Surgery on Monday to Restore Its Use

I keep thinking I’ve run out of downstream consequences of radiation treatment to my neck so many years ago. Not so!

The latest version of guess-what-we-get-to-deal-with-now is the near uselessness of my dominant hand.

I’ve struggled with neuropathy in my right hand fingers ever since chemo in 2005. But lately the numbness and tingling there has increased so much that I’ve lost nearly all tactile sensation. I’m down to my thumb and index finger for typing. On top of that, significant muscle wasting has occurred in the hand such that I have very little strength for every day tasks. I compensate a lot with my left hand, but I sure miss Mr. Right.

A nerve conduction study revealed that the median and ulnar nerves on that side have stopped working. Two different hand surgeons believe the place to begin for any hope of relief–they make no guarantees–involves carpal & cubital tunnel (elbow) surgery to relieve compression to those nerves.

The outpatient surgery will last about 90 minutes. I’ll wear a wrist-to-armpit cast for two weeks and then a brace for another two followed by therapy, leaving me without use of my right hand for about six weeks. Anybody know a good OT I can call? 🙂

I’ve enjoyed a couple years off from general anesthesia. At least doctors aren’t slicing into my neck this time! But here we go again.

I’m finding comfort and encouragement from a verse like 2 Corinthians 4:16:

So we do not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day.

My right hand wastes away for sure, but we hope to improve that with these procedures. But even if we don’t and knowing the rest of my body with age continues to decline over time, I don’t lost heart.

God continues to renew my spirit day by day through the means of grace that are his word, prayer, and people. He is continually with me; he holds my right hand (Psalm 73:23).

Your prayers are coveted and much appreciated on Monday at 9 AM Pacific time.


Ways To Pray for My Latest Jaw Journey

In about an hour from writing this post, I head for Miami. Tomorrow morning the oral surgical team at Jackson South will open me up for measures necessitated from massive radiation treatment for head and neck cancer back in 2005. Nice way to spend a Thanksgiving, eh?

Jaw dental x-ray scan front view

I must keep this brief as time escapes me. In most ways my prayer requests remain much the same as they were for Robojaw One. You can watch that video post here.

However, a few specifics come with this second major step in the four-part journey to return some form of normalcy to my mangled mandible.

Before listing those, here is a brief synopsis of the strategy for step two. The procedure should last about six hours. It is scheduled for 8 AM on 11/23. It involves taking bone marrow and stem cells from my hips, mixing that with a protein I can’t pronounce, along with cadaver bone from the hospital reserve (nice huh?).

They mix that into a paste and rebuild what they call the “vestibule.” I asked the doc if he could install a narthex while he was in there, but I don’t know that he got my attempt at church humor.

Now for the fun part. They wire my jaw shut for three weeks. Imagine the irony. A preacher with his jaw wired shut. One of my armor bearing brothers at OGC has taken to calling it, Operation Miami Vice-Grip. Nice.

So, here’s how you can pray and I am SO thankful that you might:

  1. That I adjust quickly to the wiring of the jaw and am able to take in adequate nutrition so my weight does not drop too far.
  2. That I recover sufficiently that while I’m out on this medical leave I might make major headway on writing my book.
  3. That I might be able to return to the pulpit on Jan. 1. I really, really, really want to preach the New Year’s message for my church’s joy and encouragement, if the Lord wills.

Again, thanks a ton. Hope to report on another blog post soon from the other side of Robojaw Two!


The Latest on Her Battle with Cancer

Yesterday, May 27, we admitted my bride to the hospital. Over the last week her physical distress rose alarmingly fast. Thankfully doctors quickly stabilized things. She is much more comfortable today.


This morning we learned the cause for her symptoms. The spread of disease now  compromises some major organs. The weakness of her condition furthermore prohibits the possibility of any standard of care chemotherapy treatment.

