Small Progress for the Plodding Donkey

Hi All:

Karen, Rachel and I drove down to Pittsburgh last weekend and met with Dr. Bartlett and had the leukapheresis done on Monday. Several hours of the trip going down was at about 25 mph as it was pelting rain and half the vehicles were pulled off, the rest of us going very slowly with flashers on so we could see each other a teeny bit better, Rachel did that driving as controlling the GI tract and driving in that weather is not a lot of fun at this stage of the game. The internal jugular tube they put in so they can exchange 8.5 quarts in 90 minutes was a literal pain in the neck to insert and not much better to tolerate, but thankful that phase of my life is over. They obtained the precious 83 ml of white cells and the incubation process will begin to try to create a vaccine to hopefully slow down the growth of the cancer.

Both Dr. Bartlett and Dr. De Cook are a bit encouraged that the outer pocket (above my belly muscles and the sheet of mesh) is draining less and seems smaller on the repeat CT scan, though the one inside my belly is more confusing. There must be a connection to the outside one and the fistula must hook to the inside one, but how is another issue. So, for 3 days now, both agree that I can do sips of clear liquids and will continue that for another 2 weeks, repeat the CT scan and see if the inside pocket is enlarging with the liquids, a bad sign that the fistula is still open. What to do then is even more unclear, but pray that it is getting smaller and resolving. I love water, but it tastes extra special now, even in the small sips to wet the tongue and the esophagus.

As soon as the oral intake improves a bit (assuming that it will, ie the fistula is not misbehaving), I will start on my oral iron and see if I can get my anemia improved and thus get more stamina. I tried a shot of iron, admittedly I don’t have a bunch of padding, but it was mighty sore for 3 nights, so hoping I can use the oral route for more of my meds soon. Of course, a meal, even a small one, would be great, as it has been April 9 since I had my “last meal.”

Continue to pray for especially Dr. William. He would like the resident’s strike to end and get back to the training, despite the deplorable conditions, which are not likely to change in Haiti, but, so far, it is not happening and the interim president seems very harsh towards their efforts. Undoubtedly, if he needed care, he would fly to the US and get quality care there, so doesn’t seem as concerned about what the rank and file have to endure, probably a bit like our politicians, I suppose. Next weekend, Dr. Jim Webb will do surgery for a week with Tom Failing and Dave Weener from Byron Bible doing repairs, an endless job at CSL, it seems. Jim will return (thanks so much, sir) in July with Dan Boerman to repeat the cycle and keep that part of the hospital going in my absence. Our new chaplains seem to be a ball of fire, despite both being retired, for which I thank the Lord and I need to keep up with them as they hand out tracts, make contacts with patients and follow up with them. So, trying to find bulk volumes of French and Creole tracts as well as evangelistic DVDs for Jean Eddy and them to work with. We also have shipped down another skid of food packets, they enjoy giving that to the poor patients and it opens them up to spiritual discussions, of course, another tool to help soften hearts steeped in a dead religion and voodoo. It is hard for me to not be there, so pray that the Lord would heal my body and allow me to rejoin my brothers and sisters laboring there for Him soon.

In His Service,

Bill, Karen, Rachel, James and Jenn Ten Haaf

A Quick Prayer Request for this week for the Haitian Donkey

Hi All:
This truly will be a short request for prayer for God’s direction for us this week. As you know, I have the intestinal fistula and, by the grace of God, that seems to be doing better, but after we drained it, Dr. De Cook wanted a CT scan to see if we could see where the leak was, etc. That was on May 9 and didn’t show much except a couple of fluid pockets in my belly wall that didn’t seem attached to the pocket Dr. De Cook had drained.

We sent a copy of the DVD to Dr. Bartlett, my Pittsburgh surgeon, as always, but sent it by priority next day mail so he could give us an opinion on it soonish, we hoped. We checked with his office a couple times to be sure they got it, didn’t get a straight answer, but his PA called Friday night after 6 pm to say that they didn’t like the pockets and wanted a repeat CT scan as soon as possible, as they didn’t want to do my procedure on the 6th of June in Pittsburgh if they still existed. Since it is the holiday weekend, I cannot even try to schedule something before Tuesday morning and have to get it to him and have him read it before we leave next weekend. Sometimes doctors can be a bit less than prompt in answering your concerns?

Please pray that we can get the CT scan scheduled in time and that it will be clear of the fluid pockets, so I don’t need another drainage procedure and that I can have the scheduled procedure on the 6th of June as scheduled. This is the second step in developing the vaccine, they will harvest a bunch of my white blood cells and try to grow a killer vaccine that will stimulate my own body to attack and kill the cancer cells. A great concept, but VERY experimental still, so some risk and grief, but nothing else seems to stop the cancer, so he (and Karen and I) are willing to try this.
Again, thanks so much for praying for and supporting the stumbling Haitian Donkey.

In His Service,

Bill, Karen, Rachel, James and Jenn Ten Haaf

An amazing Welcome (with pictures)

Dear family and friends;

Thank you so much for your prayers and encouragement! This morning we returned to the Renault Sunday School program and it went very well. The entire road was lined with people on both sides welcoming us back into the area. The children surrounded our vehicles and sang as we drove into the yard.

