Back Where We Started

We are back where we started, on the SICU floor at HCMC in downtown Minneapolis.  Joel came here by ambulance yesterday afternoon and had a surgical procedure done by the ENT team at about 11 pm.  Dr. H went through his mouth to access the abscess (sounds like a song, "OK, everybody, access the abscess with me!") , remove all infection, irrigate the cavity, and insert a drain tube through Joel's nose to hold the incision open until the air pocket underneath can heal from the bottom up.

Saturday, when Joel felt even worse than Friday, my heart sank.  It sank even lower when he spiked a fever that evening, and when the home health nurse recommended an ER trip.  At midnight as I lay down, I decided to take Pete's advice and put something edifying in my mind.  "EM Bounds on Prayer" caught my eye and I opened to the first chapter - "Prayer and Faith."    Tears filled my eyes as I read that we should not fret if the Lord delays His answer, because He has a greater work that needs to happen first.  "Jacob had to be changed before Esau could be."

On Sunday morning before Pete took him in, I read the passage to them and we all agreed it was what we needed to hear.  The sermon by visiting pastor B also spoke to my heart:  "If your situation has changed dramatically for the worse, like the exiles in Babylon - get on with your lives."

I cried when making the announcement in church, and got plenty of hugs afterwards.   At 3 Pete informed me that the ambulance left Willmar to head to HCMC.   Today we have heard from at least four different teams of doctors, and I am glad to be here where I'm confident they won't let Joel go until this problem is solved.  Lord, may we patiently wait for Your greater work to be completed.

One Day at a Time, part 3

Joel didn't come home - again.  On Monday, his 21st birthday, the doctors voiced their concern over two low-grade fever and an elevated white blood cell count and ordered two tests, one for an intestinal tract infection and a swallow study.  Since the swallow study was delayed until Tuesday afternoon, his discharge didn't happen.  The first test was negative - good news! - but the only good news about the swallow study was that it wasn't in vain.  It involves swallowing barium, which Joel regurgitates every time.  We were all sure that it would show nothing, but unfortunately, it did show some kind of connection between the esophagus and this abscess area.  That began a flurry of activity, leading to a CT-scan-guided mini-operation to place a drain tube through Joel's neck into the abscess, in the hope of avoiding further surgery.  We stayed another night to support him through the ordeal, which involved him holding his head back for the hour of the procedure, and the MRI Wednesday morning to look for bone infection.  Thankfully there was no sign of that, though they will continue to treat Joel with strong antibiotics just in case.

On Tuesday night after the procedure, Pete asked Joel, "Do you feel anxious?"

"Yes," he replied.

"What are you anxious about?"  Pete probed.  Joel hesitated, unable to articulate exactly what concerned him.  So I rushed in, "He's worried about having another surgery.  It hurt SO bad, and took SO long to recover and then he was SO weakened and set back by it, and...he can't BEAR another surgery!" I was bawling and Joel was crying and Pete cried too.

My head and neck and shoulders were sore, my stomach was tense, and I had a very slight headache (I never have headaches).   This continued all day Wednesday; Pete gave me a massage and I took a bath that evening, which helped.  I was fretting and worrying about the possibility of surgery.  "Lord, PLEASE no surgery."  "Lord, he can't handle another surgery."  Etc.

On Thursday morning, the Lord graciously brought to mind the thoughts, "What good does worrying over this chance do?  He hasn't had another surgery; he is coping with the nausea and feeling rotten.  You have already let your requests be made known to Me - constantly.   Can you trust Me to be good?"  Pete confirmed the message on Friday when he called from the hospital and reported that Joel was feeling much better.  "Let's agree not to worry, OK?"  OK.

We are not immune to the temptations of this trial.  We continue to face situations that arouse anxiety, and can choose to listen to the demons of doubt or to the Holy Spirit.  We appreciate those who pray for us, and trust that we will grow in faith, love and obedience to the will of God.

