The Haitian Donkey Makes Slow, Stumbling Headway

Hi All:

It appears that I have not written in quite a while.  As you all know, I am quite technologically challenged, so progress in that department moves at a snail’s pace.  I apologize for not keeping things more up to date, especially the progress in Haiti.  I finished another course of 4 weeks of Avycaz, the $1000/day IV antibiotic, now 9 days ago.  I felt pretty good throughout and have been hoping that this one will give me a longer infection free interval.  Three days after I was done, the low grade fevers, especially in the evenings, nausea, vomiting and feeling dragged out a bit continually restarted.  Thus, 4 days ago, I repeated my blood cultures and labs, the WBC is back up at 13,000 with a left shift, all signs pointing to a persistent/recurrent infection, but so far, the cultures are no growth.  However, at times it takes a week or so for them to grow out the bug.  My ostomy (the 3.5 x 2.5 inch hole in my lower abdomen) has been giving us grief as the bags are not large enough so lots of leaks.  Plus, my belly is quite scarred from all the surgeries and they make for little gaps to let the intestinal contents seep out and eat away at the skin.  Medicare has sent out an ostomy nurse for 22 visits, but so far, she has struggled even more with leaks as has never seen such a large hole and is running out of ideas.  Jenn and Rachel have a good handle on it, but have to return to their jobs soon and will be less available.  Several of my former Georgetown Med Center coworkers have volunteered to help out, I am humbled and appreciative and we will embark on that soon to try to improve the situation.

I have been working on getting supplies for Haiti with the Covid limitations, also looking to establish long term routes for others to continue this in my absence.  Allegedly, the Health Department states that there have been over 5,000 cases and about 100 deaths, but how accurate that might be is a bit up in the air, as only government hospitals have limited testing supplies.  Dr. Moise and I contact each other regularly on WhatsApp, when the connection is reasonable, and things seem stable at the hospital, though volume is down due to the fears of Covid.  School kids are especially hard hit, as very few families have a computer or access to one and the last year of frequent rioting has made for little progress as classes frequently were cancelled for safety reasons, so the Covid only adds insult to injury to these struggling students. 

At present, our hospital uses masks, but I wonder how many people out in the villages have access to one or even the understanding of the need to wear one, etc.  Since clean water is scarce in the best of times, washing techniques are used in a limited sense.  Food supplies do go from the rural areas like ours to Port, etc, on trucks piled high with the containers full of food supplies, the vendors sitting on the top of the supplies (need to duck for trees/branches, etc) so social distancing and proper handling of the food is the proverbial “pie in the sky.”  Each vendor knows which sacks of cabbages, etc, belongs to him/her when they arrive at the market and off load them.  I am concerned that, in general, fear of evil spirits, etc is more prevalent in Haiti and the Covid pandemic will only increase their anxiety levels, more even than it is doing in the rest of the world. 

When I took over the leadership at CSL, now 17 yr ago, there were many areas that needed attention and direction.  I thank the Lord that, thanks especially to Ulrike Shaller, the German physiotherapist, the PT department is making great strides and progress.  That will leave only the dental department, a place where I am really in over my head.  Would you be so kind to pray that God would send a faithful, Christian dentist who could head up that department and be able to work with our limited situation and make it functional for the glory of God?  Another prayer request is that we can locate an experienced Christian ultrasound technician who could come out for 2 weeks or so and train Dr. William in doing and reading ultrasounds after he comes in October, Lord Willing, to join us full time.  Vi Anderson, who came out and taught Dr. Moise, is unable to come again due to health reasons, so looking for someone who could get Dr. William grounded in the technique and reading.  Moise is an excellent ultrasonographer and surgeon, but sometimes those who learn and can do things so quickly don’t necessarily make great teachers, shall we say.  Those of us donkeys, who are not necessarily the brightest and best, can plod along more slowly and accommodate pupils who learn at our own pace better. 

As always, thank you so much for your prayers, support and encouragement for us as we strive to serve our Saviour at Centre de Sante Lumiere for His glory. 

In His Service,

Bill, James, Jenn, Rachel and the rest of the Haiti Team

The Haitian Donkey Is Out Of Negative Pressure But Mourns The Loss Of Grandchild

Hi All:

We have been busy readjusting as a family to the changes the last few weeks have brought.  The Donkey had been off the IV antibiotics he had been on for 12 weeks for 10 days.  After 5 days, he began having spiking temps and rigors, a really nasty situation he has had for the last several years intermittently as his bloodstream repeatedly is contaminated, likely now from the ostomy situation in his lower abdomen, where there are skin cracks that bleed and undoubtedly act as 2 way streets, letting bacteria into the bloodstream via the same holes that let the blood out.  Seems like a no win situation.  I got blood cultures after the first spike, but the medication was $1000 daily and it took a bit to get the prior authorization from the insurance, who promises to pay for 6 days/week and I pay for the 7th.  I had started the antibiotic but it hadn’t kicked in yet and I was gasping for breath, so ended up going to the ER at Holland and being admitted on the 21st.  I was quite anemic so was given some blood and ended up spending 5 days in ICU in a Covid room (negative pressure with a 12 inch vacuum hose blowing air to the outside continuously), though my Covid test was negative and was moved the last day to another ICU room.  They changed my central line to one in my right arm (a PICC line) that does slow me down somewhat, but hoping the infection will be controlled, at least for a while.  For some reason, they had trouble getting my blood pressure up out of the 70s and so had a norepinephrine drip running in the line the whole time to keep it up, requiring me to stay in ICU for close monitoring.  Fortunately, Rachel was able to convince them to let her stay with me, a real blessing as they wouldn’t let me out of bed and just getting things, like the urinal, etc is a chore when you cannot get out of bed to reach the items.  You are supposed to call the nursing staff, but can have an accident while waiting as they are quite busy and have to gown and glove and wear masks to enter each room, slowing down things considerably.    

