The Haitian Donkey Faces A Fork In The Road Again

Hi All:

Since I last updated the situations, the protruding tumors out of my ostomy site have continued to grow, making it a struggle to contain them and the intestinal output the colostomy and ileostomy contribute to the bag.  We have looked into various options, they make larger bags, but they don’t have fasteners on them as the ones I presently use have loops that I can attach a belt to and thus encourage sticking to my skin.  The larger bags are made for patients who are pretty much bedridden for the time, so we are still looking into options.  

One thought I had was to consider radiation therapy, somewhat risky for intestinal tumors as the intestines, bladder and lungs are especially sensitive to the radiation, while the tumors may not be.  I thought I would contact Dr. Bartlett at University of Pittsburgh Medical Center, as he has done over 1000 of these surgeries and likely had some experience to comment on.  I called his nurse, the recording mentioned to push various buttons for a number of different surgeons, but no Bartlett.  Searching on the internet showed that, after 19 years at University of Pittsburgh, Dr. Bartlett had been enticed by the other powerhouse in the Pittsburgh medical realm, Allegheny General Hospital System, a promotion to head up all their cancer research and work 3 months ago.  The internet stated that he would be busy with administrative duties for several months and then restart clinical practice and research.  The donkey decided that my chances for getting through to him in a new, unfamiliar system would be unlikely. Dr. De Cook thought that radiation might help shrink the growths sticking out of my abdomen and give us some relief in the way of controlling the output.  I made an appt with a radiation oncologist and saw him last Thursday.  He was very nice (I knew him a bit from surgical residency, he is 75 but loves his work and thus still doing it), examined me well, but finally felt that he figured he would do more harm than good.  

With this news, Rachel decided the donkey gave up too easily and contacted Allegheny General and was able to connect with Dr. Bartlett’s new nurse navigator.  The nurse promised that she would have Dr. Bartlett call me this week when he returned from vacation.  I was skeptical, but was amazed when he called me at 9 am this morning and we discussed options for a bit.  He wants a repeat CT scan sent to him, he will get my records from UPMC and consider the case.  One option he presented was to repeat the surgery he has done 3 times on me already, an extensive, 15 hr marathon with a lot of risk, needless to say.  It carries a greater than 5% mortality, as hours under anesthesia, lots of scar tissue, etc, make this a land mine infested territory to travel through.  However, I am not sure what reasonable options remain, other than just watching the tumors grow, leaking bags to try to control the outgoing intestinal contents and always smelling a bit off due to the situation.  

Dr. William called last weekend, he hopes to be done by August 31, though still has to write and defend his thesis by the end of the year.  Dr. Luke Channer has been helping him with getting access to information via the internet, as I am out of my element in that area.  Thus, I am excited about arriving at the end of this long struggle to be able to provide 24/7 surgical coverage for the hospital, our dream for the last 17 years.  He already has done an evangelistic campaign during the summer with a pastor and they have a group of about 60 new believers who are meeting under a borrowed tent until they can arrange for a bit more permanent accommodation.  I am excited that he and Dr. Moise do this in the summers and a new church is being formed in the area.  It will also be good to have him back home with his 5 active sons, undoubtedly a relief for his poor wife after all these years.  Pray for a good adjustment as he reintegrates back to the hospital.  Overall, the hospital seems to be functioning well, Covid doesn’t seem to have hit Haiti anywhere nearly as hard as it has been reported to strike the US and other countries, how to interpret that is unclear.  I have not been able to contact Dr. Moise since we talked on Saturday, so not sure how they survived the hurricane on Sunday yet.  

So, would appreciate prayer for wisdom for the Donkey as he considers the alternatives before us.  The huge repeat surgery would be risky and difficult, but I must admit I don’t enjoy much having the tumors on my belly either.  So, will get the repeat CT scan and see what Dr. Bartlett suggests and go from there.  As always, thanks so much for praying for us, supporting us in that way and so many other encouragements.  Will update you as we get more information.