Nan grasps the gravity of the situation. She has fought her fight with the courage of her personal convictions. She has done so without complaint. The joy of the Lord has been her strength and remains so (Neh. 8:10). She does not despair knowing what pleasures await at her Savior’s right hand (Psalm 16:11).

A hospice rep will meet with us tomorrow. Joel, our son, arrives tonight. He plans to join us for that appointment with the nurse. As soon as arrangements can be made, likely no more than a day or two, we will move Nancy to the comfort of our home.

Words cannot convey my unique privilege to serve both as Nan’s husband and pastor. We talked and wept together over the news earlier today. I reminded her (and myself) that God regards as “precious”–the Hebrew means significant, weighty, no small thing in His sight–the death of His saints (Psalm 116:15). Her times are in His hands. He will walk with her through the valley of the shadow; she fears no evil (Psalm 23:4).

Lately I’ve spent a fair amount of time meditating on Phil. 4:11-13. Paul writes from prison:

11 Not that I am speaking of being in need, for I have learned in whatever situation I am to be content. 12 I know how to be brought low, and I know how to abound. In any and every circumstance, I have learned the secret of facing plenty and hunger, abundance and need. 13 I can do all things through him who strengthens me.

This turn of events brings me low–lower than my own cancer, a broken jaw, even the loss of our beloved Joshua, or any other hard providence we have faced. My schooling in the secret of contentment faces its biggest challenge. Though I expect the degree of difficulty to grow exponentially in the days ahead, I hope to bank everything on the massive promise of v. 13–I can do all things through him who strengthens me.

Please pray for Nan’s comfort and care during this time. I want to love and serve her well at every turn. She’s pretty weak. I’m not certain at what point, if at all, she will desire visitors. We will just have to see how she does once we get her home. Many thanks.

Sorrowful, yet always rejoicing (2 Cor. 6:10), we press on toward the goal for the prize of the upward call of God in Christ Jesus (Phil. 3:14).


The Latest Update on Nancy and Me

As I write the news concerning my jaw journey and Nan’s cancer fight, I am reminded of Paul’s words in 2 Corinthians 4:16:

So we do not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day.

Stamina. Business man pointing to transparent board with text: Resilience

By God’s grace we remain steadfast (James 5:11). The Lord kindly renews us daily with His lavish mercies and great faithfulness (Lam. 3:22-23).

Through the ups and downs of doctors’ visits, lab reports, treatments et al, we continue to hang in and trust God’s unwavering goodness. Here’s what we know at this point:

First, regarding Nancy. We finally received the lab results on the fluid extracted from her some weeks ago. They tested eleven different chemo drugs for potential effectiveness on her form of disease.

Not a single one registered positive. Her doctor admitted any attempt at standard of care therapy would constitute a “crap shoot.” Not exactly overly motivating, as one might imagine.

Nan continues to fight fluid build up. It gets drained as needed. She battles away on the alternative therapy front. A new practitioner has entered the picture. She remains optimistic, reporting some symptom progress as a result of new strategies.

Now, regarding me. For the most part, I enjoy good progress since “Operation Robojaw” over fourteen weeks ago. The Lord graciously allowed me to return to the pulpit on May 15. It went better than I anticipated. I must speak more slowly than before–probably not a bad thing–but the articulation issues don’t seem overly distracting.

I’ve started therapy to improve my speech. Unfortunately the exercises helping me so much seem to have kicked up painful muscle spasms in my upper right jaw. Next Tuesday I travel to Miami for my surgeon to address that complication.

Dr. Marx will also review with me the results of my recent swallow study. Surgery changed something in the swallowing mechanism when I eat and drink. I tend to aspirate both liquids and solids.

Apparently my body can’t generate adequate pressure to get the stuff down the esophagus. Hence, something ends up going in the wrong pipe. Choking can result; I need to exercise extreme care with the process.

My primary care doctor has ordered occupational therapy for my swallow issues. Hopefully that will help. One step away from a Heimlich Maneuver unnerves me a bit.

