in Canada and prefer to donate to our mission work by cheque, please visit this page and find out more from the Iris Ministries Canada office. http://irismin.ca/giving
Mailing address:
Iris Ministries Canada, 10 - 1425 Abbeywood Drive Oakville, Ontario L6M 3R3 Canada
Telephone: 905 847-7749 Email: info@irismin.ca
Thank you for considering us and keeping us in your prayers!
PRAYER SECTION at bottom of the page!
We may have to re-think about area liposuction of the area, which would greatly relieve pressure in the two surgical sites. Both Dr S and Este would like to see the wounds heal first before liposuction is seriously considered. Some of the swelling is lymphedema.
Newsletters
So if you would like to be added to our ministry newsletters (note whether for prayer and general update), please email us at laurie-ann@coppleswesterncape.ca
If you would like to be added to the health updates, please email Laurie-Ann at laurie-ann@coppleswesterncape.ca
Help us financially (to help in radiation treatments for breast cancer aftercare or also for our ministry if you feel so led) Most of the costs have been chemo-related but the mastectomy was well over $9,000, more than we expected, but people gave far more than expected. This was like loaves and fishes :) The rest of the funds are coming in slowly, but we are thankful for anything to help clear medical debt.
UPDATE on fundraising: As of September 16th, we have raised $54,639 Canadian! We will have spent as of September 12th: $55,480. We're in the red by $841 right now, we need more funds very soon to pay for the following: 3 more herceptin injections, given every three weeks (approx $740 each dose), oncology consults, facility fees, MLD/compression Therapy, pain meds, and supplements, What is on the possible list is area liposuction under the arm (as suggested by Dr. Botha), or more possible other surgery (removing the scars and the chemo port), but these can wait. The next herceptin visit is on October 1st at CapeGate, and two more radiation appointments are to come September 14th and 15th (to be confirmed).
While we no longer have health insurance, the insurance company we had came through with a lump sum payment at the end of 2019. They covered the early diagnostic treatments from late July and all of August 2019! This includes a surgery and the hospital stay but not the surgeon or any chemotherapy. That was good news. Months later, we had the PET scan, and L-A's oncologist was delighted to tell us the results of the PET/CT scan. There is NO TRACE of any "residual disease." (However, the scans did not pick up the cancer seeds that re-grew. We sent the results to Ottawa General Hospital Cancer Care so they will be ready for L-A's return. There was a following herceptin injection on March 20th, when we attempted to re-book our cancelled flights to Canada, which had been cancelled again by Lufthanza. We are now on lockdown in our rented house, and the landlords gave us a reprieve to stay until late September 2020. We found an apartment in the centre of town that we can stay in as long as we need to. It's managed by the same landlords we currently have. We move September 1st. We will need to extend our visas. We would like to return for family reasons in May 2021.
As for the donations, everything is noted for income tax purposes, including our donor's gifts, and the insurance company payout for costs incurred in August (the testing period). Just a note that the medical costs we have already paid from late July 2019 to now include: two - 4 day Hospital stays with the meds, GP doctor's visits, surgeon visits (hospital and in office), medications (many), five ultrasounds, two mammograms, three sets of xrays, port-insertion surgery, anesthesia (2 operations, biopsies), day hospital fees, surgical fees, biopsy fees, lab-work/blood-work fees (last blood work March 4th), swabs for more lab-work, oncologist fees, the chemotherapy meds/consumable meds fees for four A/C cycles, 12 cycles of Taxol (ending Feb 10), Herceptin (last injection September 10th), port flushes, one prosthetic, one mastectomy bra, one lymphedema bra, two compression arm sleeves, compression leg wraps, compression therapy supplies, covid-19 test, cancer clinic fees, cardiologist fees (echo-cardiogram), surgical fees (port, mastectomy), two wigs, 9 cancer hats, 2 drain bags, pain and nausea meds, Lyrica, Panado, MyPaid Forte pain meds, CBD oil, re-usable ice packs and more. We also had doctor follow-ups, oncologist consultations, medications, a PET scan, 16 radiation treatments, a preliminary scan (at CapeGate Mediclinic), compression bandages, arm sleeves and leg wraps, and more post chemo-herceptin injections on March 20th, April 8th, April 29th, May 25th, June 15th, July 9th, 30th, August 20th, September 9th. The next injection is on October 1st, with another to follow three weeks later (October 22nd, then the LAST ONE on November 12th). L-A also has had MLD appointments in Paarl on July 7, 9, 21st, 24th, 29th, August 4th, 12th and September 22nd.
