The Haitian Donkey Visits Another Home Away from Home Again

 

Hi All:
This weekend, the Haitian Donkey will make his monthly trek to Pittsburgh for another course of experimental therapy (thus has to be done in Pittsburgh, under their strict control as it is a study and everything has to be just so).  Karen, of course, will go with to keep me headed in the right direction, as the triple treatment leaves the Donkey a bit weak in the knees (and the stomach). Over the years, I have heard stories of Interferon, that it is not the greatest stuff to tolerate, and I guess they were correct, one aches in places he didn’t know a Donkey had places, as the saying goes. The Rintatolamod (who comes up with these interesting names anyway) is tough on the stomach, despite the premedication with anti nausea meds. But, though the week is nothing to look forward to, it seems that a few days later, I have really perked back up this time and able to stuff my face with an amazing array of foodstuffs and enjoying every minute of that part. My Hemoglobin took a major hit and it is struggling to get back to “my normal,” at about 2/3 of normal donkey levels, but even my strength seems better.

As Karen and I head to Pittsburgh, Tom Failing and John Cushman from BCBC will head south to Haiti, where they will be joined by Dr. Fred Brown for the week we are gone.  John will follow up on Duane’s work on the generator (Rod serviced it for us, thankfully, in the interim) and hopefully we will have some stability there, as it seems the electrical situation in Haiti remains sporadic at best. Pray for wisdom and strength for the 3 men as they try to make repairs on both the physical structure and the Haitian bodies for the week. Dr. William has been coming to Cayes to help do surgeries with Dr. Moise when the surgeons come, but, thankfully, the strike is over and he is back at the residency program for the normal 90 plus hours of work each week. However, he needs our prayers as he is a bit discouraged with the pressure of the work (Luke, Jose, Jim, Fred and I did our surgical residencies in our 20s, William is in his 40s and more than just maturity comes with age, I fear). Also, having an active family he is away from adds to the stress, undoubtedly. These men are the future of the hospital, so we want to pray for them that they will have God’s guidance and strengthening for the tasks before them.

We have not heard any more about the political situation, but are praying that things will get settled in the scheduled month for elections, October and that the situation will improve. As we mentioned, Dr. Luke, Karen, Tabitha, Micah and myself hope to go in early November, to avoid the political unrest and get the ball rolling at the hospital again. In that same vein, it is almost October already and I would like to ask if you all would be willing to donate to the Rice and Goats Fund again, as I hope to be able to encourage our employees with these. Last year, one of our more sensitive donors was worried that the donated goat would be the center of the Christmas Feast, so I checked it out with Dr. William. He assured me that this would be unlikely, as without refrigeration, the whole goat has to be eaten in a couple days and that is too much money to consume in a couple days. The goat is more like a financial investment, to be grown and hopefully multiply and then to be sold if a medical procedure needs to be done or repairs to the house, etc. Yes, eventually, the little one will become someone’s meal, but hopefully not in the near future. Thus, mostly likely the gift will live to say “baa” another day.

If you would like to contribute to the fund, you can send the money to either Centre de Sante Lumiere, US,  c/o Dan Boerman at PVI Industrial Washing, 2886 Clydon, S.W., Wyoming, MI  49519 or Byron Center Bible Church, 8855 Byron Center Ave, Byron Center, MI, 49315 and label it the “Rice and Goats Fund” at either establishment and it will go in the proper designation.  Thanks from both the Haiti Team and the employees at Centre de Sante Lumiere in Haiti.