We thank the Lord for His care and direction and pray that He will continue to lead as we are definitely out of space in the existing location.

Many people came and  visited us at the Camp and encouraged us, including this group of 19 teen aged boys who came in the pouring rain and were completely soaked. Deb squeezed all 19 into the Toyota and gave them a ride part way home.

Katie was very excited to be back in Sunday school and it was great to have the Yordy’s with us again also.

This lady walked all the way out to see us at the camp last week and explained how she has 7 children. 6 of them attend Renault Sunday school  (the older boys aren’t
in the picture). She told us that when they get their six small bags of rice each Sunday, they save it and use only 1 bag per day. Even though, they only each get
a few spoonfuls of food, they at least eat something each day.

This lady brought her baby into our yard this week with a big smile and thank you!    She was brought to us, when we had the large Missouri medical team here in late Feb. She and her baby both were on death’s doorstep. They both hadn’t been eating and were so weak they couldn’t move. The medical team cared for them, and then we took the lady to her little hut and showed her neighbors how to feed her and her baby. It was really encouraging this week to see both of them doing so well, and thankful that kind people from Missouri had cared enough for them to save their lives.

We are doing well and were so thankful to find the camp well cared for and in great shape when we returned from Canada.

Thanks again especially for your prayers about the Sunday school.

bye for now,

Love Rod, Debbie and katie

The Hungry Haitian Donkey Plods Painfully Along Postoperatively

Hi All:
Today, it is 6 weeks since James asked me, “Dad, what would you like for your last meal?” He knew there was a Boston Market 2 blocks from the Family House we stay in at the University of Pittsburgh Shadyside Hospital and he and his father love the chicken, mashed potatoes and gravy. I like the corn that comes with it, but that has been off the tolerance list for over a year, so he had my portion. The surgery went well, though I felt snugged in a corset as the 4 inch section of my abdominal wall that had been taken out was closed and reinforced with a Zen Mesh sheet and things would need some time to stretch before we could do sit ups, as Dr. Bartlett explained in the postoperative visit. Karen laughed as she does them faithfully each night, me, not so much.

We got home 11 days after the surgery and settled into trying to eat a little, but never could get more than 3 bites of cream of wheat or a few bites of mashed potatoes before feeling stuffed, so I can honestly say I have had less than one meal total in the last 6 weeks. I got the drains out of my belly at 19 days after surgery and that really helped the nerve pain in the left side of my belly, as that drain must have been sitting next to the nerve and the suction of the apparatus constantly irritated it. At 22 days after surgery, my temp was running low grade and my blood count bothersome and my wound started looking a bit red and puffy. I removed a bunch of staples (I had 60 or so total, a lot of fun to remove) and after a day, some brown liquid started to drain through the staple holes. Dr. Dan De Cook opened it up wider and that is when we found the intestinal contents in the wound. So, nothing by mouth since except for my antibiotics, Zantac for the heartburn and a heart rate regulating pill in a sip of Tylenol Adult Liquid. It is amazing what 500 mg of Tylenol at 8 am and 8 pm will do for the incisional pain if that is all you can get, and am thankful that Karen found this, so we substitute a sip of Tylenol for the sip of water with the pills. Dan also placed a suction drain in the inferior aspect of my pocket of fluid in my abdominal wall and we try to irrigate and empty that several times keep the intestinal juices from chewing on my belly wall.

The incision has healed otherwise and, after giving myself 2 units of blood 9 days ago, I feel I am gaining some strength and endurance every day. My TPN gives me 2530 calories each day, plus I give myself 2 liters of Lactated Ringers to stay hydrated as the short gut syndrome I have inherited makes for at least 9 – 10 mad dashes to the rest room for rather watery stools and I need to replace those fluids. I have been able to work 5 hours daily in the clinic, which gives Karen a break from her needy husband and a chance to work on her multiple flower beds, yard, etc. It also gives me distractions from the incisional discomfort and the questions about the future of the fistula. So, we continue to pray daily and earnestly that the fistula will heal by itself, as allegedly about 60% do in 3 months, as the alternative would be surgery, surely a minefield of trouble for the surgeon as we cannot even see the fistula on the CT scan, undoubtedly I have tons of scar tissue to navigate, a potential to cause another hole in the process of trying to find and fix this one, and one often has to resect some small bowel in the area of the fistula and I have none to spare by this stage of the game.

I am thankful that Dr. James Webb, a retired general surgeon friend from Fremont I have known since the 80’s when I used to moonlight in the Gerber ER during my surgical training, has agreed to cover the surgery responsibilities at CSL for June and July. Dr. Fred Brown, who spent years training surgeons at Bonne Fin in the past, has graciously agreed to cover August and September and I hope, by the grace of God, to be able to return after that. I hope to be physically able to do more before that, but am in this experimental study where I have to return a week a month to Pittsburgh to have the vaccine injected on Monday and get 3 different chemotherapeutic agents given to me for the rest of the week and then repeat the cycle a month later. So, cannot be gone from the office in Jenison 2 weeks a month as that really cripples our ability to see our patients properly and also keep the office functioning, especially as Dr. Lugthart loves some time on the water in the summertime also.

