The Haitian Donkey Prepares To Head South

Hi All:

Will give you all an update before the next trip down south. I am very glad that the recovery from the repeat hernia repair/clean out of the mess in the groin, etc went very well, thanks to Dr. Dan De Cook, the Lord (of course) and all your prayers and I feel back to my normal skinny self. However, the weight has been returning much easier after the hernia/cleanout and I am now at 11 pounds, so cleared for takeoff by Karen’s flight regulations. I have been eating 1/2 of a sandwich, or whatever edible things I can find/Karen makes for me, at least 3 times during the night, this has supplemented the body corpulence quite nicely. So, for all you who have contributed, either by prayer, encouragement and many who have brought “tasty snacks” to me one way or another, THANKS very much. I would like to gain a few more pounds to have a bit of a buffer zone to live with, but am very appreciative that the strength is really back to normal and am able to do most anything (that I could do before, of course, still cannot climb a ladder more than a few rungs without my knees shaking, still don’t love flying, or more precisely, riding in fast moving bodies that wobble, etc) now again.

I am in the process of checking my labs to see if the anemia has resolved, or at least improved, as am planning on doing my first post hospitalization CT scan when I get back from Haiti, on the 27th of August and need the chemistries checked before they give me the “contrast smoothie” to drink. I think it should be fine, although Dr. Bartlett decided that I would not need chemotherapy for the time being and will see if we do ok without it. I am not eager to add that, but will do as told, I suppose, if the order comes down from Pittsburgh. My brother in law, Harold, is undergoing it, has had a change from the Gemzar, which I think is more aggressive (and much newer), to the 5FU that I had last year, a cousin chemotherapy of a similar class and hopefully better tolerated. He really seems to try his best to remain as active as possible, which I am sure helps keep his body in shape to try to fight the cancer and I am always encouraged to see my friend and brother keep going with a disease that has a prognosis as dismal as mine, but, by God’s grace, we are both doing fairly well. I also have been taking some chloroquine again to be sure that malaria doesn’t rear it’s ugly head as it did after my second surgery in Pittsburgh in May. I have done it with some apprehension as I developed severe hives with the treatment, using a cousin of chloroquine, called hydroxychloroquine, used for treating rheumatoid arthritis, as there was no malaria treatment to be found in the hospital otherwise. We used chloroquine for all our years overseas without reactions on my part, but had stopped as my cumulative dose would be too high if I continued it while in Haiti. But, restarting as really don’t want malaria again at this point (or ever?).

Dr. James Webb just returned from Haiti last weekend from his second trip there since my surgery and it went well, both in the number of cases done and how they went and in his travels back and forth, as he always tries to go standby and there are a lot of unknowns involved. We are thankful also that Dr. William was able to pick him up and bring him back to the airport, it is an extra burden for him and I appreciate him trying to make things as smooth for the surgeons who fill in the gap for me. Dan Boerman and I will leave next Saturday, the 16th of August, Lord Willing, and I have a number of extra projects that I would like to try to sort out as well as I can. The biggest for us at present is to continue to sort out the financial situation of the hospital, as well as the USAID continuing saga. I don’t understand still what is all going on there, not sure I will this side of heaven, but will keep working on it with Dan and other’s help. There are so many “fuzzy finances” involved that the smoke screen never really lifts the fog off the books.

I also am still making attempts to contact others re the possibility of a surgical residency for the men, not sure I am making much progress yet. I have sent out letters to several physicians and the head of University Lumiere, not sure how much this works in the Haitian culture, so will try to contact them personally also. There seem to be so many roadblocks in the path that at times I don’t know if this is God’s way of telling me that I am not to go down that path or just testing if I am persistent enough to walk in faith for His glory, as Jesus encourages us to do in Luke 18:7, in the parable of the unjust judge who delivered the widow due to her persistence, and He says God will answer those who cry day and night to Him also. So, continue to pray for divine wisdom and balance in the many tasks in front of us in the next few months. I do have a set of requirements for making a hospital in Haiti considered a university hospital, the first step in having a residency program, plus have gathered a bunch of data from our sister hospital, who would join us in this venture, but there seem to be a bunch of things that still lie before us that no one really seems to know for sure in my questionings.