In His Service,

Bill, Karen, Fred, Tom and John

The Haitian Donkey is Thankful to Be Back at Pittsburgh

 

Hi All:

As we embark on another week of some uncertainty in our journey, I have a lot to be thankful for. By the grace of God, I have been able to work pretty much full time at Georgetown Medical Center, including while my partner had a couple weeks of vacation.  My Hemoglobin has risen above 10 for the first time since the April 11 surgery and, with the healing of the fistula, I can eat almost anything. Not much at a time, but the positive thing for someone who loves to eat, I get to savor food all day long, as can only handle 3 swallows of liquid followed by 3 bites of food at a time. At home, the temptation to do more can get away from me, especially if some family members are there and I get distracted with conversation. At work, it is much easier to play by the rules, as I get a swallow or two and a bite between every other patient or so if things work out. So, I have been able to do without my Lactated Ringers rehydration during the day, though I still do my TPN at night as cannot get enough calories in during the day. Thus I am very thankful to sit up and take nourishment, not bad for a donkey.

We left Grand Rapids early this morning and are thankful that we had the best trip to Pittsburgh thus far (of our 7 trips) with no back ups at the multiple construction sites, great weather to travel and we got our luggage into the apartment. Ten minutes later at most it started to storm, pelting rain and rather significant hail, so another great thank you to the Lord for allowing us to get here safe and sound (and dry). Tomorrow morning at 8 am, we will go for round #2 of the injection of the vaccine into my left groin (we alternate sides). The rest of the week is the questionable issue, as I will have daily injections/infusions of Interferon and then another chemotherapy dose added on Friday, something being used in Europe but still experimental in the USA. Hopefully will learn more about it this week.

The political situation still has not been resolved in Haiti, unfortunately, and the interim president (whose term expired several months ago but he does not seem eager to step down) does not seem any more willing to resolve the impasse with the government hospitals being on strike for more humane conditions for their patients and themselves, so Dr. William still is unable to continue the residency he started early this year. Please pray that this will be settled soon and that he can continue his “official surgical training” again.  He does come to the hospital and help out when he can, like last week, with Dr. Fred Brown and Duane working under somewhat less than ideal conditions. I think Duane figured they had maybe 5 hours of government electricity all week and our main generator died, so hard to keep the hospital functioning. I am thankful that at least this happened when Duane was there to handle things (not sure he would agree with all the grief he had to go through).  He has a new generator up and running and is working on getting the old one repaired, always an interesting situation under the conditions in Haiti.

Will keep you up to date as we learn more about the rest of the week and the effects the new round of chemotherapy has to bring us.

In His Service,

Bill and Karen

 

The Haitian Donkey Makes Some Progress

Hi All:

The last time, I told you I was enjoying eating and drinking as, by the grace of God, the intestinal fistula (bowel leak) was one of the 60% that healed on their own, ie without surgery. I have put on a few pounds, will likely not put on more as the mesh does not seem to like being stretched much, it becomes a bit tight and tender, so will slowly switch getting my food and fluids from IV sources through my port to oral supply. It is amazing how much fun it continues to be to eat and drink again. Also, with this, I can take in iron orally and my hemoglobin is creeping up. This seems to increase my endurance tolerance accordingly, so the donkey can carry his normal load of work and other burdens as he should and wants to.

Although I grew out the dreaded MRSA from my wound and am allergic to the sulfa we like to treat it, it has slowly healed and my cultures allow me to use another antibiotic to control the redness and mild inflammation that persists, as well as some local applications of infection control. This allowed me to have my first vaccine injection on the 1st of August at Pittsburgh. It went well, the 6 inch needle they use was a bit intimidating, but the PA found a couple lymph nodes in my groin on ultrasound, then came in at an angle towards them with that needle, and, using the ultrasound probe to guide her, speared (or as she put it, harpooned) the nodes and injected half of the vaccine in them. The rest went under my skin of my thigh and the procedure was done for this month. Karen and I will return on the 28th to do that again, then have 3 more chemotherapy agents administered the rest of the week for 3 more weekly cycles separated by 4 weeks each time. Will have to stay in Pittsburgh for this as the treatment is an experimental study and thus closely controlled.  Am praying that this will give me more length of life and that I will use it properly for His glory no matter how long it is.