You Never Know

When we returned Joel to Sister Kenny on Tuesday after a fairly successful, though overwhelming, trial run at home, his neck and throat hurt badly and they decided to keep him another day to give those muscles a chance to rest before another car trip.  Dr. O, the internal medicine doctor, informed us they would perform a "swallow evaluation" to figure out why he kept having trouble.  We visited friends to examine their accessible van and appreciated the chance to ready a few more things for Thursday's homecoming.  We continued to pray that if Joel wasn't ready to come home, the Lord would make that clear to the doctors and prevent it from happening.

On Wednesday, Joel called to tell us that they discovered a leak in his esophagus with a sac of infected fluid between it and the spine.  At about 9:30pm, he said he was scheduled to have surgery to take out the abscess - that night!  And he wouldn't be able to eat or drink for seven days while the esophagus healed itself.  I pressed the nurse to give my number to the surgeon so he could call me as soon as he was finished, and Joel and I agreed that I would come to be with him on Thursday.

At 4:30 am, Dr. D called and in a hearty voice informed me that the surgery was successful and that Dr G, the original neurosurgeon from HCMC, had come over and taken the plates and screws out of Joel's neck also.  "It's hard for infection to heal in the presence of hardware so we removed it."  Wow.

Thursday morning I called the nurse's station as I drove, and the Sister Kenny nurse explained, "Oh, he's not on our floor any more.  Just a minute, I'll get you his new room number."  What??  I called the ICU at Abbott Northwestern Heart Hospital, and his nurse, Molly reported that Joel was experiencing almost uncontrollable pain, probably from the hardware removal.   I asked how long he would be in the ICU, and whether he would return to Sister Kenny after that.  "Probably overnight, and no, up to the spine or neuro unit."  I started fretting about this and that, but had the presence of mind to turn on the Christian radio station.  As I sang praise songs, they helped soothe me and remind me of God's power and love.  Then a d.j. came on and told how he was praying for a motorcyclist in a coma at the hospital and received the inspiration to tell him who God was.  "Holy, holy, holy is the Lord God Almighty, Who was and is and is to come."  And the biker started jerking and the machines started beeping and the nurses came running and - he woke up!  I determined to remind Joel of who God is when I arrived.

Molly had the pain mostly under control with a morphine drip plus pump by the time I got there at 12:30pm; it was at a level 6 or 7 instead of 9 or 10 (on a scale of 1-10).  I held Joel's hands for an hour, then one hand for another hour while we listened to praise music on his iPod.   The pain had been "as bad as I've had ever in my life," but by the time I left at 7 pm, he felt fairly comfortable and much more at peace.  Remembering who the Lord is and how much He loves us solves some of our problems at the deepest level.

Dr. O stopped in and expressed his gratitude that the swallow evaluation caught the infection, and reiterated that this may have been the cause of numerous problems for Joel.  Dr. A agreed, and further explained how much easier it is to treat infections without metal nearby.  Apparently bacteria love to hide in the pits and grooves of titanium hardware.   Dr. O seemed to think that Joel could possibly return to Sister Kenny when he's a little stronger, to make sure he's still up to speed for coming home.

As I drove back home (thankful that I was on 35W South because 35W North was backed up for at least 3 miles), I reflected once more on the futility of worry.  I lacked something to give Joel when I started the day, but the Lord provided it through the radio station.  Wherever Joel goes after this, Jesus will walk with him, and with us.

What are We Worth?

Following Joel (in his wheelchair) down the hall at Sister Kenny last week, I met three other folks in wheelchairs as we made our way to the Therapy Gym.  In the waiting room, several patients with various levels of disability anticipated the arrival of their therapists to begin the session.  Most of them have greater capabilities than Joel at this point.  They strive to sit up, stand alone, or walk without a cane; he tries to roll himself over or stand with the help of two therapists.  But it struck me that all these levels of effort are worthwhile.  Most of us take our ability to work for granted, while at the same time scorning those whose lives are "unproductive."  We subtly devalue people, whether disabled, young, old or in certain jobs, who don't contribute things we find valuable.  And we definitely elevate people whose work benefits us.  Think rock stars or Bill Gates.