I also hope to join our sister hospital in making combined IDA orders from the Netherlands, so that we can save money and get meds and supplies more frequently (so keep fresher stock in the pharmacy, etc) in 40 foot sea containers, we hope to go maybe for 3 or 4 times a year. However, this takes more time on my part to do the ordering, as it has to be done online and coordinated. We hope to also accomplish the first order in the next few weeks. In addition to the medical work, Dan, Duane and Jeff have been brainstorming on how to fix a sewer leak from the septic tank that handles most of the waste of the hospital and is located next to the “condominiums” as the hostels have been dubbed, so that looking out your back door may lead you to decide that the odor is not worth the lush greenery that grows in the immediate area. A storage space was inadvertently built right on top of the tank, limiting access to a considerable degree. Things in Haiti never seem to have easy solutions and I am eternally grateful for my dear friends who help so much in keeping the physical grounds clean, functional and constantly improved.

So, will stop with the update and write again when we are in Haiti. We certainly appreciate your prayers, encouragement and help as we continue to serve Him in Haiti at Centre de Sante Lumiere.

In His Service,

Bill, Karen, Rachel, James and Jenn (and Dan)

Donkey Trots

Hi All:
Not even sure if a donkey, let alone a scrawny Haitian donkey, can trot, as his more elegant relative, the horse does, but if he can, we feel like that is happening, for which we praise the Lord. As we mentioned the last time, I am under a strict regulations from Karen that I have to get 10 pounds on my skinny frame before I can return to Haiti and we applied the proverbial feedbag with the addition of three nighttime feedings to help with the number of daily meals, as trying to increase the size of them only produces our not so happy “dumping syndrome.” We had a couple episodes of this over the Fourth of July holiday, as Jenn and Karen combined to make some “smoothies” which went over big with most of the family and I decided to try one in the evening, when could recuperate in my chair if the tasty treat proved a bit much for the system. It reinforced the idea that such calorie boosters like Ensure and Boost will remain off the diet for the rest of my life, as more than 1 ounce of them bring immediate cramps, sweats and a definite ill feeling. As it was the holiday spirit season, I even tried a small “moose tracks” ice cream dose, as it has been over a year since I tasted ice cream, but I knew beforehand that would not fly. It tasted good enough to make the grief which followed worthwhile, though won’t do that too often.

However, the weight has been slowly creeping up. I have to have the pounds on board for 5 days in a row before it goes on the official record book towards the return to Haiti, but I am up to 5 pounds for sure, working on the 6th at present. The best part of the news is that Dr. Dan De Cook, my friend and surgical colleague, agreed to do my repeat hernia surgery July 1 and that has really made a big difference in what I can eat, how much pain meds I have to take (have cut to half the preop dose already) and how active I can be, though I have to remain obedient to not lifting and straining as much, as certainly do not want a three peat surgery, two is enough and I have mesh in there. The surgery at Holland Hospital went well, though he found a fair amount of not so great looking tissue to remove, but repaired it the same way we used to do in the US (and what I still do in Haiti), then threw a mesh over it all for good measure and sent me back home. Almost immediately, my nausea has diminished greatly, the pain from the new incision is there but the “ball and chain effect” of the dead tissue is gone and this is much more bearable, knowing the healing process has begun in earnest.
As my partner, Dr. Lugthart, had vacation planned starting the 7th of July, I was able to work full time that week and put in almost 60 hours in the office and Sunset Manor, so thankful for the good recovery.

As many of you know, the sad news of last week was that our “partner” in the building industry, Lamar Construction of Zeeland, MI, went out of business. Thanks to our contacts there through Duane Ver Kaik, they have helped us tremendously with supplies for the hospital building and repairs of surrounding structures, etc. We have been very blessed by their help over the last many years, including sending a team out to build the hospital chapel last year (2013) and the gym for the camp the Wrays have up the road in 2014. As we have made many friends there, it was doubly sad to think of all them (among the 280 or so employees who lost their jobs) now having to find new ways to support themselves and their families in our less than robust economy.

