I was thinking this morning about what I would like to do four years from now. I thought things like, will I be alive in four years, of course everyone can ask that question, for none of us know what tomorrow will bring. Yet I look to tomorrow with optimism, joy, excitement, and faith, because of the one who holds me in His hands. What I would really like to do, if I am able, is to travel to every National Park that allows camping, and camp at each one for one week. During the week, my wife and I would ride our motorcycle to interesting places near the park. I am thinking that it would take the greater part of a year to do, and that I would enjoy thoroughly. We would take our car, and tow the motorcycle with our utility trailer, where we would store all of our supplies, for camping. I know I will be a bit older then, and so will my wife, but if possible, that is what I would like to do, and so far my wife agrees.

Warning Hot Dogs Can Wreck Your Health: Billboard warns NASCAR fans of cancer link Oh no, I really like hot dogs.

Variability between patients – One of the striking things about CLL is that it behaves very differently in different patients. For example, some lucky patients have a very gentle form of the disease that never causes any symptoms or complications and never requires any treatment. At the other end of the spectrum, other less fortunate patients have an aggressive form of the disease that progresses rapidly and does not respond that well to chemotherapy. Lets not forget, that many, if not most are in the middle, where remission is favorable and long-term. Many patients and their relatives find it useful to have some idea about how their disease is likely to behave as it gives them the opportunity to plan their lives accordingly. There are a number of ways of obtaining prognostic information ranging from very simple things to very complex tests, ask your doctor, or use the internet for information.

Lymphocyte doubling time – This is really a reflection of how fast the CLL cells are dividing and is most useful in patients presenting with early-stage disease. Patients whose lymphocyte count takes less than 12 months to double have a poorer prognosis than those whose lymphocyte count takes more than 12 months to double. Some authorities consider that a lymphocyte doubling time of less than 6 months is an indication to start treatment. However, caution should be exercised as the lymphocyte count may fluctuate, sometimes dramatically, due to infection or stress. At the bottom of this post, is a chart that show prognostic factors and their relevance.

Now to finish our thoughts about the Fruit of the Spirit.

To help clarify our thinking about our emotions it is useful to categorize the various emotional states.

Positive    >                      Love                       Joy                        Peace        

Negative   >                     Anger                    Anguish               Concern

Sinful        >                      Hate                      Self-Pity              Anxiety

Each term on the chart may be thought of as a category of emotional states. While other terms may be used to describe each category, these have been chosen to correlate with the biblical terms, and minimize semantic confusion. In addition, each category is headed up with a positive emotion (LOVE, JOY, and PEACE), and may be viewed as a degenerating range from complete love at the top to no love (HATE) at the bottom of the chart.

The positive emotions of love, joy, and peace are obviously ones that feel good. It is crucial to note, however, that these emotions are called the “fruit of the Spirit”, and are therefore, emotional states that only the Holy Spirit produces in us. Since these emotions are, in fact, the fruit of the Spirit it is possible for us to experience love, joy, and peace in spite of the circumstances of our lives.

A notable example is that of Paul and Silas being able to sing praises in the midst of their suffering in prison (Acts 16). The opposite of the positive emotions are referred to as destructive or sinful, rather than negative, emotions. Hatred, self-pity, and anxiety are not sinful simply because God has arbitrarily decided to call such feelings sin, but because such emotional states are destructive, and leads us to death in some form. These sinful emotions may produce psychosomatic disorders that bring on the death of a tissue, organ, or even the individual himself. Likewise, sinful emotional states lead to a relational death as they destroy our relationship with others.

The Bible declares that anything leading you to death, in any form, is sin. For the wages of sin is death.(Romans 6:23)

Somewhere between the positive and the sinful emotions are those feelings we may describe as negative. Negative emotions are not pleasant, but they do not produce death in us. Although they are obviously different from the positive emotions, they may be seen as including a measure of the positive emotions in them. For example, Jesus was obviously angry when he cleansed the temple during his public ministry, yet he still loved the merchants he drove out. It is possible to be angry, and not sin (Ephesians 4:26) since anger still contains a measure of love.

Likewise, we may experience excruciating pain and anguish without feeling sorry for ourselves. Jesus’ own agony in the Garden of Gethsemane is a classic example of pain that contains an element of joy or biblical hope. Finally, we may experience genuine concern for our own or other’s welfare without becoming anxious or worried due to the “peace that passes all understanding.

As our supreme example we look to Jesus who truly experienced all of the negative emotions in life yet was without sin (Hebrews 4:15). Most of his earthly life and ministry was not spent in some sort of blissful state of “love, joy, and peace.” Rather he was “a man of sorrows, and acquainted with grief” (Isaiah 53:3) who, though he felt the negative emotions, maintained the love, joy and peace of the Spirit, daily, throughout his often difficult life.

He did this by choosing daily to believe in who he was, and trusting in the provisions of his heavenly Father.

We must recognize that the only way to stay away from death-producing sinful emotions is to exercise faith in the Gospel that produces the fruit of the Spirit in our lives.

For those of you with CLL, you may already have seen this chart, but I thought I would show it to all that are interested.

The following table is an overview of prognostic factors and their relevance.

Prognostic Indicator

Indolent

Intermediate

Aggressive

IgVH

Mutated

Un-mutated

ZAP 70

Less than 20% (-ve)

More than 20% (+ve)

CD38

Less than 30% (-ve)

More than 30% (+ve)

FISH

Normal karotype

Trisomy 12

11q deletion or 17p deletion

B2M

Less than 2.0

More than 4.0

Rai Staging

Stage 0 and I

Stage II

Stage III and IV

Binet Staging

Stage A

Stage B

Stage C

Lymphocyte Doubling Time

More than 12 months

Less than 12 months

Advertisements