Dr. William is hoping that the governmental hospital strike will end June 1 and that he can return to the residency program and get on with the show. We paid the government electrical company to run a wire to his apartment, but so far, no one has done so. It does make for difficult studying at night if you do have some time off to do so. The water seems to not be able to be arranged, so will have to purchase and haul water up to the apartment to clean himself (one does not drink that water, not advisable). We certainly are blessed when we can just drink water from the faucet in abundance both at the hospital (we have our own deep well) and in the US. Dr. Moise and Jon Bed have held the hospital down and now that Dr. Adulte dropped out of the residency due to health issues and is back at the hospital, I hope that will function smoothly even in my absence. Tom Failing and Dave Weener from BCBC (our home church) will join Dr. Webb on the 18th of June to do repairs, a never ending job at CSL, while he does surgery with Dr. Moise. Pray for wisdom for them and us as we try to negotiate the speed bumps on the road for the Haitian Donkey and his friends to arrive at the goal of doing God’s Work at CSL in a fashion acceptable to Him and for His Glory.

In His Service,

Bill, Karen, Rachel, James and Jenn Ten Haaf and the encouraging Haitian Team

The Speedbump develops into a Major Hole in the Road

Hi, All:
I wrote a couple days ago that we needed prayer as to the possibility, serious as that was, of a major wound infection in my incision. That option was troubling, but there were other, more severe but less frequent, options to consider. On Wednesday, with the redness, we started “big gun” antibiotics and hot packs as much as possible, to help things “come to a head,” if you will. While seeing patients on Thursday, I suddenly noticed that my many layers of shirts were soaked through with a yellow/white thick liquid. We checked the wound and it seemed to be seeping from two different holes that I had left when I removed some of the staples the day before. I tried teasing the wound edges apart gently to get better drainage of this troublesome fluid, but no success. We continued hot packs, antibiotics and changed dressings by the handful for this continuous ooze. Friday morning, I called upon my great, faithful and dependable friend, Dr. Daniel De Cook, to ask if he could squeeze me into his schedule and look at me, as I needed better drainage and a trustworthy surgeon to do so. He put in my ports in the office in 2013 and 2015 for free (as he put it, the “old way, as we used to do before radiology took over,” for which I would have had to pay $7000 cash for each one, so you can see what sort of special friend he is). He also repaired my complication of the second surgery in Holland Hospital for me (that the insurance did pay for), but needless to say, a most special friend.

Incidentally, next weekend, he and his doctor wife, Cecelia, will be going for a stint at HBB in Togo, where we were for 10 years full time, so as he says, he will have been all 3 places I have been, as he grew up as an MK in Bangladesh and has returned there multiple times for short term work and replaced me after the earthquake in Haiti and still has fond memories of working with Dr. William, but then, who doesn’t? In any case, he probed the wound gently and suddenly got into a huge cavity of fluid that gushed out but is NOT an abscess. It is the most dreaded complication for any of us surgeons who work on the bowel, that we get a leak from an anastamosis or other site of bowel injury to the skin or elsewhere, an intestinal fistula. Since the cavity was so large, Karen was right there and said his 8 inch q tip went in to the end, but who knows where in that dark hole the connection to the inside is, we don’t know how to approach things further. He applied a stoma sac to collect the fluid, as this is intestinal juices, ie secretions by the bowel and pancreas to digest the meat we eat, etc, so you can imagine what this can to my own tissues, the mesh, the repair, etc. So, will try to see if it will heal up by itself. This is by far the most serious complication I have encountered, just having this has a 20% mortality rate, so quite serious. Also, will likely get a huge hernia, although at present, that is the least of my concerns. I will take absolutely nothing by mouth for several months, in hopes that this will reduce in flow and heal, which about 60% allegedly do in 3 months. If not, surgery is the last resort and that would be a most difficult and dangerous surgery with all my scarring from the 3 previous surgeries and the heated chemo they put in my belly each time, something that could have led to this complication in the first place. For me, surgery is even more troublesome as I already don’t have enough small bowel and undoubtedly will have to sacrifice some in this process.

So, have had not a drop to drink (except a tiny sip of water twice daily with my acid reducers) or eat and am not taking any of my meds, including my vitamins, Tylenol for pain, etc. I have the TPN in place already, thankfully, and ask you to join me in prayer that God would see fit to heal this complication soon and without surgery if possible, though His Will be done. The ever optimistic Haitian Donkey is stumbling a bit and needs a special touch of the Master’s Hand to keep going. I cannot express my thankfulness to the whole team of people who support me, from #1 being Karen, who just does whatever it takes to keep me alive a bit longer, to Dr. De Cook, a most treasured friend and surgeon, to my most supportive office staff and patients, who put up with a stumbling Donkey for a doctor, to the host of friends who have done so much to help me keep going in so many different but appreciated ways.

In His Service,

Bill, Karen, Rachel, James and Jenn Ten Haaf