In my personal devotions, I have just finished rereading Nehemiah, where he sets such an incredible example of how to do God’s work in His way for His glory and it keeps me asking Him how to proceed with the surgical options for our hospital and doctors in our attempts to negotiate through the maze of political posturing that exists in attempting to accomplish something of a legal nature in Haiti. Nehemiah’s finishing the wall of Jerusalem in 52 days despite opposition from the neighbors and other government officials makes me jealous. At present, it appears that one first must become a university hospital to be eligible to train residents and then one can apply to have a residency program, ie there is no such thing as community residency programs like we have in the US. So, trying to see if maybe our sister hospital, Bonne Fin, can become one and we then can combine forces to complete the eligibility process. Needless to say, I need a lot of God directed wisdom and patience to navigate this process without making mistakes as this is a new procedure in a country that is able to produce more red tape than I can wiggle through without supernatural help.

My second partner is negotiating trying to get his kidney stone dislodged, then blasted in the hopes of getting this nagging pain out of his system in the next few weeks, so I have pretty much resigned myself to not being able to go to Haiti in July (as we are only 3 in the practice and only one can leave at a time, understandably), plus my lack of spare tissue growth has prevented that possibility. I am again very thankful that Dr. Jim Webb has graciously agreed again to fill in the gap in surgical coverage for the month of July and will leave the 26th of the month for a week of work with the crew down there. Dan Boerman and I are aiming for the 16th through the 23rd of August and then I plan to go the 27th of September through October 4 with Duane Ver Kaik (and Ruth, I think), as well as my medical school classmate/partner, Mike Langdon and his nurse son, Josh, a physical therapist, Jenn Wichterman and her parents, who will work with Duane and Ruth on repair projects, etc while the rest of us (four medical and four repairers of the gaps)concentrate on medical and financial issues. Those plans are not yet written in stone, though starting to sort out fairly well if the Lord continues to give us all green lights in the way of health, time off work, finances, etc. Part of my goals for both weeks include making some headway on the political process involved with the possible surgical residency program.

So, once again, you get a bit of a rough draft form update, but wanted to let you all know what has transpired and hopefully will in the near future as we greatly appreciate your prayers for wisdom in our efforts to serve Him in Haiti.

In His Service,

Bill, Karen, Rachel, James and Jenn

Who can refuse them water?

Hi Friends and Family:
We are thankful to have had camp several weeks already this summer. Our most recent camp was a volleyball camp. We are grateful to the visiting team who helped and for the way they shared their testimonies each evening in front of the children. Many children are turning to the Lord.

The gymnasium has been a great asset to the camp. We have been able to have most of the activities in it and are thankful to be out of the sun and wind. With three courts, we are able to have a couple hundred children in it at the same time, no problem.

The latest addition to the camp are the sewing machines all set up and ready for use. The young ladies really enjoyed making a bag or a skirt with their newly learned skills. We are thankful to each person who has kindly sent these machines to Haiti via sea containers.

Yesterday morning we woke up to the front fence fallen over from the storm in the night. We had high winds and it seemed to be just enough to push over the galvanized fencing along the ocean that was put up just a couple years ago. The fence was covered in salt and rust which happens quickly living just a few feet from the ocean. Thankfully, we had received a container two weeks ago with some fencing for future use. The Lord’s timing is amazing and we are thankful for His provision. Rod and Tim quickly got to work with some young friends and had the new fencing up by the end of the day.

It was a privilege to have the water slide pool of water used for a place of baptism for 9 people yesterday. The river beds are dry and the ocean is rough, so it was a good alternative. This church group drove from about 1 hour away to come to the water of Camp Mahanaim to be baptized.