In HIs Service,

Bill, Dan, Duane, James, Jenn and Rachel

Treading Water

Dear Family and Friends;     Thank you so much for watching, praying and asking about us as Tropical storm Laura passed through Haiti yesterday.   We are very thankful for the Lord’s care and that the river wall held firm through the flood.    The yard was full of water, but other than banana plants, there was no damage done. 

Our Sunday school helpers have faithfully delivered “Manna Packs” for 4 months now going from home to home on both sides of the Ravine.   These young men have delivered about  100 boxes (3,600) manna packs per week  to the poorest most needy people. 

School has now restarted in Haiti and also we have a very low supply of Manna Packs, so this month we have stopped the distributions.    We are hoping to be able to begin Sunday school in the very near future again, Lord willing.  

We have had a  summer full of volleyball ministry this year, which has mainly focused on the children in our village.   We had several 30 team ongoing tournaments, plus 2 on 2 tournaments when social distancing was required.  

Katie led a week long training session on setting which went really well. 

Also, Katie organized and hosted a wrap up party for her volleyball team; the Angels.    9 years ago we began playing volleyball with this group of young girls from our village.    They are now young ladies and although we never made it to the Olympics with them, they are great volleyball players and they all serve the Lord.

Katie and a few of the Angels were able to participate in the Canadian;  Athlete’s in Action total athlete online volleyball camp this month.   It was a great opportunity for the girls and they had fun. 

Rod turned 60 this month.   He enjoyed working with his friend the Bobcat on his birthday.

Deb is always organizing and caring for all the different young people that work with us.   These young people helped us run the volleyball tournaments this summer.

This is our friend Wendy, who is growing up.   4 years ago, before hurricane Matthew, we gave Wendy a job selling coconuts and bags of ice to the people of the village.   Due to the extreme heat that we have been having this summer, our neighbors asked if Wendy could begin selling ice again, so he comes during the week and does a great job and all the proceeds go to him. 

Thank you so much for your continued support and prayers and for sending things.   We are able to give out food, clothes and even prizes, thanks to those of you who continue to send.    Thanks also for your prayers  for our Harvest director;  Mr. Danny Thomas.   We are very thankful that his open heart surgery went well and he is back on the job.   
bye for now, 

Love Rod, Deb and Katie 

The Haitian Donkey Is Back In The Hospital

We were stumbling along pretty well on our own, not necessarily doing great but stable.  The last week the donkey started losing steam again.  Some chills, nausea, vomiting and feeling out of sorts.  The temps remained low grade so started on low grade prophylaxis with Sulfa, one daily, per Dr. De Cook but  it didn’t seem to help.  The chills got more intense, the donkey’ wobbly legs were struggling to hold him up and my temp went up to 103.  I tried to hold on for a few more days, the donkey loves his stall at home so much more than the hospital accommodations.  To be fair, they have been great and gracious, the straw on the ground is clean and renewed daily, but they have no idea of thermostat control for a Haitian type.  We have it turned up full blast but it is only 71 in the hospital, while I keep it close to 80 in my stable.  They have drawn multiple sets of labs to the point they gave me a unit back yesterday and I will try to wiggle out another.  Have had 4 chest xrays, 2 CT angiograms, a TEE (transthoracic echocardiogram) and many other tests they could dream up. Some were encouraging, others troubling, but so far, none definitive.

They first decided I had a pulmonary embolism,  fairly scary diagnosis, thus the 2 CT angiograms, then decided it was pneumonia (not Covid) and put me on antibiotics and now have decided it is clotting on my PICC line and yanked that yesterday.  They started me on blood thinners,(scary to me as my ostomy has the 2 golf ball size cancer masses protruding from it and they bleed plenty easily on their own, they don’t need any help).  So, I have two more shots to give myself daily.  At least Rachel and Jenn are experts at it, James declines the adventure.  Rachel made it home yesterday and is with me in the hospital, giving Jenn a break, thankfully.  Jenn had taken the week off in hopes of doing something with her mother, but that got rerouted.  Due to line concerns, they have not given me any TPN and I have not taken in anything orally, so the legs are more scrawny to behold.