Thanks so much to those who have helped us financially (for chemotherapy, PET/CT scans, bloodwork/pathology, supplements, meds and herceptin injections) (first names only): Ellen, Bev, Luanne, Minx, Mella, Claire, James, Kathy, Cindy, Diane, Gaets, Don, Miriam, Koliah, Samantha, Terri, Cathleen, WC, Dave, David, Henry, Jennifer, Keith, Tanya, Harry, Stewart, Christine, Richard, Susan, Dennis & Lee, Carolyn, Johan & Marie, Melissa, Phil & Maureen, Elaine, Chris, Alma, Rob, Karen, Deborah, Dave, Laila, Myriam, Anthony, Pat, Beth, Neesa, Sandy, Worcester Primary School grade ones, Peter, Rob, Suzette, Karen, Sarah, Pat, Beth, Anthony, Gary, BHCC, Maureen, GMCM, George, Dave, Peter, David, Deborah, Joel, Patricia, Helen, Brandon, Alison, Richard, Jiri, and anon.
Then other special people helped us with surgery, surgical aftercare, MLD/compression therapy for lymphedema, and herceptin injections: Dianne, Dale and Linda, Morris, Jane, Norm and Audrey, Sheila, Cate, Miriam, Gord and Heather, Summer, Jake and Helene, David, Chad, Archie, Doug and Michele, Pastor Richard and Terry, Rev. Fred, Wayne, Sarah, Rosemary, Helen, Fr John, Carol, Don, Dave, Rudolph, Rev. Sally and Ed, Dave, Cheri, Anthony, Fr Neil, Zoe, Nikki, Jennifer, Merilee, Sydney, Miriam, Laila, Peter, Denys, Michelle, Eternal Hope Anglican Church, George, Yvonne, Ethel, Francis, Mary, Bob, Mella, Richard and Margaret! A few on this list have generously given twice or more; some very sacrificially. We are so, so thankful for your kindness and loving hands reached out to help carry us through.
Still other special people have been reaching out and helping us with the 16 radiation treatments, multiple lymphedema treatments, 7 more herceptin injections and pain meds/anti-inflammatories. These include: Chris, Alma, Jake + Helene, Luanne, Steve, Tara, Dianne, Renate, Terry, Minx, Deborah, Ansa, Myriam John, Lisa, Terry and Ellen, Juliet, friends in BHCC, Gaylene, Helene/Jake, and more to come as people respond to our campaign! May the Lord bless each person deeply with love and peace. We pray and decree over each one that they will prosper due to their kindness and love. We are so thankful.
We even have received hefty discounts from surgeon Arnold Smith (port/radical mastectomy surgery), Pathcare (lab work) and Mediclinic hospital (hospital stay) because we pay as early as possible! We also get a discount on the prosthetic, mastectomy bras, compression garments and for the radiation therapy as well. L-A's radiologists also offered at ten percent discount. We will take that gratefully.
Here's how you can give financially:
DIRECT GIVING TO THE COPPLES (For Medical expenses, NO TAX RECEIPT)
Canadians can contribute via our regular Canadian banking account by e-Transfer to tonycopple@gmail.com
South Africans can contribute via Tony's South African account. via EFT to: FNB (First National Bank) Account Number 62757609494, Branch Code 200407 Account holder: Mr Anthony C Copple.
Anyone can contribute via Tony's Paypal via this link: https://www.paypal.me/WaystogrowinGod
MISSION GIVING TO THE COPPLES - This option is available until we leave for Canada, which may be in October, 2020 or May 2021
(Online Tax receipt through Canada Helps for Canadians, IMC Tax receipt sent later for those donating directly through Iris Ministries Canada office)
Due to Canadian charity laws, our ministry (or 'work') funds from Iris Ministries Canada has to be kept separate. IMC is not a sponsor of L-A's medical needs. IMC is however, the sending agency of the work we do.
Iris Ministries Canada online portal at Canada Helps - please scroll down to South Africa-Tony & Laurie-Ann Copple
https://www.canadahelps.org/en/dn/2555
If you are in Canada and prefer to donate to our mission work by cheque, please visit this page and find out more from the Iris Ministries Canada office. http://irismin.ca/giving
Mailing address:
Iris Ministries Canada, 10 - 1425 Abbeywood Drive Oakville, Ontario L6M 3R3 Canada
Telephone: 905 847-7749 Email: info@irismin.ca
Thank you for considering us and keeping us in your prayers!
PRAYER SECTION at bottom of the page!