Haiti continues to be a great prayer concern. As many of you may know, the presidential elections have been a major problem, the ones last October were felt to be invalid and President Martelly departed on time in February. After that, the interim president took over for 3 months, but seems to be fairly authoritarian and unwilling to give up his powers at the end of the time allowed. He also has not been very kindly disposed to the medical system’s breakdown as the employees, from the staff doctors to the residents, nurses and other staff have all gone on strike to protest the deplorable conditions of caring for the poor patients in the socialized medical system (no water or electricity a fair amount of time, doing surgery with the light of their cell phones according to the Miami Herald article). It stated that there are like 20 governmental hospitals on strike now since early spring. As in all socialized systems, there appears to be a 2 layer system, so that those who have finances can get care for a price, but those who don’t just suffer and may just die. There have been a number of rather liberal media descriptions of the situation that underline the sadness of the system’s malfunction. Again, somewhat like in the US, the politicians who could resolve the difficulty are not affected as they have their own medical care available, so less motivated to do things correctly for the sick and suffering. Dr. William would dearly love to get back into his training, but there doesn’t seem to be any reasonable solution on the horizon in the near future. Pray for wisdom and resolution soon as God wills as Dr. William is getting discouraged. Being away from his family and not making progress towards the goal of becoming a legal surgeon is frustrating.

The hospital is functioning well, thanks to the volunteers who come monthly to both help with surgery and maintenance (equally needful and appreciated). I keep in contact with Dr. Moise and he seems to be doing his best to carry on and keep the hospital afloat. Pray for wisdom and strength for him also, that he will not “be weary in well doing.” The chaplains continue to be the bright spots on the horizon, as they are both past retirement age but seem most diligent in reaching out to the patients with the Great News of salvation through Jesus Christ, a Light that can pierce even the thickest darkness. Dan, Duane, Theresa and a goodly number of the Haiti Team have been slaving away in the heat to get the supplies gathered and prepared for loading and shipping a 40 foot container next Tuesday. Pray for safety for the wonderful workers and the arrival of the container at the hospital soon and safely.

Again, the Donkey has stumbled on longer than he planned, but wants to keep you up to date on all the affairs related to him and the ministry in Haiti.

In HIs Service,

Bill, Karen, Rachel, James and Jenn Ten Haaf and the Haiti Crew

Food at Last!

Hi All:

With the US Independence Day just around the corner, I am celebrating the ability to return to a somewhat normal eating style.  Anyone who has been around me for long knows that I normally love to eat almost anything edible and a goodly quantity of it. So, since my last meal was April 9, 2016, it has been a long fast, but the end is in sight. As you know, this surgery was tougher than the first two, partially because they took the midsection of my belly wall out and replaced it with mesh, which, incidentally is working fairly well at holding my insides inside. However, a couple weeks after surgery, I sprung a leak in my incision that clearly demonstrated, on incision and drainage by Dr. Dan De Cook, to contain the same yellow intestinal contents that I would deposit in the toilet, a discouraging sign that I had a hole in my intestines. So, I stopped all oral intake except for 2 sips of water twice daily with my antibiotic, heart rate pill (only needed after the surgeries, hopefully can wean off again soon) and acid reducer pills, as nothing in my stomach led to non buffered acid running freely in my GI system and causing considerable heartburn, etc.

Dan left a drain in my abdominal wall which has worked well until recently, when I think my daily irrigations may be doing more harm than good as I developed another wound infection early this week ON the high power antibiotic we started me on due to the cultures of the drainage. It looks like Strep or Staph, but I think I am allergic to Sulfa, which would be the treatment of choice for MRSA. By the grace of God, the wound infection seems to be slowly responding to Keflex, which I appear not to be allergic to. I was taking both drugs about 6 years ago when I came back from Haiti with a very nasty leg infection from a presumed insect bite there that took months to heal. Karen threatened to not allow me to go back there as she feared I might lose my leg, so I hit it hard with both meds, but after a week had a nasty rash, so dropped both drugs and went to Levaquin and it healed over about 9 months, though I still have a reminder on the back of my leg of the event. I had not needed to take either drug since until now, so thankful that it seems to be responding on the Keflex alone.

