Thanksgiving Day is Coming

Hi All:

This will be a quick update before the special time of year that we thank our Lord for all the benefits He daily bestows upon us.

1. I am very thankful that I am alive and able to work, thanks to the great medical care we are able to receive in the USA. I have seen a number of patients who have this same cancer, both in the US and in Haiti, since contracting this rare form of abdominal cancer, many of whom have not been able to either have access to the care I have received due to living in Haiti, where a 15 hour surgery and the heated chemotherapy cooking your insides for 2 hours is just not an option, or have been too old or otherwise deemed unable to withstand the marathon surgery. Yes, I have had 2 of the marathons and likely will undergo another if I can withstand it in the future, and am struggling with my second course of chemotherapy, thus far more fierce than the first 9 month series, and we are only one fourth of the way through the 12 rounds and the donkey is reeling from the knockout punches delivered to his scrawny frame. But, by the grace of God and the prayers and support of His saints, I am able to sit up and (sometimes) take nourishment, and this makes me very thankful.

2. I am thankful that I have a very supportive family and coworkers, as well as patients, who put up with my efforts to continue to work and see patients in the clinic as well as at Sunset Manor, where almost every patient reminds me that they are praying for my continued health and strength, surely a great blessing and encouragement to keep going each day. I am blessed to have a job where I can sit down a fair amount of the time, as my wobbly legs don’t want to hold me up for more than 30 minutes at a time for the most part, often less, so a great source of encouragement at I try to continue to work at my job, which I find a joy to do (for the most part, nothing on this earth is perfect yet). Just for the biased record, I do think the donkey’s mind still works fine, though some of you may debate that finer point?

3. I am thankful for the generous outpouring of gifts from all of you towards our attempts to brighten up Christmas for our employees of CSL, when we can celebrate Christ’s great gift of Himself in coming to earth to die for our sins so we can have the hope in our hearts for eternity with Him. Your gifts will show your love to especially the poorer employees who live hand to mouth daily and for whom this will be so much more special a season thanks to these gifts of food and a financial investment (ie the goat will be saved for a financial reversal, as mentioned, NOT go into the pot for stew).

4. I am very thankful that Drs. Jose Dominguez and Luke Channer were able to go to Haiti in October and November, respectfully, to give me a break and a jump on the chemotherapy process, as both have now become veterans and capable of working there with the cross cultural team very effectively, and they are planning on doing this twice yearly each. I also have Dr. James Webb, a retired general surgeon, willing to fill in when I need help on short notice and he is greatly appreciated by us all and will be pressed into service soon, I am sure.

Now, a few prayer requests:

1. This weekend, Karen and I have decided that I will go forward in faith and we purchased my ticket to fly to Haiti on the 5th of December. Since I will just be coming off round # 4, given from the 2nd to the 4th of December, we have decided that eating is just not an option, as it just causes severe nausea, vomiting and abdominal cramps for the 3 days, followed by rather significant diarrhea with little warning. As I shared with you in a previous update, I am on Folfiri, the IRI being for Irinotecan, noted for GI problems. As I made yet another trip past the nurse’s station to the bathrooms at the chemotherapy center, I commented that my insides didn’t like to keep the poison in me and they assured me that this was normal and they have given the Irinotecan the nickname of “I run to the can” due to it’s behavior. For those of you who, like me, don’t count English as our first language and may miss the slang, “can” means “the bathroom” (Karen always tells me I miss most of the nuances in ordinary conversation, so will help those with similar struggles). I tried to work Friday, 2 days ago, but spent much of the time hugging the toilet as my new best friend. But, how to deal with this with flying to Haiti has been a bit of a puzzle. However, I don’t think I have an option as the next request will explain why I need to go, not just to allow surgery to proceed, but also to try to clear up some things. So, I will leave GR at 6 am on the 5th and fly straight through to Haiti and travel directly to the hospital, hooking up my TPN in the car on the way, to minimize dehydration as I will only sip fluids for the 48 hr before departure to limit further GI irritation. I will also invest in Depends for the trip?

