|Hi All:In the world in general, I suppose that donkeys are not well known for having rather high Intelligence Quotients. Those in Haiti, and the one braying to you in particular, are likewise not overly endowed with wisdom and thus we come again, asking for prayer for divine wisdom in knowing how to treat the struggling Haitian Donkey and plan for future trips to the homeland, etc. I am well aware that the Lord has allowed medical care to advance to the level it is at now in the USA, even amazing the Donkey in his 40 years of practice. Because of this wonderful care He has permitted, I have been privileged to benefit and be able to live fairly well for the last 6 years despite my aggressive cancer and the consequences of the extensive surgeries I have undergone. Also, the progression of the TPN (Total Parenteral Nutrition) again in my lifetime has allowed me to keep living and working despite not having enough intestines to live (I only have 180 cm of the minimum 200 cm). But, the Donkey is also acutely aware that it is especially by the prayers of so many faithful friends and supporters, some of whom I will never likely meet this side of heaven as we don’t live on the same continent, that He has ordained that I am allowed to live despite the severe restrictions and conditions imposed on me by the nasty cancer and the consequences of the treatment of same. I am constantly humbled, amazed and encouraged by you all and your kindness and willingness to sacrifice your time and energy on my behalf. To God be the glory.
So, I come again, asking for prayer for God to guide my thoughts as well as those working on and with me for the near future as well as a bit longer, should He allow me to continue to live and work for Him. As I mentioned, my strength was a bit down in Haiti last week. I had a sinus infection a few days before departure and felt a bit dragged down, but treated it and, although it is still there, is tolerable. However, Wednesday night and each night thereafter, I had fever and chills, tolerating the warm nights only with my sweatshirt on to keep things on an even keel. The trip home went well, though very thankful for my heated jacket (like the hunters wear, with batteries to keep me going) and the team took care of the 11 suitcases of stuff while Karen took me directly to the ER from the airport. I had a temp of over 103, a white count over twice normal at 21.500 and they wanted to keep me in the hospital. However, they always take my bundled clothing away and I shake like a leaf. I know they want the temperature down, but I don’t do so well with chilly temperatures. They did start me on the ever faithful Vancomycin and I have continued it to this day as it seems to be the only antibiotic that will work. However, we checked levels on Wednesday morning and the usual dose was not sufficient this time, so have bumped it up and yesterday the levels were acceptable. Thus, am hoping this critter will surrender his territory and go away soon.
Part of the body’s way of dealing with sepsis, the severe infections that I get from either my hole in my intestines or the lunch line in my chest, where we dump in 35% Glucose with other nutrients that the bugs like to share with me when possible, is to third space fluids, causing swelling in the legs and a bit in the lungs. This normally has been a bit of a struggle for the Donkey, but this time, I seem to be hanging on to considerably more fluid, about 15lbs. worth, and it is causing some congestive heart failure for me. Thus, a flight of stairs makes me so short of breath that I have to rest before going back the other way with whatever I have come to get, etc. Additionally, in my first 15 hour surgical marathon, they spent a fair amount of time picking cancer globules off my cardiac area (as well as the rest of the abdomen, etc) and since that time my heart has done more than it’s share of flips and flops and other fun things that the Haitian Donkey does not enjoy, so have been taking a beta blocker with help. As I have been struggling, I did see a cardiologist on Thursday, who did what all medicine men do, shuffle your pills, trade a green one for a red one and a yellow one for 2 white ones, etc, as well as do an echocardiogram that shows I have some heart damage from the infections. So, am slowly getting back on my scrawny (though puffy with water) donkey legs and hope the healing process will continue. My blood tests done yesterday showed some improvement, the white count down to 13 but still having low potassium due to the water pills, etc. We are making progress, I have lost 10lbs so far, but not out of the woods yet and appreciate prayer for wisdom.
Also, as we are working on organizing work teams for Haiti for the future months and my health status being a bit unknown complicates things. I am deeply grateful to Drs. Jim, Jose and Luke for their invaluable help, especially as Jim and I both struggle with significant health issues and he never states no when I ask him to help, often on short notice. However, we need God’s wisdom and help/direction as we work through other topics that need addressing at the hospital that they are not able to help with, due to language, cultural, etc barriers. We have been working on getting the rather gentle new administrator, who similar to myself, needs an infusion of backbone stiffening, better organized in setting up rules and guidelines for the hospital. He is so much easier to work with than the last one I have endured for 12 years, an autocratic ruler that all hid from when he came around and who now seems to have made his way with his family to Canada??? However, we are trying to set things up in the administrative realm for years to come with the help of Dan and Duane when they are available. We also are working on getting the reintegration process going for Dr. William, who hopes to be done in 20 months more with his Haitian Surgical Residency. How this picture will work out is taking lots of time, prayer and wisdom that the Haitian Donkey lacks but asks you to pray for divine intervention in this regard. So, planning on future trips, the composition of them as I never am able to go alone just for the TPN that needs a second person to help haul, etc is a bit difficult as he struggles with health questions and concerns.