About 3 1/2 weeks ago, I obtained a CT scan of my abdomen right before visiting Dr. Bartlett  on the 6th of June and getting my leukapheresis done. He felt the outside fluid collection/abscess was shrinking with the drain Dan put in it, the inside one maybe some. So we started on sips of clear liquids, a very great blessing, for 3 weeks and then repeated the scan last Friday to see if the collection was enlarging. The intrabdominal one (the most troublesome one) does not seem that it is enlarging with the fluids, in fact, Dan feels it is pretty much gone, a real answer to prayer and he now encourages me to increase my oral intake but “watch that old drain for green peas or beans to come out, not a good sign.” I am happy to oblige (did break the rules with tiny bites of Norwegian at a Bierema wedding 2 weeks ago, one only gets those treats at Christmas and special occasions) and will rejoice in the fact that I am able to eat some again. Once that smooths out, will work on reducing the number of bathroom trips to less than the dozen plus daily, some with little warning using Metamucil and other agents. I do thank the Lord for the provision of the TPN, which has kept me alive through this prolonged inability to take in food or fluids orally. The wonders of modern medicine are especially apparent to me, having spent so much of my professional life overseas, where we have no such provisions/capacities.

Speaking of Haiti, please continue to pray for both the team at the hospital, the government and governmental hospital system. For the first, Dr. Jim Webb, who has considerable hip pain awaiting his hip replacement in August or so this year, has most graciously agreed to cover June and July for me, and went down the week of the 18th to cover the surgical needs, along with Tom Failing and Dave Weener from BCBC, who worked on the endless job of hospital maintenance. The trip was productive on all fronts, for which we are thankful. However, they, like Dr  Luke and company the month before, had to leave early to avoid travel during the night time as per the curfew imposed by the American Embassy. The interim president’s 3 month term has expired without much change (not sure he intends to do all that much and seems quite reluctant to relinquish his position), so there is a fair amount of unrest. All the government hospitals (socialized medicine is alive, not quite sure about the well part of that phrase, in Haiti) have the doctors on strike due to the conditions at the hospital, no running water, etc, and the president is threatening to punish the doctors by pulling their licenses rather than fixing the situation. So, it appears that there is no end in sight for the near future and Dr. William’s training is on indefinite hold. Pray that this will be resolved soon for him as he is one hard worker and is very frustrated at spinning his wheels. There was a lengthy article on line from the Miami Herald today, maybe some pressure will be put on the proper authorities to return to an improved function soon? One doesn’t dare hold his breath too long, though.

Sorry, again I tend to ramble on a bit at length, but praising the Lord for my health progress and praying for the future for both my therapy and the situation in Haiti. Thanks for your love, concern, prayers and other encouragements.