2. The most pressing reason I am going is because the co-head of the leadership team, our administrator, despite the fact that Haiti is struggling with severe inflation with the goude falling like a stone and thus no buying power for our poor employees and we have been trying to figure out ways to fairly raise everyone’s salaries some, especially the lowest paid employees, has decided in my absence to give himself a 50% increase in salary, thus hurtling himself to a salary much higher than my veteran doctors, something he has been trying to do for years. This certainly is not what I had expected and it has raised a major firestorm amongst the hurting employees. He is a lawyer by trade, just went back to Bible Institute, but, at least in my opinion, has not demonstrated the attitude the Lord encourages Christian leaders to have in I Pet 5:2-3 “Feed the flock of God which is among you, taking the oversight thereof, not by constraint, but willingly, not for filthy lucre (dishonest gain), but of a ready mind. Neither as being lords (or lording it over) God’s heritage, but being examples to the flock.” I will need special wisdom and guidance from the Lord to deal with this properly before this gets further out of hand. Pride, power and prestige are great obstacles everywhere, but seemingly more so in Haiti and can derail the best Christian efforts to serve Him with a servant’s heart, as Christ said in Matt 20:25-8 – Paraphrased, “But it shall NOT be so among you, but he who will be chief among you, let him be your servant. Even as the Son of man came not to be ministered unto, but to minister, and to give His life a ransom for many.” In this season when we remember His great Example of Service and Giving of Himself, how can we do otherwise?

So, as usual, the donkey is not great with words and doesn’t want to offend anyone needlessly, but neither can we let this go on without correction. As you can see, I am very disturbed with this seeming lack of concern for others and ask you to join me in prayer for His direction and attitude in resolving this situation to His glory and the advancement of His work at CSL in Haiti.

In His Service, with gratitude to Him and you all,

Bill, Karen, Rachel, James and Jenn and the Haiti Crew on both sides of the pond

The Haitian Donkey Eyes Christmas

The Haitian Donkey Eyes Christmas

Hi All:
Although wobbly at times, thanks to the chemotherapy, the Haitian Donkey continues to plod along towards the goals he feels the Lord would have him to accomplish, among them being to try to get our dear doctors, William and Adulte, into the residency program, a goal we are fervently praying will be something realized, by the grace of God, by the end of the year. They then would spend 4 years obtaining formal surgical training in an approved surgical residency in Cap Haitian, 140 miles as the crow flies, 200 or a bit more on land and 12 hr by treacherous roads from Les Cayes, where it appears their families will remain at least for the foreseeable future. If this comes to pass, we will have a bit more work to keep the home front at CSL going with the 2 contracted doctors who are learning the ropes while the veterans are still waiting impatiently to progress with further surgical certification. As mentioned, achieving this goal will allow them to do surgery 24/7 instead of only when one of us USA surgeons are there to legitimize and supervise them. Drs. Moise and William do an excellent job together (Ok, I may be a bit biased, having done the great majority of their training these last 11.5 years), but Haitian law states that they need a formal certificate, the goal of this endeavor.

So, that is the greatest prayer request before us to bring to our Heavenly Father, who knows our needs before we ask Him, yet has ordained that we approach Him in prayer for these needs. A second request that the Haitian Donkey just realized is before us is that, as he is not a feathered fowl and thus doesn’t have to fear for his life for the upcoming holidays, he is concerned that he may not be able to bring some gifts in his satchels for Christmas this year. As many of you know, since the earthquake, finances have been even more difficult for our Haitian coworkers, as limited supplies come from the US and other countries to supplement what little they can grow on the eroded terrain. The Haitian goude has really fallen in respect to the US dollar and other currencies, so that the prices have risen considerably and the value of the goude continues going in the other direction. Since the earthquake, thanks to your generosity, we have been able to at least brighten the holidays for our 110 hospital employees by giving them a sack of rice, at times also a goat to the poorer employees (the 26 or so that make less than $100 USD/month). Last year, we were able to do more than that and we thank the Lord, as all employees got a sack of rice (about $50), a goat and a chicken and we had enough to give the poor ones a second goat.

We would like to be able to raise funds to do what the Lord provides through you all again this year, if possible, and the donkey just realized that time is quickly approaching to gather funds and get it to Haiti, something I hope to bring down with me when I, Lord Willing, can go on the 5th of December. In case you have fears of your gift being eaten for Christmas, I checked with Dr. William last year as some concerns were raised that the little goats would meet an untimely end before the holiday celebrations and that could bring some sadness. Dr. William assured me that most of the employees, and especially the poorer ones, would never eat the goat as that would be like one of us slaughtering a cow and trying to eat it all before it rotted, as they have no refrigeration and it would be too hard to get enough people together to buy a piece of the goat (and, let me assure you, very little is not eaten, Miss Lisberthe assured me that the lungs are very tasty, not sure it would be right for a donkey to eat his fellow animal’s lungs, so likely will not try that in this lifetime) to make the cost of the meal reasonable to the family. So, the goat lives and is kept as an investment, to be sold if a medical problem or other financial reverse occurs. If you would feel led of the Lord to contribute to this gift to the employees at Christmas, please send it to CSL USA (write check to that and designate it for the Rice and Goat Fund) c/o Dan Boerman, PVI Industrial Washing, 2886 Clydon Ave, Wyoming, MI 49519 or to BC Bible Church, 8855 Byron Center Ave, Byron Center, MI 49315 and put the same designation on it. We will gather all we get and make the appropriate purchases in time for the holiday. We thank you all in advance for your gracious help in making this special encouragement possible for our Haitian coworkers at CSL Haiti.