The Haitian Donkey, true to form, has rambled on a bit, but appreciates all your prayers for wisdom, encouragement and strength from on high.
In His Service,
Bill, Karen, Rachel, James and Jenn Ten Haaf
I am sitting in the oncology department getting my infusion of goods and thought I would bring things up to date on a couple fronts. I finished my IV antibiotic course 2 days ago, so they could give the next treatment now, as it is experimental and they don’t want any complicating issues, ie extra meds on board, etc. This is treatment # 9, they raise the dose each time until # 10, not sure what, if anything, happens after that. I will get a repeat CT scan again on October 8 and will see if the cancer is progressing or not and I guess that will impact what happens next.
I had my line changed over a wire (so that I won’t lose the last remaining site in my upper body, not as desirable as just pulling it, leaving it out for 2 days and replacing it, but didn’t want to take the chance it would not be able to be put back in) and have finished the antibiotic course after that to cover the critter growing on the line. I am hoping that I can eat a bit more now as still seem to have nausea pretty regularly, not sure who is the culprit but the weight slowly dwindles with it. Am continuously thankful for space heaters, a heated jacket (battery powered, what a “cool” thing) and other aids to staying warm when not in my Haitian homeland. I think the strength is returning some, have been able to continue working pretty much normally in the interim, as hate sitting home feeling poorly, at least seeing and caring for patients takes one’s mind off his own situation. So, hoping to get back into the rotation for Haiti next month, as will have a bit of a backlog of patients to take care of.
I thought I would just comment on a couple other issues that are of interest to me and hopefully to you also. First, our statistics for last year included:
62,924 Outpatient consultations
2,028 Hospitalized Patients
19,844 Laboratory evaluations done
276 Deliveries done
Plus a few hundred xrays and about that many ultrasound evaluations each month, mostly on our own patients but we also have patients being sent from elsewhere for testing.
However, I am also very thankful that we have been able to have our evangelization department functioning, to accomplish our goal that each patient, and often their caretakers or family members, receive a clear presentation of the Gospel of Christ Jesus as their only hope for eternal security. We show the Jesus film and other evangelistic films, I make it a point to speak to each surgical patient each day and give them a different tract and encourage them to consider not only their physical/medical health but also their more important spiritual health. We are happy that our two chaplains, Pastor Zidor and Pastor Juste, faithfully follow up on our patients, sharing more in depth teaching and encouragement to consider the claims of Christ on their lives and help them follow up with Bible based churches in their home area, contacting pastors to introduce them, giving them a letter of introduction to the church/pastor and also calling them, if possible, to see how they are progressing and if they would like further information. They have kept track of the numbers of people they have counseled and tracts they have distributed and it is encouraging to see their hard work for His glory.
So, as we bounce back from this major health speed bump and anticipate going in mid October again with Duane, Ruth, Tabitha and Zella, I wanted to take this opportunity to thank you all for your prayers, support and encouragement for our efforts to serve our Lord at Centre de Sante Lumiere. Continue to pray for especially Dr. William as he now has a year where he will be shipped here and there to “complete areas where the resident needs training.” He is presently at the burn center at Doctors Without Borders for September and October. We don’t know the rest of the plans yet, but need wisdom and encouragement for him as he sort of has to go where he is assigned.
In His Service,
Bill, Karen, Rachel, James and Jenn Ten Haaf
We finished out the week well, doing all the cases that came our way and finished off a few more on early Friday morning. As we were finishing, a lady came in, with arrested labor with her baby in distress. We gave it a try as she had delivered 2 children already normally and we figured the space was adequate for the little one to pass on out. I left the nurses and Dr. Moise to do this while I finished packing my carry ons, cleaned up the room (I try to leave all spic and span to reduce the influx of cockroaches that make the place their home in our absence) and loaded the truck. We only had the kitchen to wipe down and we would be on our way when Dr. Moise came to suggest that the baby would not be able to find it’s way out and wanted to do a C section. We did it, very thankful that we made the decision as the uterus was paper thin and the baby in major distress. We were able to finally get the little one breathing on it’s own, repair the lady and take off for Port.