Dan, Duane and the Dutch Donkey are planning on heading back to Haiti on September 11 through 19, our first trip since Dan, Duane and I went in February.  They will have administrative work to do, organize the start of various construction projects, including the peds ward in Karen’s memory, starting prep work for the solar project, moving USAID to a centralized location and do the usual multitude of repair projects, the list has undoubtedly grown considerably.  We are looking for 6 or so carpenters and 6 or so electricians to help with the projects if that would be possible.  The dates are a bit flexible still at present as we are trying to flesh out more of the details and finances needed to prepare Centre de Sante Lumiere for the future.  Also, if you will, continue to pray for an ultrasound tech to come out and train William in ultrasound technique and a dentist part time to help out that department.  If you have skills in any of these departments, please contact Dan (616-901-6104) or Duane (616-299-3454). 

Once again, thank you for your prayers, friendship and support..

In His Service,

Bill, Dan, Duane, James, Jenn and Rachel

The Haitian Donkey Continues Preparations For His Homeland And The Hospital

Hi All:
Once again, I would like to update you on where we are and hope, by God’s grace, to be headed.  My health has stabilized, I now have been off the IV antibiotics for 4 weeks, the low grade temperature seems possibly related to a new complication.  For several weeks, I had discomfort when urinating, then started passing air, so clearly I have a connection between my colon and bladder.  For years, I have had tumor implants on my bladder, we have made the decision that I will not remove my bladder as life without it would not be very good (making a bladder out of intestine, an alternative, would only complicate things as my intestines are already too short to sustain life and this would sacrifice more).  Now, the tumor must have connected the two organs together and mixes contents, with resulting complications.  I have started a smaller dose of sulfa in hopes of keeping the infection somewhat under control.  Thus far, it seems to be helping. 

Eating has been pretty much nonexistent as the blockage seems to only allow passage of liquid without substance to it and air at times.  Not a lot of fun for a donkey who has always loved to forage freely.  My left leg remains quite shrunken from the nerve damage and painful, so I have to be careful with walking.  I use the walker if not on level ground, like in the house, etc.  Still experimenting on pain control during the night, that seems to be a bugger, as most pain meds work but keep me from sleeping, sort of a self defeating situation.  The size of my ostomy hole is so large that we have a lot of trouble keeping the contents coming out contained as they don’t make appliances large enough to fit this opening. It is a constant struggle to keep clean, I have had 5 leaks/floods in the last 24 hr.  Bummer!  Just keeping up with the washing of clothes is a struggle.

We are moving forward slowly on the solar project as we need further funding before proceeding too far.  As soon as we figure out how to get in and out of Haiti without too much complication with Covid (who wants to spend time in quarantine?), we will be starting to replace the electrical system where needed to accommodate the new system, redoing the roof to be able to tolerate the weight of the solar panels and building the pediatric ward (using the donations given in memory of my much missed wife) and other adjustments we have been needing to do for a while but have been unable to accomplish due to first the months of unrest and now Covid.  If we get clearance and more funding, we would love it if we could find 5 or 6 electricians and 5 or 6 carpenters to help with the electrical and roofing/construction projects, respectively.  The time frame is a little questionable yet, but feel free to contact Dan or Duane (will include numbers below) if you would be willing to help with these endeavors.  Also if you have questions about funding the solar project, I again am not an expert on these issues.

Dr. William will, Lord Willing, be freed from his residency at the end of August and can return to Cayes, though still has to do his research and defend his position, but at least he can work on it from Cayes and return to complete this last step by the end of the year.  Pray for wisdom for navigating his reintegration as we all want it to work but need to get the details figured out.  We have given a 3 month contract to the Physiotherapy Technician and a nurse that has worked there for the last year with Ulrike Schaller, so we hope that department will continue to do as well as it has under her leadership as she is going back to Germany for their furlough soon.  We wish her the best in her time back home as she has contributed so much to our progress there.

Once again, thank you so much for your prayers, support and encouragement as the Donkey and his friends make progress on the health issues at home and at Centre de Sante Lumiere, to help the work there progress for His glory.

