Update on Dr. Bill

Since I have been unable to go back to Haiti, at least at this point, I will update you on my health situation and allow Dan Boerman to share his update of the work projects in Haiti.

 

Since the last health update, I did go home with the catheter in to keep the bladder decompressed and protect the repair on it. Unfortunately, the debris from the repair, etc, has repeatedly blocked the outflow and the repair appears to have fallen apart.  After 12 days of constantly soaking everything, despite wearing the large Depends, I returned to Pittsburgh to have another pigtail catheter put in the largest urine collection in my belly (but outside the bladder).  Not fun, but have drastically reduced the urine from my incision and I am dry, except for some on the incision, tolerable.  Around the clock bladder irrigations have also helped prevent leakage, though have to be done gently to not push the hole more.

 

In light of the fluid collections getting infected, I am on IV antibiotics, they take about 1 ½ hr to run in each 6 hour, so sleep has been disrupted as my brain wants to sleep while the IVs run, but I need to watch the infusion, then doesn’t understand why I want to go to sleep afterwards, sending it mixed signals.  I am back home, dry and happy to be able to be there, so will keep trying til the antibiotics are infused and pray that the infections stay away, the wound will heal and the bladder hole will fill in by itself, without need for further surgery, which would be difficult at best.

 

I now have 2 pipes sticking out of my upper abdomen to drain the small remnants of intestine.  The bile and pancreatic drainage are tough on the skin and it is often red, raw and tender.  We are still working on a variety of techniques to figure out how to make the bag stick to the skin and prevent leaks.  As my skin is more of a war zone than a plastic repair, the irregularities of the surface make adherence of the stoma wafer difficult at best and often needing to be replaced, only aggravating the irritation to the skin.  Plus, I think that I will feel much better once the antibiotics are done, they aggravate the nausea and “benauwd” sensation, for those who understand that untranslatable word from my native Dutch, a feeling of being off kilter all the time, etc.

 

The view from my recliner at my sister Margie’s handicap accessible basement apartment is most appreciated as fall progresses and the critters run from the hunters across the fields, etc.  I am very thankful for all my family’s help in caring for me, especially Gord and Margie plus brother Will, a nurse who has gone with me both times and helps wash me in the short times he is allowed to be in the hospital.  It seems like the well intentioned nurses never have time to help and I am not allowed to do it myself. As he spent most of his life in the service and our family overseas on the mission field, we really rarely saw each other and have found this a good time to share our lives and goals and desires to see ourselves and our families live for God in the time we each have left to live.  It has been a blessed time and a break from the long hours alone in the hospital (especially as they had me in isolation and thus staff came in only if absolutely needed, as they had to gown up, etc each time).

News from Bill

Hi All:

 

The Haitian Donkey now had his 8 hr surgery, emptying out what was left in my belly cavity one week ago (not hot chemo this time, risk benefit ratio not encouraging) and we are making progress.  We are very thankful to the Lord for His help and encouragement during this time.  I just got done making a loop around the floor, feel good and strong enough, though a bit wobbly.  My brother, Will, has been superb in being my personal nurse, caretaker and only visitor allowed.  He can only come once daily, from 9-12 am, and they are so RIGID that you cannot enter 1 minute earlier (I fear sometimes we empower people and it may go to their head?   Though final decisions have yet not been made, it appears that I will probably go home on Saturday with home care nurses helping with dressing changes twice daily, etc.