Also continue to pray that I will gain more strength, I raked some leaves yesterday and couldn’t believe how feeble I have become. I have lost some weight, but I guess a lot more of it was muscle mass than I realized as my job is not all that physical and I have been able to do it fairly well, though have reduced the length of my days to more reasonable levels with the gracious help of my staff and patients. I really want to go in December (and of course, after that also) but am not sure how much the chemo is killing in the range of cancer cells vs my own good ones and thus making me weaker instead of stronger. The TPN is tremendous and I feel stronger every day, but then the chemo hits and we go back a bit again. So, need clearance from American Airlines to fly with my lunch on my back as well as the pump and all the bells and whistles that go with this, but will work on that this week.

Thank you all for all your encouragement, prayers and support as we go through this difficult time together. I could not have asked the Lord for more wonderful family, friends, coworkers and other supporters. Thanksgiving will be especially special this year because of you all and the donkey brays his vigorous thanks.

In His Service, With A Grateful Heart,

Bill, Karen, Rachel, James, Jenn and the rest of the crew

A Cold, Shivering, Scrawny Haitian Donkey Faces a Michigan winter

Hi All:

I know that Karen sent out a short update on Care Pages yesterday, I think, but not all of you (or the challenged Donkey himself) know how or are connected to that, so promised I would send an update myself once we sorted things out a bit. On the Donkey Cancer front, after the first surgery in March, 2013, I underwent Chemotherapy for 9 months, towards the end of which the serial CT scans showed a small recurrence, which grew enough in the next 3 months that Dr. Bartlett and we decided to repeat the arduous surgery in May of 2014. After that procedure, it was his opinion that the chemotherapy didn’t seem to have done much, so he wasn’t in favor of doing that again. As it was not a whole barrel of fun for all concerned, plus cost, after what the insurance did cover, almost $30,000 USD, we weren’t about to argue with him. After the second marathon, we had 2 small spots show up at 6 months, double in size by 9 months (April 2015), at which time Dr. Bartlett recommended trying a different course of chemotherapy. Since we had already planned a trip to my homeland with James and Jenn to visit my aunt and a few other places, we asked if we could wait til we got back to start it, seemed reasonable. However, in May, my GI tract, which has never been the most cooperative since it was replumbed, began rebelling in an increasing fashion, making eating more and more difficult to accomplish and, by the time the repeat CT scan done in early August had been sent to Pittsburgh for the 3rd time and read, we placed the new port into my other subclavian vein and started chemotherapy. However, by now, I had wasted down to a level I have not been at since high school, except for a brief period after the first surgery when the Haitian Donkey began his forays into the world.

The first round of chemotherapy was not bad at all for 3 of the 9 rounds of 3 weeks each, then slowly became more difficult as my throat swelled more each time, making eating and drinking difficult for several days after each burst. When we finished, I had lost some of my starch, but was still quite functional. So, I was blissfully expecting that this second round would follow a similar, maybe a bit more vigorous path. Admittedly, I was maybe a bit more feeble at the start, but I figured it would take a few rounds to knock me back a bit and planned my regular trip to Haiti next weekend, another in December and one more in January. A lot of the developed feebleness was due to the fact that I could not eat much and was losing weight a bit like the proverbial stone, but eating has always been a great pleasure for the Donkey and he hoped to bounce back quickly with the help of the chemotherapy. Dr. Bartlett felt that the cancer cells studding the bowel were preventing the bowel from contracting normally, causing obstruction and not letting food pass. So, we all are still hoping that the chemo will kill more cancer cells than my good ones and allow me to build back up in both strength and weight.