Thank you for your continued support and prayers. We are thankful for each one who prays, gives, sends and comes to help with the various ministries.
God Bless, Rod, Deb, Tim and Katie

The Haitian Donkey Stumbles Through Another Surgery

Hi All:

I think that I might have figured out how to send this in a bit larger font, as some had some difficulty reading the tiny font this machine sends out. As mentioned, Dr. Dan De Cook graciously agreed to sort out my groin and repair the hernia again today. Overall, it went well, just there was more of a mess from the previous surgery and the chemotherapy than one normally encounters in a hernia repair, even in repeat ones. It appears that, one way or another, the blood supply to the groin structures had been compromised, which explains the significantly increased pain in the hernia after surgery than before, plus about quadrupling in size of the mass. I had blamed the inordinate amount of pain on the fact that the chemotherapy had damaged my nerves from my waist to my knees and that area has burned/been supersensitve since surgery. That remains true, but on exploration, Dr. De Cook found that the blood supply to the area had been interrupted, so things had literally died from lack of nourishment and thus were much more painful and swollen than expected. He is not sure if the damage to the blood supply was from scarring from the chemotherapy burn to my insides from the 2 hours of cooking done again or from a more mechanical cause, but regardless, a bit of a surprise and explains why things hurt so much more than I normally have seen in hernia patients (and on my other side or even this before the surgery).

Thus, am very glad that this has been completed, although will have a fair amount more pain postop than I had on my left side years ago and am very thankful for the timing, that we were able to do it the first of July and I can be off til the 7th, to let things literally settle down. I have a drain placed in the area that so far has removed 50 ml (cc) of the red stuff, and hope that calms down also and lets things scar back into some semblance of order. Not sure I will be jumping up and down for a while again, but appreciate the opportunity to heal properly once again, albeit a bit slower than desired.

So, will need prayer for wisdom and patience for both Karen and I, as she tries to put up again with a traumatized husband. The anesthesiologist tried to put in a block under ultrasound guidance just in front of my illiac crest/hip bone area. He kept muttering about the fact that there was no fatty layer for him to aim at, had a second anesthesiologist come in to verify where they were before it was done. They did use nicer words instead of “scrawny,” “emaciated,” etc and overall, the entire experience went much better than it could have, under the conditions. So now, it is up to us two to put up with each other as the Lord again provides healing of my body at His pace. In the couple hours I have been home, I have tried to make up for lost time in not feeding for 17 hours for the surgery, as am hoping to not lose any ground that I had gained in the “Battle of the Bulge” since the May 9, 2014 surgery. I must admit that, so far, my appetite has progressed nicely since getting home and will see if the creative intestinal replumbing done March 19, 2013 will respond appropriately and allow continued reconfiguration of my scaphoid (medicalese for lack of a nice, round tummy) abdominal appearance.

The next week will tell a lot as to my future plans in the work realm, how fast I can move in seeing patients, doing procedures and, hopefully, planning a return to Haiti with my friends, likely Dan Boerman and Dr. Jim Webb (the latter may need to go earlier without me if I am too slow, to do surgery again). I am always very grateful for the number of people who graciously step up to help me/us in so many ways, from prayer support, to finances, to physically carrying the loads that I cannot do yet. That includes the lawn mowing (Karen really appreciates Howie and his kindness, I also, but I have not slaved over all the flowers spread around the scene, so the beautifully groomed lawn doesn’t match my labors), those who slave in the Haiti building, either bringing supplies there, sorting them out into priority levels for packing, and the high pressure loading of numbers of containers for the hospital as well as a goodly number for the Wrays this last year, working against the clock while the trucker waits to take off for distant lands with the goods stashed inside.

We also will greatly appreciate prayer for wisdom as to how to progress in Haiti, for sorting out of the financial situation with the help of Dan Boerman, what to do about the possible surgical residency plans, which don’t seem to have much of a light at the end of the tunnel (and not even sure there is an opening on the other side to head for) in dealing with the Haitian authorities, who sometimes can have unrealistic expectations of what we Americans can do. This is one big reason I hope to head back to Haiti as soon as I can keep my two legs under me, as others have promised to help with the surgical load while I try to see what avenues are open/reasonable to getting some sort of certification for our doctors to do surgery without me there. As I read about the numbers of our examples in the Old Testament from whom we should learn, I am impressed that, “the Lord knows our frame, that we are but dust,” and that I need to act accordingly to accomplish His Will for His Glory.