 

As you may have heard, I did the surgery as only vomited everything for the last 4 weeks before and felt ultra miserable.  Plus, had the hole between the colon and the bladder, so chronic UTIs made life difficult and complicated, with frequent hospitalizations.  Dr. Bartlett scoped my stomach remnant and discovered that where the loop bringing the pancreatic and bile juices back to the intestine, to recreate flow, a large cancer had grown around it and totally blocked the bowel passage.  The rest of the abdomen was a mess of tumor and troubled bowel mixed.  He ended up taking out the piece of bladder attached to the cancer nodule in the colon and had rotted through, allowing mixture of the two systems, with attendant complications.  This was repaired and I have a pipe in my bladder for a while to let the hole heal well before stressing the balloon by blowing it up.  Then he took out all the rest of my cancer and bowel mix, I only have now 2 x 1 foot sections, one from the end of my esophagus to the skin (my ONLY area of absorption, normal people have 26 feet of absorption in their small bowel, plus another 6 feet of large bowel).  The other section goes from my bile duct and pancreas and brings them out to the skin in the second one foot length of bowel.   The rest of my belly is empty except for my kidneys, liver (removed some cancers stuck to it) and bladder, so a bit more scrawny looking, I fear.

 

Dan, Duane and Evert are back in Haiti and will be home next weekend.  I am eager to hear what progress they have made, especially in the compensation area, and hope that my improved health will allow me to be more active in helping on these projects.  Pray for wisdom and safety for them as they undertake the projects.  We have heard that a generous donor to CSL has offered to match up to $25,000 USD for the solar project and thus am trying to contact people to make them aware of this possible solution to help towards this goal.  And, amazingly, we are coming towards Christmas and it is time to ask for donations to the “Rice and Goats” Fund again.   It is always appreciated by the employees but again will be especially so this year with the runaway inflation making life unaffordable for so many people in our area.  If you are able to contribute to the Matching Gift for the Solar Project, please send it to:

CSL USA

c/o Dan Boerman

2632 – 28th St

Wyoming, MI  48519

USA

 

And the “Rice and Goats Fund” can go to either the above or to:

Byron Center Bible Church

8855 Byron Center Ave,

Byron Center, MI  49315

USA

 

In either case, make a note on it as to how to properly channel the funds into the appropriate project.

As always, thank you so much for your support, encouragement and prayers for the ministry at CSL.  Every penny we receive goes directly into supporting the Haitians, we all “work for free, something we know God can do and we pray He will.

 

In His Service,

 

 

 

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

Update on Haitian Donkey

Dear All:

 

A quick update for those of you who have been waiting on word of the Haitian Donkey’s hospital stay. After having been in surgery roughly 8 hours, his surgical team finished their work. They reported that they had done what they had hoped, and sent him to the ICU. They have cleared large sections of tumour and repaired some of the damage and blockages that were making life difficult for him.

 

Now the big work begins for the Donkey. Because of Covid, unlike his last surgeries, the Donkey will be alone for all but 3 hours a day in the hospital, trying to recover from this massive shock to his system, get through the pain and let his body heal enough to be cleared to leave. This is a task that will take time and strength, so I am sure he will appreciate knowing he is in your prayers. We will keep you updated as we can.

 

Rachel for Bill et al

The Haitian Donkey Leaves for Pittsburgh to Try Surgery Again

Hi All:
On Wednesday, the 7th, we had a visit with both Dr. Bartlett (that was a last minute add on but welcome, as he is the most experienced at this, likely one of 3 people in the world who have done this many cases and have done well) and his partner at her office.  He happened to be in the hospital on administrative work for the cancer team, something he may do, just not see patients and do surgeries as the primary doctor.  He feels that my abdomen is soft and thus is hopeful of being able to give me relief of the nausea and vomiting and also some of the tumor burden with the surgery.  Gord and Margie took me and were very impressed with their kindness, thoroughness, and care, so we all feel more comfortable with the procedure.  He did say that he felt the risk of complications, including death, was higher than the 5% mortality rate with the previous three operations, more likely 15%, a bit daunting.

 

So, will leave Tuesday morning (the 13th) and get my brother Will and I settled into the Family house, go early on Wednesday to have all the preop evaluations done and hopefully get cleared for surgery and then they will begin early on Thursday.  Please pray that the operation will go well, likely 12 hrs or so again, and that complications, especially infections and intestinal leakages, will not occur or be minimal and allow me to recover well and return home again soon.  Will will do his best to keep you all updated, the exact specifics still have to be settled as he lives in Wisconsin but we will do our best.