So, I have been unpleasantly surprised when the first round scored pretty much a knockout punch on the donkey. His head is still ringing, his legs even more wobbly and his belly gaunt. His energy level, normally fairly bubbly, has somehow had all the juice drained out of the batteries. I have been pretty much able to keep up my share of the workload, thanks to all my precious coworkers at the clinic and at Sunset Manor, and the patients have been overwhelmingly patient with my feeble efforts to keep going. However, this Monday, the rest of the crew that has to put up with me, my partner, my wife and all my staff, pretty much to a person, held me hostage and took things into their own hands. Without my permission they investigated ways to put a bit more than skin on this bag of bones, mainly the possibility of feeding me through the port Dr. De Cook had so kindly stuck into my chest. After all the arrangements were made, all of us are still praising the Lord that it appears that the insurance will cover 80% of the price (undoubtedly in the many thousands of dollars per day) after my deductible and, after another level is reached, all of the cost. As Karen and I did some calculations of how many calories I was getting in each day with even my most extreme efforts and came up with only about 500 daily, this option seems to be the only one able to prolong my life and usefulness. So, I started this Friday night and have run through the first 2 quarts in 21 hours and am hopeful this will put some more power into my batteries.

I have made the decision that there is no way I can make this next trip in November and am thankful that my great colleague (one of many God has richly blessed us with), Dr. Luke Channer, can follow Dr. Jose Dominguez and do the surgeries at CSL. So, it means that I will not be able to maybe gently encourage the Haitian Health Department to allow Drs. Telusma, William and Adulte, Ernst to attend the surgical residency up in Cap Haitian this fall. With everything up in confusion with the political elections taking place, I am praying about asking my good friend and senior statesman, Johannes Schuer, who has been in Haiti over 35 years, teaching in the Bible School, to connect with the former MEBSH leader, now a presidential candidate, Pastor Chavannes Jeune, to see if they can procure a written form of documentation that the doctors can attend the training program for us.

Will update you more when I know more, but wanted to get the above information and prayer requests out to you all, my friends and encouragers.

In His Service,

Olga Visit


Attached is the flyer for the event Olga is doing in Rockford this weekend. Olga runs the training center (Centre Lumiere) by the hospital. We always enjoy the dinners Olga and Caleb put on for us at their home.

The Open House will be at Bella Vista Church in Rockford on Friday (10/30) from Noon- 8pm and on Saturday (10/31) from Noon – 5pm.

I’m sure she would enjoy a visit to say Hi.

Many of you have had full suitcases of these items on return trips!

HaitiHope-Poster-Sm-8.5x11-01 (3)

The Scrawny Haitian Donkey enters the Boxing Ring

Hi All:

This will be round # 2 in more than one way. The Haitian Donkey has tried to send out somewhat of an update but not sure how I did it or how it got onto Facebook, as Facebook is something way beyond a Donkey’s technological capabilities, as you can imagine. So, will just continue to communicate by my stumbling braying speech, or whatever a donkey says if he is not Balaam’s talking friend. To bring things up to speed as far as the bumps in the road, I had a negative CT scan in September last year, 4 months after my second marathon surgery in Pittsburgh, but had some returning spots in the left groin area in the one in January. These enlarged and spread a bit by April, so Dr. Bartlett wanted to start chemotherapy as I felt good and it was too soon after surgery to try again. As we had planned a trip to the Netherlands to see my aunt, Tante Milly, in July, I didn’t want to mess that up, as the chemo is more frequent and all IV, so difficult to squeeze the rest of my life around. Plus, the last words Dr. Bartlett said to Karen and me in May, 2014 were that he didn’t think there was any sense in seeing the oncologist again, as he didn’t think it did much, except give me numb feet (actually neuropathy, at times they burn, at times have no feeling, tolerable but a bit scary as my hands also had a lighter degree of the same problem and a surgeon without feeling in his hands, well, not so good, I suppose). So, we went and had a nice time seeing my aunt and family and doing some sightseeing in my native country (though I thank the Lord regularly for allowing me to grow up in the GREAT old USA!).