In His Service,

Bill, Karen, Rachel, James and Jenn

Second Try at Hernia Repair?

Hi All:

Will try to get an update out for the last bit of time. Overall, I think I have recovered quite well from the major surgery done on the 9th of May. I have not gained as much weight back as I would like, not sure what my last hemoglobin was, drawn on the 26th, but not back yet today, the 28th, in the office, but the one before that was up to 8.9 from 8.2 (normal 12 – 16) after we got home from Pittsburgh. However, my strength is quite decent, for which I am very thankful. I have returned to normal work for 3 weeks now, did a bit of Sunset for the week before that at a bit slower pace (I fit in quite well with my friends there at that speed), but not able to eat all that much yet. I have restarted my night time feedings, usually 2 to 3 half sandwiches whenever I get up to do whatever needs to be done during the night, keep them handy in the utility room. I think that will really make a difference soon.

However, the thing that is slowing me down the most is my hernia. I had my left one done in 1997 on our return from Africa, it went great and was able to return to work in a few days. So, when my hernia showed up last December, I figured I would wait til an appropriate time came up to do it, as paying the large deductible again in 2014 (I had far surpassed it in 2013, of course) was a bit daunting. When we decided that repeat exploratory surgery and removing all possible cancer again was the best option in April, I asked Dr. Bartlett if he would repair my hernia (it would be about 5 more minutes max, as he had me wide open and the hernia could easily be repaired from the inside). He agreed and it was done, but unfortunately, it only lasted 6 days and has been considerably larger (about 4-5 times the size it was before) and much more painful, partially because the chemotherapy they heated and swished around inside me for a couple hours again caused my skin from my waist to my knees to be supersensitive since surgery. Even when the nurses would give me my heparin in my thighs, they would want to pinch the tissue before injecting, as they often do. This hurt considerably more than the shot itself, due to the nerve damage. So, since this hernia is right in the same zone, it is without doubt much more painful than normal due to the supersensitive nerves.

Thus, when my good friend and colleague, Dan De Cook, who I had bugged since surgery about his thoughts on how soon I could repair this newfound bit of grief, offered to do it on July 1, I jumped at the chance to remove this offending situation. My partners and office staff have graciously rearranged schedules so that I will have the rest of the week off (including the holiday and the weekend), so am anticipating being able to relax/recuperate a few days and return to work on the 7th of July, Lord willing. I may be a bit more slow, but the Haitian donkey has only had creeper gear for a while now, so it won’t be that much of a change. I am excited that this has worked out to allow the surgery to happen and appreciate all who have helped it come to pass.

On the Haiti aspect, I need a lot of prayer and Godly wisdom. It has always seemed to us Americans, who want to get things done yesterday, if possible, that the speed overseas is also low gear. However, I have been trying to proceed on the possibility of setting up a formal surgical residency, to legitimize what we have been doing especially with Drs. Moise and William for 10 years now and wanting to do what I am supposed to do at the speed the Lord would have me to proceed. I have been reading in my personal devotions of the comparisons of Kings Saul and David, who proceeded, for the most part, very differently in major wars/campaigns, etc. David always seemed to ask the Lord for wisdom and direction and then do exactly what was supposed to be done and the nation of Israel was blessed as a result. When he didn’t, things could turn out quite nasty for all involved. So, since I know I don’t have the legacy that he had, “a man after God’s own heart,” wow, I want to at least try to follow in his footsteps in this project, so as not to do something foolish or dishonoring to God and His work in Haiti. I know the epitaph applies to the other side of the world, where we also spent years of missionary work, but I don’t need it said, “here lies the (foolish) man who tried to hurry the east.” Neither do I want to sit while the Lord of the harvest wants us/me to be laboring for His glory.

So, this is a bit of a whipped off note, as trying to let you know of some of the developments before they happen, but appreciate prayer for God’s direction for all of us in the days that lie ahead, that we may do His work in His time for His glory.

In His Service,

Bill, Karen, Rachel, James and Jenn