You notice that I didn’t mention the gender of the little one. Everyone is amazed that I didn’t notice but all I ever care about is keeping the mom healthy and having a healthy baby, whether it is a boy or a girl seems like the last thing on my list (and I get a lot of ribbing over this). My priorities seem a bit different than others in that department, for which I get a goodly amount of grief. However, the little one was really wedged in the pelvis and we were covered with sweat trying to get him or her out of the belly alive. I woke up the next morning with a significant strain of my neck, bouncing back home on the plane and in the airports didn’t do a lot to make it better and it still gives me some grief. I have had a couple of physical therapy treatments by my good friend, Todd Wehrmeyer, and they have helped, but am ready to have those aches and pains go, especially as I get another immunotherapy treatment tomorrow and it tends to cause aches and pains all by itself, especially as they up the dose each time I visit them. Ibuprofen does a lot more to help me feel better, but that little remnant of stomach I have left does not tolerate it and Tylenol is like sending a child to do an adult’s job, makes me feel better but the patient, not so much.
Dr. Bartlett’s PA, Heather, called me 3 days ago and said that they were happy that the cancer progress seems to be slowed down to maybe stable and want me to continue the treatment as long as possible/tolerable. So, will submit to it tomorrow and appreciate your prayers that it will continue to kill cancer cells instead of me and, Lord Willing, prolong my life and productivity. My partner has been on vacation, so the office has been a bit of a rat race, especially as my neck is still stiffer than it should be.
I had a nice visit with Dr. William on Friday night as he came to see us on our way out. I was encouraged as he seems to be more perky, likely because he can “see the light at the end of the tunnel” and the second 2 years are less punishing than the first two years, as the lower two years do all sorts of “grunt work” to keep patients happy until the older doctors can do the surgery. A bit different, maybe more than a bit, than what we do here in the US. We talked a bit about his plans for next year, they ship them off hither and yon to round out their training, in theory, a good idea, we will just leave it at that. Dan, Duane and the wonderful team of Haiti USA members loaded a 40 foot container with stuff for the hospital as well as Rod and Debbie Wray on the 30th, so that is underway, thankfully. Since Karen and I and our family members always did this the years we were in Africa, we greatly appreciate the number of folks who help out in this area.
So, as this has been written in a couple segments as I have time between patient duties, will send this off and update you a bit later on some of the information of what we have done at CSL Haiti in the last year, etc. As always, thank you so very much for your help and encouragement.
In His Service,
Tom and Bill
The weather has been most perfect for a small, stumbling Haitian Donkey, maybe a bit warmer than Sam and his Haitian coworkers might like, as they work in the container organizing the latest shipment of building materials into some semblance of order. Duane tries hard to put things in the container in a fashion that will facilitate unloading and putting things away in one step, NOT a Haitian priority. So, Sam and crew are getting things out needed for the next couple construction crews and putting spacers between the treated lumber pieces so they will not sweat too much and warp, etc. They have worked very hard at emptying the beds, furniture, etc from downstairs. There is an excitement among the employees as they have bugged me for a long time to put some tile on the floors and, thanks to friends in the US, it is becoming a reality. Seeing the new administrator, the newish head nurse, etc all pitching in with us in moving the stuff to the temporary storage spot also was encouraging, as their predecessors would not have dirtied their hands in manual labor. The whole spirit is encouraging.
We recently had a huge deluge of rain, again washing away a lot of people and possessions. Dr. William’s wife and family have been raising baby chicks and had 350 that they were preparing for market, including 110 that I planned to purchase so that the employees could have a special family meal at Christmas. Unfortunately, the sudden flash flooding included his yard and 295 of the chicks drowned. Even worse, several school children in the area left school to walk home and the flash flood washed them off their feet and they drowned as well as a motorcycle taxi driver. This morning we had a lady on a motorcycle totally crushed by a rogue bus coming over to her side of the road and she never had a chance. It again reminds us of the brevity of life especially here where it seems life is not valued as much as it should and the fact that the Christ of Christmas is our only hope for eternal life.
We also lost a 24 year old lady who tried to abort herself last week, then came in Sunday night as a transfer from another hospital, quite ill and anemic. We gave her mega doses of antibiotics and some blood but could never get her stable enough to take to the OR and do a hysterectomy and she passed yesterday despite our attempts to save her. When I proposed the possible surgery, she was very hesitant as she had no children yet, but in wanting to not have one now, she lost her life instead. Very difficult for us all. Sam told me he is squeamish about surgical procedures but we had a lady come in tonight with 2 washers and 3 rings on her left 4th and 5th fingers. I got my needle nose pliers and wire cutters and we put the lady to sleep as her fingers were necrotic due to infection and swelling. We worked at trying to cut through but the large washers (like those for a large bolt, fairly thick) would not budge. So I asked Sam for some more tools from the tool shed and he brought some and worked along with us as we sweat for quite a while before they gave way. Only then did his stomach rebel and he had to go out of the room, so I was proud of him concentrating on the job enough to see it through.