So, I am back home in my apartment with Jenn and Rachel helping in my care (Rachel actually did the ostomy changes in the hospital, they are tricky as I don’t have a traditional ileostomy or colostomy, normally the bowel protrudes from the belly wall and allows for the inside wastes to free fall away from the body into the bag, but mine are below the surface and more tricky to seal).  I have lost a bit of strength and am hoping to get up and outside as the weather allows some to build up some strength in my left leg especially.  Otherwise, we are stable, but looking into Hospice alternatives to help with the medical needs, etc.  

As many of you know, on Karen’s one year anniversary of her going to glory, a beautiful baby girl was born to a mother in Flint that didn’t want to see or even know the gender of her little one.  So, the next day, we got the call asking if we were interested.  James and Jenn went to Flint on Monday, the 18th, to get Willa Maren, the little one we were hoping to adopt.  The mom always has 28 days to change her mind and, much to our dismay, on the 22nd, the social worker picked up little Willa and took her back to her mother.  Admittedly, she got tons of attention from all the members of the family, but she was such a perfect baby and worked her way into our hearts and lives in just those 4 days and we all miss her terribly.  These emotional roller coasters have been hard on all of us, especially Jenn, and we appreciate your prayers as we adjust to life without her and consider what the Lord would have us do in the future, as this is the third time we have worked on an adoption, only to have it fall through.   

Covid seems to have given Dr. William some grief, I have heard that one of his fellow surgical residents has Covid so that has crippled their work at the government hospital a bit.  We have had some cases out in Cayes now, all is done through the government system, they have the testing kits, so hard to know what exactly is the incidence, but the country is also limited in supplies and ability to comply with the regulations.  It appears that there have been 2000 confirmed cases of Covid and 40 deaths, though likely there are considerably more cases due to the limited capacity to test individuals.  Haiti, with a population of 11 million, has only about 156 ICU beds and like 40 respirators, though the unreliability of electricity and shortage of oxygen tanks, etc, makes that option very limited.  Social distancing is rather impractical as the overcrowding that already exists makes it difficult to reduce population density.  The hospital has remained quite functional, though our volume of patients has reduced considerably due to Covid.  We are struggling a bit to find supplies, as sources in country are drying up and the borders are closed to outside sources at this point.  So, appreciate your prayers for wisdom for the hospital and staff/support personnel as we try to keep things functional for His glory at Centre de Sante Lumiere in Les Cayes, Haiti.

As always, thanks so much for your prayers, support and encouragement for our family and ministry in Haiti.

In His Service,  Bill for James, Jenn and Rachel

The Haitian Donkey Has A Short Update

Hi All:

Last time, I discussed that I would get 3 units of blood and have a stomach tube put in for a blow hole if the pressure builds up.  I got the blood, but the CT scan showed that my tiny stomach remnant was stuck to the posterior abdomen and thus not accessible.  After all my extensive surgeries, the tons of scar tissue would make an open procedure quite risky and I could have more grief, so we did this with needles and dilators under fluoroscopy.  There was a dilated loop of small bowel in front of it, so they placed a smaller tube into this, hoping it was not too far downstream.  It is small in diameter but has provided a fair amount of pressure relief.  I close it when I take medicines, etc for a bit, though have stopped any oral intake except maybe about 3 glasses of water each day and a few spoonfuls of blenderized whatever the kids are having.  This seems to have worked pretty well and I am thankful that I have less vomiting.  I still have a considerable amount of heartburn, so sleep in the upright recliner a lot to limit that. 

I now have an immobilizer for my gimpy left leg.  I cannot lift it up off the bed, etc, so presume the cancer (I have several palpable masses the size of golf balls and one the size of a baseball in my belly) has put pressure on my nerves that control my leg as it had been fine until 6 weeks ago and have had 6 falls since.  Now being careful but hate being limited.  The immobilizer helps a lot, though one has a stiff leg in it and slows me down.  Since it is my left leg, I am hoping I can drive some, as I feel decent otherwise.  The kids are not quite as enthusiastic about that as I am. 

Rachel flew back home to Arkansas to do some work at the university she cannot do on line, hopes to be back in 2 1/2 weeks.  She has been a great help and encouragement, keeps us all on our toes and has helped Jenn a lot with sharing the tasks of meal preparation and laundry, for which we are very thankful.  She sleeps in her bedroom in the basement, so if I vomit or have some grief in the night, she is right there.  Between the 3 kids, I am very well taken care of.

