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