The town of Simon, where we are located, recently petitioned the government for a road through the village. They have been working on it a while and work started several months ago. Some of the cement has been poured but then a gang of robbers broke into the container they had full of the cement and stole it all. Then, a few days later, they sold it all to the residents of Simon at almost half price. One wonders about a population who is willing to be in cahoots with gangs just so they can get cheaper cement for themselves. The moral climate sometimes sinks too low and makes progress impossible around here.
So, the Haitian Donkey is most appreciative of the progress we have made here by the grace of God and for all of you who encourage and support us as we serve Him here for His glory.
In His Service,
Bill and Sam
Once again, the wobbly Haitian Donkey is carrying his load around in Haiti and glad of it. The temperature is so much more agreeable though he still wears his MSU sweater hoodie at times (not out in the sun, but in the clinic and where it is a bit cooler). I have been struggling with a bit of a bug for the last 2 weeks, starting with a fever and body aches for a couple days, then seemingly better and just a bit more tired than usual. Also, no appetite, never a good sign for a Hungry Haitian (Donkey or otherwise). I have been juggling somewhat contradictory advice from my new oncologist (in Grand Rapids, my friend, who took excellent care of me for the last 5 years has retired) who is not fond of chemotherapy and Dr. Bartlett and the new surgical oncologist at University of Pittsburgh. The latter would like me to restart the chemotherapy, either one of the two I already have had a course of. I tolerated them, but at least the one has given me persistent neuropathy in my legs and feet (I can walk on my bare feet in the morning to start the truck to warm it as cannot feel anything there) and difficulty swallowing, not a fun thing for a Donkey who likes his food. Neither proved to be a lot of fun but we made it. So, praying about how to best follow the conflicting advice of the experts. I am leaning towards Dr. Bartlett as he has treated over 1000 of my rare cancer, but will see what settles out when I get back, repeat my blood and scan (and hopefully have been able to get rid of this infection).
When I got my biweekly blood draw last Monday, it was evident that I had my fourth blood infection in a bit over a year, despite my being very careful with my line. This is a bit discouraging. Theresa, my nurse, sent me the results but the internet is not working (doing this off line and will send/correct when the internet comes back up, hopefully) so know I have a Staph Epidermitis infection that is sensitive to the IV antibiotics we started on the night before we left for Haiti. So, please pray for wisdom for both of the above. I am glad to be basking in the warmth with my buddy, Sam Baughman, who has come 9 times and has his work cut out for him this week with the number and complexity of projects Boss Duane has assigned him.
When we decided to go with the IV antibiotics, the cold storage space in our carry ons was at a premium, as had to take 18 bags of antibiotics in addition to the 8 bags of TPN (my lunch). I called American Airlines and asked if I could pay for a 3rd carry on, no promises there. There was no room to spare, but we made it. We had a great flight down and our luggage made it, though the suitcase with the batteries for the DeWalt power tools was totally destroyed due to the weight, etc. Three of the 4 were 1/2 pound below limit. For the first time in 14 years, I experienced the joy of using the toilet at the halfway point as the need was there, though the desire to sit on it was not so much. Real donkeys have it so much easier. There was an inch of water on the floor, the seat was not attached and needed vigorous cleaning before any hope of use and I had to keep all the equipment off the ground to have any hope of cleanliness. However, the last 2 hours to the 11 pm arrival at the hospital was a lot more relaxing. Maybe I will take along a little step stool to keep the TP, Wipes and my clothing from touching the floor.
We have had a good surgical clinic and saw a number of patients we hope to operate on in the next week. My tiny cleft lip is growing nicely and will do it next month as mom has been worried since she brought it at 4 days for repair. Our first patient was a 13 yr old with a widely dislocated left elbow, we had him stop all oral intake and did him at the end in the OR so could put him to sleep. It certainly took a bit of pulling and manipulating by Dr. Moise and myself (with just the right timing by Miss Lisberthe who pitched in at the end and it popped gently back into place). One of Sam’s many jobs is to take everything out of the downstairs, beds, dressers, desks, etc so it will be ready for the construction crews coming in January to revise the 70 year old structure to make it more useful again and also allow the tile laying to begin in February unhindered. Pray for safety for the crews as they work together towards that end. Sam also has to sort through a container worth of supplies that were tossed into storage from 6 feet away, I know it was heavy but a bit of organization on their part would make a lot less double work today (but I suppose that accounts for job security).
Will send the update if it flies and correct the infectious information whenever I can access it. Thanks for your prayers and support of our service here for our Lord.
In His Service,
Bill and Sam