In His Service,

Bill, Karen, Rachel, James and Jenn Ten Haaf

The Haitian Donkey’s Hectic Life

Hi All:
As most of you know, I like being busy, don’t do all that well sitting around. However, maybe it has been a bit crazy even for me. Trying to get everything done before we went was all done rapid fire, trying to clear up the workload of patients at Georgetown Medical Center before my departure. Our friends at TSA, Charlie and Mike, again were gracious and helped us go through the search and destroy part of leaving Grand Rapids without a speed bump. However, the rest of the trip was a bit rougher. The only flight available (I am blaming the snowbirds going back to the sunny south after the holidays) had only a 47 minute layover in Charlotte, NC, a rather spread out airport.  We were delayed in GR for 1/2 hour as the deicing crews were short handed, so landed in Charlotte pretty much with the need to move quickly so we hiked to our new gate with a few minutes to spare, but were told that, due to weather, cloud cover or some explanation offered, our landing spot in Miami was delayed 30 minutes. We were to meet our nurse practitioner friend in Miami, as she flew in from Chicago. She spent a couple of years overseas in Africa, with us, so was experienced in overseas travel, but we had no way to tell Jean Eddy and Dudu whom to look for nor let her know who would be taking her on her way, if we didn’t arrive. We landed in Miami only 1/2 hour late, but then they had nobody who knew how to work the jetbridge, so we sat for 40 minutes, watching the time slide by. When they finally let us out of the plane, we had 2 minutes before the gate would close for the Port au Prince flight. I am ever so thankful for the fact that I am gaining some strength as I gain some weight, [I have some jowls where I had sunken cheeks 3 months ago when I started chemotherapy again, etc.] but my legs would hardly go fast enough, despite me willing them to find a higher gear.
We got to the gate a few minutes late, as they were about to close the door. As it turned out, there were about 60 folks, including 2 teams of 25, who were on our Charlotte to Miami flight and so we waited for another 20 minutes for them. Then the door wouldn’t close so we waiting another 40 minutes for maintenance to fix that. Most of the people were frustrated, while Butch and I were rejoicing as we figured this would allow our luggage to catch up with us, which, thankfully, did occur. I found Tabitha snoozing soon after we got on board, as she had been waiting ages for departure. We landed in Port, got our luggage and were able to get on the road to the hospital without further difficulty.
By the time we arrived, the rest of the crew were sound asleep, but they had left us some rice and fish, so we feasted on that and went to bed. As the Wray’s expected team did not make it, our team was able to go to Renault and participate in the Sunday School program with them. I was tempted to go as I enjoy it and can connect up with the Wrays and many Haitian friends there, but felt I should stay, as my TPN was still running due to our late arrival and would need to be disconnected and that likely would not be the best place to do this. Within 2 minutes after they left, Dr. Morose, one of my younger doctors, came to find me as a teenage girl had been hit by a bus and was brought in to see us. We placed 2 large lines and poured the fluids into her; got xrays and saw she had broken both legs just below the hip, very nasty, unstable fractures where one can lose several units of blood in each thigh. Since we no longer allowed by the government to type and cross blood, we have to get it from the Red Cross in Cayes, usually a minimum of 4 hours, undoubtedly worse on Sunday morning, where you have to go to the lab tech’s house and bring her to the Red Cross before starting the process. Thus we were unable to save the poor girl, definitely a discouragement with such a young patient in dire straits.
The rest of the next 2 days have been productive, though the pace leaves the Haitian Donkey quite breathless. We met with the German folks who have helped us for several years with the Poor Fund and we are scrambling to get things together for them to possibly help us with funding our doctors in the residency, as they are interested in funding things that will be an investment in the future. Certainly this would qualify. Monday morning, Dr. William and Dr. Adulte were still with us, so we ran both ORs most of the day and got a good jump on the surgical load. However, at noon, Dr. William’s contact at the government hospital told him the hospital he was assigned to would not respect the rules of the Department of Health and were starting their own residency on Monday. Thus we sent him off to do his best to get into the residency, as he is the ONLY non public school trained doctor and will get his share of grief from these arrogant, rich kids, the only people who get into the public medical school. All the poor kids with potential go to the private schools, all run by mission organizations and definitely discriminated against by the public system. I have not yet heard what transpired, pray hard for Dr. William, that he will be able to keep his spirits up and be able to do the residency as planned. 
There is a ton of unrest in the country, with the opposition party burning cars and election places in preparation for the election to be held next Sunday, the 24th. We have set up some contingency plans for Dan and the German couple to leave at 2 in the morning tonight and I have talked to Jean Eddy for our departure on Saturday am, as we will leave at 1 am and if there is trouble, have him hide out with our truck at a safe place until the riots calm down. There certainly does not seem to be a lot of reasonable thinking going on here at times, as we wreck the little we do have with little hope of improving anything in our living situation. The Haitian gourde continues to plummet in value and this only fuels the tempers of unrest among the millions of unemployed Haitians.

Thanks for your prayers and support of the Haitian Donkey and his friends, Brianna, Butch, Dan, Dave, Marge, Paul, Tabitha, Teri, and Tia.