So there you have it. The Heff House saga continues. We remain immensely grateful for the outpouring of support and the prayers of countless numbers of fellow believers.

I will post additional updates whenever we have significantly more to report.

Another Personal Update

More Health News from the House of Heff

Many of our OGC folks and others probably wonder how our busy medical Monday went this week. Here’s the latest:

HealthCare News,Newspaper with white background

First, on my front, Monday proved a total washout. Somehow the wrong test got ordered. Back to the drawing board with my PCP. In other words, still waiting on that swallow study I need.

Now, on Nancy’s front, some significant progress. She underwent an outpatient procedure to remove two liters plus of fluid from her body–ostensibly not that uncommon with ovarian cancer.

BELIEVE IT OR NOT WE FINALLY GOT THE BIOPSY RESULTS! Relatively good news. The enlarged node the surgeon took over six weeks ago tested out as the same ovarian cancer as elsewhere in her body, not some other form of the stupid disease.

Unfortunately the node didn’t meet the size specs necessary upon which to grow a culture. So we still don’t know what chemo drug would best target her cancer, should she choose that route of last resort.

Other than a bit tired and sore from lying in the same position for the procedure, she feels much relief after the siphoning off of all that fluid. A sample of the same now gets sent to the company for testing to determine the best drug for her use. We should hear in two or so weeks.

Yeah, sure.

Forgive my cynicism and thanks for those continued prayers!


A dear self-professed atheist friend of mine follows my blog. This both humbles and encourages me. But he did recently complain about the content. “Too much religion. Not enough about you.” Just like my buddy. This post he will like, I think.

Sick Leave

I had to shut down the blog for a couple of weeks recently due to ongoing treatment during my current medical absence. Following jaw surgery six weeks ago my surgeon ordered ten hyperbaric dives to aid in my recovery. They completely wiped me out. Productivity of any kind flew out the window from day one. Fortunately I’ve left those in the rear view mirror. I am actually starting to feel human again.


Before I write anything more about me, let me update on the Queen of the Manor, Miss Nancy. Honestly, we don’t have a great deal to report about her cancer battle. She continues diligent treatment with her latest alternative protocol.

She remains optimistic in every way. She has no pain or symptoms. Still no word on the results of her lymph node pathology. We may wait as many as two more weeks for those. Sigh.

Needless to say we pray a lot through this journey. Thanks to so many of you who join us in petitioning the Father in Jesus’ name for her complete healing.


Now back to the less interesting part of this post. How do you like my new look? Yep, allow me to introduce you up close and personal to “robojaw.” This most recent scan shows my titanium implant.

Note the span. It runs from the socket by my ear all the way past the midline point of my chin. Just above the “chain” shows my remaining live bone in the mandible. Noticeable by their absence? All my teeth in that quadrant. Needless to say the left side does all the chewing work these days. I’m wondering if my dental hygienist will discount me 25% now at teeth cleaning time.

I still have some swelling. My surgeon, whom I saw recently in Miami, refers to these weeks as “the accommodation” phase of my healing. But everything looks good. I can eat anything I find tolerable. Some speech and swallowing therapy lies ahead as soon as we can arrange it, but things overall improve daily.


Thankfully, this week I’ve returned to the office for a good part of each day. Prime time pulpit work will have to wait a bit longer, but writing and administration–no problem. Seems I can manage the occasional appointment as well. Sure beats breathing 100% O2 at a simulated 45 feet below sea level in a claustrophobic chamber.

Our elders huddle up in a couple of weeks. At that meeting I expect we will discuss my progress and what steps might lie ahead for a more complete pastoral reentry. In the meantime, I praise God for His kindness in sustaining me through this marathon journey. Go ahead and say it “L.” “There you go again with that religious talk.”

I just can’t help myself.



NancyA natural-friendly MD Nan now sees in Lakeland advised from the get-go that she have a full-body PET scan. I remember them well from my own cancer journey back in ’05. This will give us a baseline from which we can determine how things progress over the course of treatment.