L-A with Tony and our friend and spiritual daughter, Jamelia
(in Hillsong Somerset West)
(in Hillsong Somerset West)
Here's Laurie-Ann walking out of physiotherapist - MLD Therapist's office in Paarl in compression bandages (on July 24, 2020). We hope her sandals can be modified soon. But there already is a difference in L-A's lymphedema treatments. She's walking without the walker in the house! L-A graduated to easier to use (although expensive) velcro leg wraps (which cost $770).
Here are the posters that we are sharing on Facebook, and different websites. We will update it in time, but meanwhile it's sufficient for what is needed now. When you see one, please feel free to share with anyone you believe may be able to help.
Thanks and may God bless you.
Thanks and may God bless you.
Prayer Points
- For Laurie-Ann's healing – accelerated and gradual. On November 8th, We were given the great news by a second oncologist that the tumour has shrunk 60 percent. The lymph nodes in L-A's left underarm also greatly improved. On the December 2nd chemo, the oncologist was very pleased with L-A's progress. The scan results from Marcy 11th's PET/CT scans were nothing more than a miracle - the tumour has disappeared! We are working on repairing the damage caused by the tumour and the side effects from chemo and herceptin. However, the cancer came back with a vengeance. We trust the surgeon got it all in May 12th's mastectomy, but inflammatory cancer can be sneaky. Pathcare Worcester confirmed there were good margins in the breast and no cancer in the nine removed lymph nodes. This is a miracle. However, L-A's oncologist says that even then, stray cancer cells can still regather and grow again. Pray that if any remains, it will be zapped. The radiation treatments occurred from August 13 until September 16th, 2020.
- For God’s glory to shine as he does something wonderful as promised. This illness was allowed for a good reason. Meanwhile we have met some wonderful medical people and have enjoyed the special personal interactions with them.
- For Holy Spirit to work through the medical staff to help L-A. For Este M/Marzanne on MLD/compression therapy, for the radiation people, for Dr H., L-A's oncologist.
- For finances to cover the surgery, hospital and all aftercare, including radiation, lymphedema and physiotherapy.
- For pain management for the side effects of herceptin, the damage from the cancer and the after effects of the mastectomy (lympedema) and radiation sickness (exhaustion and weakness, mouth sores, taut skin, and soreness).
- That L-A can continue certain assigned work and ministry within the context of rest.
- Debt cancellation for what has already been spent. We still owe funds on L-A's credit card for medical debt.
- For continued healing during our delay in South Africa (effects of chemo, damage from the cancer, the surgery, lower back pain, osteoarthritic knees, lymphatic swelling in legs, arms and side, and serious tendonitis in L-A's right hand and behind her left knee).
- For L-A's mobility to increase and get better and better to help our return to Canada, but also to make ministry easier.
- For continued funding towards our ministry work, which we are still continuing.
- Wisdom on tying up loose ends in ministry and selling many of our items (delayed until we leave - timing depends on favour with visa extensions. We hope to return in May 2021).
- For the children and teens we work with: that they understand the process, and grow spiritually through it.
- For supernatural grace for all the medical team working with L-A various places, including Cape Gate Oncology Centre, Dr. Smith's surgery, E. Mellet, and Cape Gate Icon radiation folk.
- For Tony: wisdom, grace and strength as caretaker and missionary husband, and his health (pleural effusion, iron deficiency anemia, cataracts).
- Our regular finances to continue to pay for Ottawa and South Africa expenses. (non-mission related)
- That L-A can be inspired and can sell her South African colouring books while in SA (they are available from us or at two retailers in Worcester and Robertson. They also available online via Takealot).
- For preparation for treatment in Canada that will follow treatment in South Africa despite the covid19-travel restrictions and delay.
- For the rest of the oncologist's and physio treatment as long as we are in South Africa
- For good communication and favour with the Breast Health Care Centre in Ottawa. L-A was to receive surgery and radiation there. Now we will see what treatments remain when we return (it may be check ups, medication and mammogram check-ups).
- For the transition between South Africa and Canada - that the travel in different countries is as comfortable as can be, whether in stopover mode, airport or plane (when we can travel again).
- For L-A to heal well during continued lockdown.
- AND a Praise report that L-A will NOT need to take tamoxifen after she is done with herceptin innections! This drug is in very short supply world-wide.
Thank you for your perseverance in reading! If you get any words of knowledge or encouragement, please do pass this on to us. We thank you for praying, loving and supporting us as you are able.
Love, Laurie-Ann and Tony