We repeated the CT scan in early August and, as normal, the CT team sends a CD on to Dr. Bartlett for his review, as he can give a more patient adjusted view than the radiologist, as he knows what was there, the nature of the cancer (in his words at our first meeting, “it is not a question of IF it will return, but a question of WHEN,”) and thus can better interpret the findings. Somehow, in the fine electronic medical system we all must struggle with, the first two CDs never got into his hands, not the first piece of information I have sent there that never got to him. Thus, his PA called me on my return from Haiti on September 30 to tell me that things had progressed considerably and we talked about the options. During the same several months, I have had increasing problems with food processing, basically having intermittent bowel obstructions every couple of weeks with 24-36 hours of severe abdominal cramps that prevent me from doing much and certainly not sleeping, something the donkey does with gusto normally. If I can upchuck the last day’s food, I get relief and can go on with life. However, it is not putting any meat on my bones and I continue to look like my Haitian counterparts grazing the few clumps of remaining grass in the drought Haiti has suffered of late. Karen and I have tried adjusting the diet with some success, so we considered surgery, especially as it would let them get some tissue to try the experimental vaccination technique of the study they have enrolled me in (so now I also am a Haitian guinea pig?). The long and the short of it is that, for now, we are going to retry chemotherapy (i.e. Round # 2 here also) and Dr. Dan De Cook has again graciously offered to save me the $7000 it would cost me to have another port put in by interventional radiology, as my crazy insurance doesn’t cover anything outpatient. He will do it in his office again, blindly, the way we used to do things during our training, and plan to run across the street to the hospital from his office on the small chance we puncture my lung and I need a chest tube put in in the ER. So, pray for God to guide my friend’s hands as he again helps me out on Wednesday, the 14th, at 3 pm. He is just one of many special people the Lord has brought into our lives to help us live and serve Him better and they ALL are greatly appreciated.

We have applied to have my 2 week cycle of chemotherapy start the next Wednesday in the morning, Oct 21, so that I can work in the evening in my office and, hopefully the next 2 days if it doesn’t wipe me out too much. It will be more aggressive than the last set, and iscalled Folfiri – the IRI is the scary part. I had the middle F before (5-FU), something my mother had in 1982, so an old and relatively well tolerated drug, the FOL will make the 5-FU work better, make it more nasty I suppose, but the IRI is Irinotecan and its biggest side effect is diarrhea, which may have the greatest effect on trying to be functional, work in the office, and fly to Haiti to do surgery. It also causes decreased immunity, low blood counts, mouth sores and more of the lovely neuropathy. Oh yes, also hair loss, but donkeys don’t worry about that much, just wear a hat to keep warm. We will try to remain positive and pray the side effects don’t develop or slow me down too much. I will have to keep a pump going for another 2 days after the 4 hours at the chemotherapy infusion center, so am timing trips to Haiti around these life confining and defining moments.

Regarding Haiti, we are sort of stagnated with sending Drs. William and Adulte to Cap Haitian for completion of their surgery training in the official government system. After being seemingly so cooperative last trip, I got nowhere with them this time as they rarely answer emails, not always phone calls and I did try texting them somewhat on William’s phone with some results. But, no definitive written hard copy of acceptance as yet, which is needed for them to start. I did get a text back from them via William’s phone now a week ago stating the very politically correct, “your doctors will be treated in a fair and just fashion.” So, keep praying that things will progress in the next couple weeks to allow this to come to pass. Dr. Jose Dominguez and Dan Boerman left this morning for a week of service, during which Dan will be installing the new laundry washing machines among a host of other repair projects, while Jose does the surgery needed. Then November 7, the day after my second cycle of chemotherapy, I hope to go with Dr. Luke Channer to Haiti, with possible plans of starting the week out with him in the OR/hospital and maybe camping out a day or so at Dr. Leveille and DuBuche’s doorstep in hopes of a favorable piece of written confirmation. Pray for wisdom and divine guidance, so our efforts don’t backfire on us. Having my buddy Luke with me will take the pressure off the OR and also make me feel comfortable in case I have a side effect, which I am hoping to avoid for at least the first while.

If all goes well, Duane and a group of us will return December 6. I am tentatively planning a painting and repair group accompanying me in January, including my sister Marge and other returnees, so, please pray for our health and stamina to serve faithfully in the days and weeks ahead as He allows us to do so for His glory.

Thanks again for enduring with my marathon update and praying for God’s help and sustenance for your donkey friend.

In His Service,

October 16: Two days ago Wm went in for placement of another port in preparation for the chemotherapy which will start Oct. 21. It did not go particularly well, and after a couple of attempts they had to put the port in the other side of his chest, possibly because of scar tissue. When an x-ray was done later that afternoon, we saw that he had a 30% collapse of his right lung. It seemed to get a little worse over the next day and this morning we thought that he would have to go in for placement of a chest tube. They did another x-ray at the office, however, which did not show further collapse, so after taking all the films out to Holland, Wm and the surgeon determined that the tube did not have to go in, Praise The Lord. One worry has been that the surgeon leaves today for 2 weeks of vacation. *:-S worried
As you may guess, Wm has continued to work every day. The pain has been controlled with Tylenol, and we thank the Lord for all of this.

Please pray that the chemo side effects will not be too severe, so that the scheduled work can still be done, the Lord willing.

K for the Scrawny Donkey