Rob was always the one with the ability to express himself in written communication. So I went back and found his post on Facebook when he was first diagnosed. His first sentence was “Cancer.”. Well, here we are again.

Cancer. Earlier this week, I was diagnosed with breast cancer.

I found an enlarged lymph node in my left armpit on October 8^th and noticed some changes in my left breast tissue also. Three days later, I saw my regular doctor who quickly scheduled me for a diagnostic mammogram and ultrasound. The results of the mammogram were “highly suspicious” and three biopsies were completed even before leaving the imaging center. The next day, the results came back that cancer was present in all three locations. Since then, I have met with a surgeon and a medical oncologist to discuss the specifics of the cancer and a treatment plan. As best as they can determine from the biopsy samples, there is a mix of both invasive pleomorphic lobular carcinoma and invasive ductal carcinoma. The good news is that my type of cancer is not as important as the biomarkers of my cancer. All three biopsies came back as HER2 positive, which mean I am a candidate for targeted therapy, in addition to chemotherapy. This particular treatment is known to be highly effective. The doctors also continue to reiterate that this cancer is "treatable".

As of Friday, I am awaiting the approval and scheduling of a PET scan to evaluate the spread of the cancer, the scheduling of a port placement procedure, and approval of the planned course of chemotherapy treatment by my health care coverage. 

Today, we enjoyed the festivities of the season.

Unicorn and jaguar face paint at St. Francis Oktoberfest

We were always so thankful for the love and support given to Rob. Once again, I ask for your thoughts and prayers in this new fight against cancer. 

The memorial service to celebrate the life of Robert Yale is scheduled on Saturday, April 29, 2017 at 2:00pm with a reception to follow. The service will be held at Northwest Bible Church, 8505 Douglas Ave, Dallas, Texas 75225.

Should friends desire, contributions may be sent to a fund for Matthew and Raegann (PayPal account using rob@robertyale.com), the University of Dallas, or a charity of your choice in honor of Rob.

It is with great sorrow that I write this update. Rob, also well known as Dr. Yale and Daddy, died in his sleep early morning on April 25, 2017. 

On Sunday, he started wearing the oxygen cannula because he was finding it so difficult to breathe on his own and he had lost almost all control of his hands. Yet, he still had his dad and I typing responses to many of the messages and texts he received. He was still making plans to have visitors and phone conversations. One of the many things I loved about him. 

Rob was always the one with the right words and the compeling narrative, so I will just say that he may be gone in body but his teachings, both in and out of the classroom, will live on in all who knew him. For me, he taught me most about trust, love, and friendship. Those are the three words I had engraved in his wedding band, but they are so much more true today after twelve years of marriage. He lived his life as an outpouring of God's love in him.

Thank you so much for the overwhelming support that has been given to us over the past year. Rob and I were speechless so many times by the generosity of funds, food, and time. Details of the memorial service will follow once it is scheduled. 

After several days in the recliner, it became apparent that if I could find one that was comfortable, a hospital bed would provide much more flexibility and make it easier for my caregivers to attend to my needs. Given the difficulty moving because of the tumors in my large back muscles, I was anxious about the process of transfering me from the recliner to the hospital bed. Further, given my experience with the hospital bed during my two night stay in the hospital several weeks ago, I was somewhat worried the transfer would fail and I would have to move back to the recliner.

Rob's setup in hospital bed

We are so thankful that none of my fears came true. With the help of four people, a bed sheet was placed under me in the recliner, and I was lifted without significantly changing my position as I moved from the recliner to the hospital bed. Even better, the new hospital bed from hospice is much more adjustable than the one I received in the hospital and so, on the whole, I have been much more comfortable in the hospital bed compared even to the recliner. I also know it has made caring for my specific needs much easier for Melissa, my parents, and my hospice nurses. I am so thankful that I was able to make the transfer to the hospital bed with minimal pain and that has been such an improvement over my previous circumstances.

Physically, the paralysis has continued at a rapid rate; I can no longer wiggle my toes or move my knee joints. My abdominal, chest, and back muscles are all paralyzed. My left hand can move at the wrist and fingers but have very little dexterity and strength. My right hand can still move from the elbow down and I have somewhat improved motor control compared to my left hand, but this does make using my phone and computer very difficult. Please know that I read every message, post, text, card or letter that is sent but please do not expect to see much in the way of a reply from me anymore, simply because it is so difficult to operate a keyboard now. You will have the best chance of getting a limited reply if you send me a text message, as I can dictate to my phone fairly acurately. I expect soon that I will lose complete control of both hands, and at that point it will be up to others to respond for me to those messages that require a response. If you are local here in Dallas, I still welcome seeing visitors, or you can always give me a call on Skype (robert.yale), Google Duo (708-762-9253), or a phone call or SMS (708-762-9253). If you do plan to stop by, you can call or text me for the address and we can work out a time that will be best. 