She had the scan this past Tuesday. Her OB/GYN called us in to review the findings just this very morning. I wish I could post a more encouraging report. The results showed that my beloved lost ground over the last few months. The disease definitely has spread. Nan asked me to divulge no greater specifics than these given the sensitive nature of anyone’s health history.

What does this mean now that we’ve got a clearer picture of her condition? Beyond one move for certain, we don’t know just yet what the Lord would have her do. I respect my wife for the patient processor that she is. She will definitely talk with the Lakeland doctor today for his input. The additional move for certain involves her getting a medical oncologist on the team. Her OB/GYN enthusiastically consented to my suggestion that she refer Nan to the medical oncologist who cared for me way back when. The personal relationship we have with Dr. G will serve things well in terms of helping Nan weigh her options. Once a direction comes into focus I will post further updates as necessary.

How are we doing? Good question. I think Nancy is sorting that out for herself; I feel a bit numb at this point. Of course we continue to covet the prayers of God’s people for His purposes to carry the day at every turn on this roller coaster ride. The emotions ride higher than usual in January as it brings each year another anniversary of our son’s death back in 2014. These latest developments challenge the emotions all the more. Through it all I keep asking the Lord to anchor us in a Job-like grip on reality. Naked I came from my mother’s womb and naked shall I return (Job 1:21a). Mike Mason captured it well:

Job knew one of the great secrets of faith: the believer in God has no worldly rights. The true believer is someone who has abdicated all rights, freely accepting the status of a slave and no longer laying claim to any earthly chattel, whether it be “houses or brothers or sisters or father or mother or children or fields” (Matt. 19:29). These are precisely the sort of things that Job has just lost, and yet his initial response to their loss is not bitter complaint, nor even mere acquiescence, but adoration (The Gospel According to Job, Crossway, 37).

Blessed be the name of the Lord.



Can’t say I don’t know how to show my bride a good time. Yes sir, I’m pulling out all the stops this year. I’m taking Nancy to the Magic City on February 14. Unfortunately we won’t be having a romantic dinner for two on South Beach, unless you count Smoothie King a five star establishment. No, we will head that way on the 14th so I can report for jaw replacement surgery first thing in the morning on the 15th.


After visiting  on Monday of this week with Team Marx associated with Jackson South Community Hospital, we had no doubt the Lord had led us to just the right resource to deal with my fractured mandible. The image above shows the results of a CT scan they did in the office that day. If you look closely at the largest of the pictures head on at the top, you can see to the left (my right side) the break in the bone. Apparently there are some splinters of the jaw floating around in there adding to my misery. To use one of the doctors words after they examined the area treated with radiation in 2005–“You got fried.” And so I did and these are some of the unfortunate consequences.

titanium jaw implant.jpg

The procedure takes anywhere from seven to nine hours. It begins with removing all the dead bone on that side of jaw. I will lose the next two teeth in line as well since they are sitting on top of dead bone. Fortunately the titanium plate (pictured above) then implanted will not, in my case, pass the mid-line, as in this stock picture I grabbed from the web. While the oral surgeon does his thing up above, a micro-vascular surgeon will work below on my right thigh to start something called a “free flap” transplant. When the jaw is finished, then the second surgeon will attach the vein he pulls from my leg to a good blood supply on the left side of my neck and run it across to the right side. This will insure adequate blood supply for the needed tissue growth and healing of the jaw.


After the surgery I will spend two nights in ICU to monitor the free flap part of the process carefully. Assuming all goes well with that, then it’s off to the main floor of the hospital for another four or five days. The docs are very optimistic about how quickly I can heal and get back to work, but some of that depends on how many HBO2 dives I am likely to need after surgery to aid in the healing process. I’m still waiting for more info in that regard.

Honestly I had hoped for a sooner surgery date than February 15, but supply and demand being what it is in this highly specialized kind of procedure, I am grateful I don’t have to wait even longer.