I have had regular contact with Dr. Moise, who tells me that the hospital is functioning fine but the patient load has tapered down to about a quarter of normal volume due to the Covid scares.  They persist in only having the government controlling testing, and that only a limited amount in Port au Prince, so one really has no good idea how many cases they have.  It is reported that they have 81 proven cases and only 8 deaths on the WHO site, but due to limited testing capacity, it is likely a lot more.  He said that, due to government regulations, they try to practice “social distancing” for the patients coming to the clinic and have spread them out over the hospital veranda, etc, but the patients have trouble comprehending what they are doing and cooperating.  Most of them were packed like sardines in the taxi getting there, so why do they have to stay apart.  Haitians tend to have a lesser concept of personal space than we do, they live under crowded conditions for the most part, so like the more cozy atmosphere.  No employees seem to be ill, thankfully, as they do wear masks and protective gear as much as possible.  I am continuing to look into avenues to get more supplies, including more surgical tools for the future as they are very expensive to buy and trying to get good used equipment where possible.  I have not had contact with Dr. William for several weeks, as the internet does not work well in Port, so only usually have contact with him when he is with his family in Cayes, but travel is very limited at present due to Covid. Pray that he will finish well and adjust well to reintegration at the hospital when he hopes to be done in October.

As always, thanks so much for your prayers, support and other encouragement for our ministry at Centre de Sante Lumiere. 

In His Service,

Bill, James, Jenn, Rachel and the rest of the Haiti Team

The Haitian Donkey Ventures Into Holland Hospital (Again)

Hi All:

Since we are keeping our social distances, I will update you on what is going on.  All 4 of us are living and working from home (Rachel teaches her classes on line at University of Arkansas from here), I just take call for the office, which has been quite busy, and James and Jenn each have set up a home office in the bedrooms upstairs.  I continue to fight the infection, we upped the dose of the Amikacin a little and checked levels yesterday (not back yet) in hopes of killing the critter for good.  I had my line changed over a wire on Friday and that went well, but did grow out the critter on the tip.  However, in checking labs for the antibiotic levels on Monday, my Hemoglobin has been drifting down slowly and reached a critical enough level at 6.8 that Dr. De Cook was willing to help me get some blood tomorrow.  I had some blood in January, but between the cancer sapping my condition and the multiple blood draws, my Hemoglobin has drifted down again.  

As you remember, I had severe heartburn and vomiting for 2 days last week, with milder problems on each side of that time.  We hope that I can get a gastric tube placed at Holland Hospital to provide a blow hole for the backed up pressure to be released when needed without all the vomiting and heartburn.  It is only a palliative procedure but if it avoids weeks like last weeks, it will be well worth it.  Dr. De Cook also has arranged for me to receive 3 units of blood, for which I am very thankful.  Unfortunately, with Covid 19, they will not allow anyone to stay with me there in the night, likely not a problem but my left knee is “gimpy” as well as painful.  After 7 years of being numb, the left leg has become alive again and has a throbbing pain that first was in the lower leg, now has moved up to the knee and thigh.  It is troublesome at night in keeping me awake, but sometimes (like yesterday at the pharmacy in the parking lot) it suddenly gives way and I go down.  I use the walker a fair amount if not in the house, will take it with me to the hospital and also use a wheelchair but my frequent nightly bathroom trips will have to find another solution.  

There have been no new updates from Haiti, I have talked to them, but no cases of Corona diagnosed in our section of Haiti, but then, they have no testing supplies, so who really knows what is going on.  Plus, anyone who has ridden down the roads there realize that one can get a nasty cough and congestion just from riding in the open busses and taxis, as they all belch black smoke from their diesel engines and cough, sputter and gasp a lot themselves, let alone the humans who ride in them or follow them.  Please continue to pray that the ministries at CSL can continue and the workers be protected from the nasty virus, as treatment options are about as available as the test kits.  Dan Boerman and I have been trying to figure out how to get more supplies, as IDA in the Netherlands is still on lockdown and even if they open up, who knows when Haiti will and we don’t need our supplies locked up in Port for months.  

In His Service,

Bill for James, Jenn, Rachel and the Haiti Team

The Haitian Donkey gets a small break

Hi Everyone. 

This is Rachel for all of us, to give you a brief update on Dad’s situation and to thank you for all of your prayers on his behalf. He and I spent most of yesterday at the hospital having his port line changed. The procedure went well, but he is quite sore now from all of the poking and prodding. 

In regards to the specific prayers for his blockage, he continues to deal with that situation. He was able to have a little bit of a respite from that as of yesterday (unrelated to his procedure), but it remains to be seen how much has cleared and for how long. It’s one day at a time right now. He does appreciate knowing how much support he has from his family, friends and patients; James, Jenn and I are especially grateful for those of you who have helped us with food and even plants that brighten an otherwise difficult time. 

I am sure he will reach out to you with a more comprehensive update when he is feeling a bit better and has had some rest. In the meantime, we are thankful for you and your prayers on his behalf. 

Rachel, James and Jenn for the sleeping Haitian Donkey