In His Service,

Bill, Dan, Duane, Rachel, James, and Jenn

Dan:  616-901-3104

Duane: 616-299-3454 

The Haitian Donkey Makes Slow, Stumbling Headway

Hi All:

It appears that I have not written in quite a while.  As you all know, I am quite technologically challenged, so progress in that department moves at a snail’s pace.  I apologize for not keeping things more up to date, especially the progress in Haiti.  I finished another course of 4 weeks of Avycaz, the $1000/day IV antibiotic, now 9 days ago.  I felt pretty good throughout and have been hoping that this one will give me a longer infection free interval.  Three days after I was done, the low grade fevers, especially in the evenings, nausea, vomiting and feeling dragged out a bit continually restarted.  Thus, 4 days ago, I repeated my blood cultures and labs, the WBC is back up at 13,000 with a left shift, all signs pointing to a persistent/recurrent infection, but so far, the cultures are no growth.  However, at times it takes a week or so for them to grow out the bug.  My ostomy (the 3.5 x 2.5 inch hole in my lower abdomen) has been giving us grief as the bags are not large enough so lots of leaks.  Plus, my belly is quite scarred from all the surgeries and they make for little gaps to let the intestinal contents seep out and eat away at the skin.  Medicare has sent out an ostomy nurse for 22 visits, but so far, she has struggled even more with leaks as has never seen such a large hole and is running out of ideas.  Jenn and Rachel have a good handle on it, but have to return to their jobs soon and will be less available.  Several of my former Georgetown Med Center coworkers have volunteered to help out, I am humbled and appreciative and we will embark on that soon to try to improve the situation.

I have been working on getting supplies for Haiti with the Covid limitations, also looking to establish long term routes for others to continue this in my absence.  Allegedly, the Health Department states that there have been over 5,000 cases and about 100 deaths, but how accurate that might be is a bit up in the air, as only government hospitals have limited testing supplies.  Dr. Moise and I contact each other regularly on WhatsApp, when the connection is reasonable, and things seem stable at the hospital, though volume is down due to the fears of Covid.  School kids are especially hard hit, as very few families have a computer or access to one and the last year of frequent rioting has made for little progress as classes frequently were cancelled for safety reasons, so the Covid only adds insult to injury to these struggling students. 

At present, our hospital uses masks, but I wonder how many people out in the villages have access to one or even the understanding of the need to wear one, etc.  Since clean water is scarce in the best of times, washing techniques are used in a limited sense.  Food supplies do go from the rural areas like ours to Port, etc, on trucks piled high with the containers full of food supplies, the vendors sitting on the top of the supplies (need to duck for trees/branches, etc) so social distancing and proper handling of the food is the proverbial “pie in the sky.”  Each vendor knows which sacks of cabbages, etc, belongs to him/her when they arrive at the market and off load them.  I am concerned that, in general, fear of evil spirits, etc is more prevalent in Haiti and the Covid pandemic will only increase their anxiety levels, more even than it is doing in the rest of the world. 

When I took over the leadership at CSL, now 17 yr ago, there were many areas that needed attention and direction.  I thank the Lord that, thanks especially to Ulrike Shaller, the German physiotherapist, the PT department is making great strides and progress.  That will leave only the dental department, a place where I am really in over my head.  Would you be so kind to pray that God would send a faithful, Christian dentist who could head up that department and be able to work with our limited situation and make it functional for the glory of God?  Another prayer request is that we can locate an experienced Christian ultrasound technician who could come out for 2 weeks or so and train Dr. William in doing and reading ultrasounds after he comes in October, Lord Willing, to join us full time.  Vi Anderson, who came out and taught Dr. Moise, is unable to come again due to health reasons, so looking for someone who could get Dr. William grounded in the technique and reading.  Moise is an excellent ultrasonographer and surgeon, but sometimes those who learn and can do things so quickly don’t necessarily make great teachers, shall we say.  Those of us donkeys, who are not necessarily the brightest and best, can plod along more slowly and accommodate pupils who learn at our own pace better. 

As always, thank you so much for your prayers, support and encouragement for us as we strive to serve our Saviour at Centre de Sante Lumiere for His glory. 

In His Service,

Bill, James, Jenn, Rachel and the rest of the Haiti Team