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,