 

As always, thanks for your prayers, support and encouragement as the Haitian Donkey enters this new phase in his life.  May everything be done well and to His glory.

 

In Him,

James, Jenn, Rachel and Bill

The Haitian Donkey Considers Another Huge Surgery

Hi All:

In the last letter, the Donkey explained that his bowels are blocked, nothing comes through and the normal intestinal juices, about 1.5 quarts daily, go in the reverse direction and are vomited daily.  This has shown no signs of letting up but I am relatively stable otherwise.  I originally had called Dr. Bartlett to see if he thought radiation might help shrink the tumors, both he and Dr. De Cook thought this might, but radiation specialists by and large have been reluctant to try this, including those in our area.  When the obstruction showed up, I called him again and sent him the latest CD of my CT scan.  He reviewed it and thought he might be able to help me get some relief with a 4th exploration.  As he has been there 3 times before, he knows the difficulties likely he will encounter but thought it was worth a shot.

I obtained cardiac clearance a couple days ago and will go on Wednesday, the 7th, to see his partner in Pittsburgh at a new hospital (to us), Allegheny General Hospital, the consortium he has switched to and is the head of the entire cancer department, I think there are 7 or so hospitals involved.  As this location is too close to University of Pittsburgh Medical Center, his partner will be the official surgeon but he will be one of the 4 on the team and assures me things will be no different than before.  If she feels the large hole in my abdomen through which now just tumor protrudes is closeable, etc, we are scheduled to return to Pittsburgh on the 13th for preop testing, blood typing and crossmatching, etc on the 14th and surgery on the 15th.  

Since it does not appear that Allegheny General will relax it’s rules and allow switching to a new caregiver after a week or so, my nurse brother, Will, will take that role, as he is retired and his family can keep his farm going in his absence.  Needless to say, he is a great answer to prayer for wisdom as we carefully seek the Lord’s will concerning this major step in my care.  The Covid rules still only allow him to see me from either 9-12 am or 5-8 pm daily and the family house he will stay in is the same as the one we had before, across from UPMC. They only have 3 houses scattered throughout the city and none near Allegheny General.  Due to Covid, the shuttle is not running but they will arrange Uber to get back and forth.   

Needless to say, this is a major decision for the Donkey, but the obstruction doesn’t seem to let up, the protruding tumor continues to enlarge and make care difficult and smelly, so this seems a reasonable, though risky, solution.  We would greatly appreciate prayer for God’s guidance through the remainder of this pre procedure evaluation and the surgery itself and recovery, if that is the way He chooses to lead us.  

The Haiti Team filled and sent a 40 foot container on Friday, October 2 with building and medical supplies and it is on it’s way with equipment for the teams coming later in the year.  I am very thankful that we were able to obtain a fair number of general surgical and orthopedic tools from an organization in Pittsburgh that hopefully will keep the surgical department going for years to come.  The tools are especially useful as so much of surgery is being done laparoscopically and thus the open tools are much less available.  Continue to pray that we will get more funding for the solar project as this would ensure reliable, 24/7 electricity (maybe with a couple hour generator boost daily for Xrays and the washing machine) in the midst of the continual political upheaval and uncertainty.  Rumors have it that the government has mandated an almost 50% increase in minimum wage, understandable with the runaway inflation, but where do they expect the funds to come from?  We may have to increase charges for services some, but that is only a limited solution as the patients don’t have increased funds. 

We would appreciate prayer for His wisdom for the Donkey’s surgical situation and the hospital construction, maintenance and financial organization.  Thanks to all you who so faithfully support us in these endeavors for our Lord at Centre de Sante Lumiere.

In His Service,

Dan, Duane, James, Jenn, Rachel and Bill