Given the complete paralysis of my chest, abdominal, and back muscles, it is becoming more difficult to breathe, as my diaphragm must do all the heavy lifting. Although my ability to interact significantly with my children has been greatly reduced, I love seeing the art work they are making and viewing pictures of them playing outside and receiving snuggles on my arm from my baby girl and my sweet little boy. Melissa continues to be a rockstar caregiver for me, our children, and my parents while they are here assisting us. I cannot imagine that I could possibly have married a more capable and loving woman. 

As you pray for us, and we are so grateful for your prayers, please remember these requests:

• Strength, peace, and endurance for Melissa and my parents as they care for me
• For a merciful transition and no prolonged suffering in these final days
• For my children, as their schedules are disrupted, and as they process the loss of a parent
• For continued joyful experiences personally, and with my family, in spite of what is happening with my body

Just thought I would write a quick update on how things have progressed since we officially started hospice care.

The paralysis from my waist down is all but complete. I can wiggle my large toes a very small bit with much effort, but for the most part, my legs are completely dead weight. I can still feel touches on my legs, but with greatly reduced sensitivity.

For me, this means I have very rapidly moved from fully functioning with a slight limp about 12 days ago to completely non-functional from the waist down today. As my paralysis includes my internal organs and digestive system, I am also in the unfortunate position of now needing a catheter and diapers. It's been a fairly rapid descent, and so far I'm able to occasionally still see the humor in these events, but day-to-day life is radically different now than it was just a few days ago.

Hospice brought a great deal of medical equipment to my home to make things easier for my family and the hospice nurses as they care for me. One such piece of equipment was a Hoyer lift, which is basically a hydraulic lift with an attached hammock-like sling that allows caregivers to easily move and lift an individual who is completely or partially paralyzed. Unfortunately, the lift proved useless to me due to the rapid growth of the tumors in my psoas (large back) muscles.

In order to make use of the lift, the patient must be placed into the hammock/sling, and then connected to the arms of the lift in order to move them from one place to the other. Unfortunately for me, this means someone (or several individuals) must lift me from my chair and place me on the hammock. When we attempted to do this with the assistance of the hospice nurse, the stretching of my tumor-ridden back muscles in the process took me to a level 10 pain state for at least 15 minutes - and this was after being pre-medicated with an unusually high dose of several different narcotic pain killers prior to the attempted move.

So, for now, I remain in my recliner within a fairly narrow range of acceptable angles that are tolerable to my back muscles. This makes caring for my needs much more difficult for my family, since processes that require moving me must be done very carefully to avoid the excruciating pain that comes when my back or abdominal muscles are stretched. It also means that all of this movement must be done manually, since the hydraulic assistance is unable to be used. Truly, the efforts that my wife and parents are exerting to care for me are nothing short of heroic.

Our bedtime family photo

Although I can't really leave my chair or my room anymore, I relish the time I get to spend with my children, my beautiful wife, and my parents, who are also here helping with my care. I continue to notice significant declines in my upper extremity strength and dexterity. I have lost even the strength required to lift my hands all the way above my head, so I expect that the tumors are quickly working through my spine and will eventually paralyze something more important. For me, this will be a blessing, as my quality of life has dropped so quickly and so dramatically. I am confident of my eternal destination, and am excited to meet my Savior.

Today, as we celebrated the resurrection of Jesus on this Easter Sunday, I had the privilege of spending the morning with one of my oldest friends and mentors who came to stay with me while my family attended church. He was kind enough to change his family's Easter plans to be here in Dallas rather than at home in Nashville so he could see me once more. It was a sweet time of remembering old memories together, reflecting on the Easter story from the Gospel of Luke, and reading through Paul's exhortations about the central importance of the resurrection to the Christian faith from 1 Corinthians 15. There really have been so many wonderful moments of joy over the past week as I've been able to talk with good friends from various stages of my life.

As you pray, please remember these requests:

• Strength, peace, and endurance for Melissa and my parents as they care for me
• For a merciful transition and no prolonged suffering in these final days
• For my children, as they process the loss of a parent
• For the ability to continue to experience true joy in spite of life's circumstances