One last tidbit. When one of the doctors who will work on the free flap procedure heard I was a pastor, he smiled and shared with me that he takes online courses at Southern Seminary in his free time! He went out of his way as a brother in Christ to give me his contact info and even friended me on  Facebook. The Lord is so kind to add those touches of providence to our circumstances when we are asking for His clear leading.

While I wait for “Operation Robojaw” to take place, I hope to make as much progress as I can on my manuscript for Baker Books. Fortunately it doesn’t hurt when I write, only when I preach!

Jaw Journey Update


I gave this report in our church’s e-news this past week:

Thanks a ton for all your prayers as I continue to travel the healing road with the wound/infection in my jaw. I am now essentially under the care of infectious disease doctors for my osteomyelitis. They have put in play every strategy known to help my particular problem. It’s a two-fold approach. First, I have an at-home, every six hour, 24/7 antibiotic infusion—for four to six weeks. The hardest thing about that is the disruption of my sleep patterns. Pastor needs his sleep!

Second, the infamous hyperbaric oxygen dives. The toughest thing there is the time involved and somewhat the discomfort. I arrive at the hospital every morning, Monday through Friday, at 6:30 AM. They load the dive chamber somewhere around 7:30. It takes about fifteen minutes to pressurize the cabin to the equivalent of 45 feet below sea level. My sinuses tend to object strenuously on the way down. Think ice pick thrusts above the eye and you will get the idea. Once at depth, they install a clear plastic hood over my head. I breathe 100% O2 for 30 minutes, 5 minute break, another 30 of breathing, take five once more, a final half-hour of oxygen, and then 10 or 15 minutes or so back to the “surface.” I’m home in Altamonte usually by 10 AM. Fun, huh?

Needless to say, this treatment regimen has cut in significantly to my morning study time. As a result I feel I need to suspend the Genesis series until finished with this stewardship. I’m planning something less strenuous for Advent from the gospels. That will give me some breathing room as I keep on the healing path. My apologies for the disappointment this causes anybody. I just can’t bring myself to cheat study time on arguably the most challenging book of the Bible I have ever preached.

Most of my work hours for now will occur in the afternoon, evenings, and weekends, as energy allows. I appreciate the patience and grace I’ve received as I try to navigate the schedule with wisdom and grace.

Ten Years Cancer Free & Still Learning


This month marks a decade since I finished treatment for head and neck cancer. By God’s grace I remain cancer free. I have remarked to others more times than I can recount a single thought: “Cancer is a terribly effective tutor.” Here are several lessons I learned through the healing journey and continue to learn as the Lord kindly gives me length of days.

  • One, the actual moment of a believer’s death is a terribly significant matter in the heart of God (Psalm 116:15).
  • Two, illness is a form of suffering which God uses to train us in holiness (Psalm 119:71).
  • Three, God’s grace is sufficient to sustain even when healing is delayed or doesn’t come at all (2 Cor. 12:9).
  • Four, one’s capacity to comfort others in their affliction increases significantly to the degree one has experienced comfort from God in something similar (2 Cor. 1:3-5).
  • Five, dying is gain for the believer, but remaining alive to serve others is better for them in God’s providence (Phil. 1:21-26).
  • Six, God sees the tears and hears the prayers of His people when they cry out to Him (2 Kings 20:5).
  • Seven, joy doesn’t depend on circumstances but rather on the filling of the Spirit which focuses on giving thanks in all things (1 Thess. 5:16-18).
  • Eight, true worth comes from who we are in Christ, not what we can or cannot do for Him (2 Cor. 5:17).
  • Nine, prosperity and adversity both come from God and require different responses in faith (Ecc. 7:14).
  • And, ten, life is a vapor, faster than a weaver’s shuttle, requiring one to live every moment’s anticipation of the future governed by a careful “if the Lord wills” (James 4:13-15; Job 7:6).

These lessons and more I have learned and continue to learn as I live one more day cancer free to the praise of His glorious grace.