I've always believed in my head that each person, regardless of ability, is created by God in His image, redeemed by Christ on the cross, and infinitely valuable.  This situation is helping that belief to travel to my heart.  Joel's activities of eating, exercising, resting and recovering benefit himself primarily, but they also advance God's Kingdom by bringing order out of chaos and overcoming evil with good.  Perhaps some invalids can "only" pray; that advances God's Kingdom as well.  A few individuals might lie in a hospital bed in a coma, or unable even to pray (as Joel did for several weeks); Jesus died for each of them and loves each of them just as much as He loves President Obama or Pope Francis.  Their continued existence may thwart Satan's evil designs.  I believe:  Lord, help my unbelief!

Overwhelming Busyness

Just over two weeks have passed since I left Joel and his full therapy schedule at Sister Kenny to return home to motherhood of a big family.  Two weeks of homeschooling, household management, church music, and trying to restore organization seem like a blur.  I still want to enjoy reading a good book, as I did during lunch breaks and before bed while caring for Joel in the hospitals, but guilt plagues me because if I take the time to do so, tasks remain unfinished.  Coordinating trips to town ("Can anybody carpool today?"), meals for six ("Who's going to be home for lunch?  Supper?"), laundry, cleaning chores and educational needs takes a lot more energy, effort and time than scratching Joel's head, listening to his caregivers and medical personnel, and keeping a positive attitude.  Plus I don't sleep as many hours or get outside as much.

Reading the above paragraph makes me wonder why I'm not spending more time with the Lord.  It sounds like I need His strength more than ever!  But ironically, I seem to think I can get by with less prayer and Bible time, and skipping the "gratitude journal," because now I'm in familiar territory.  Also, I have much more human interaction with the kids and Pete, so quiet time is harder to come by.  No wonder I'm feeling burned out already, and lack energy and motivation.   Lord, forgive my pride and help me seek Your face, Your Spirit, Your wisdom and Your strength.

Musings about Money

I finally dug into the file for the health insurance Benefits Summary and discovered - we have no lifetime maximum!  "Unlimited benefits for each individual."  Thank You, Lord, and thank you Blue Cross Blue Shield!  I knew we had good insurance, but I still thought we might have a $1 million per person limit or some such.  Joel's bills will quite likely exceed that total, although BCBS might not pay that much; they negotiate down with Preferred Providers, sometimes as much as 50%.

A few weeks ago, an envelope came from Life Links, the Hutchinson helicopter provider that flew Joel to HCMC on the night of the accident.  The bill for almost $30,000 was accompanied by a notice that BCBS had "denied your claim because we are a Non-participating Provider.  They will pay you directly."  They included a whole page of instructions on possibly routes to take if BCBS did not pay us the full amount, and concluded with a reminder that "you are responsible for the full amount."  That caused a few nervous moments, along with questions - "How could they refuse to pay it?  It was an emergency; it wasn't like we had a choice to go with a Participating Provider!" - and gratitude that we actually do have the money to pay that bill if necessary.  But within a week, a check arrived from BCBS for the exact amount.  Once again - we have great insurance!

Because we have the top-of-the-line policy, we (and our employer) have paid a lot in premiums over the years - well over $1000/month since going to work for Gorans Bros.  But even if we've averaged $1000/month for our entire married life, that totals $300,000 - less than the bill for Joel's stay at HCMC, let alone Regency and now Sister Kenny.  As sister-in-law Tanya and I agreed the first week after Joel's accident (and before Steve's accident), that's why we have insurance.  But the ability of BCBS to pay these bills depends on a whole lot of people all paying more in premiums than they take out in claims in order to have enough money left over for Joel.  And to think of all the money that goes into caring for Joel, and that has gone into developing all the procedures and machines that are helping him recover, boggles our minds.  Our American health care system is serving us well, but there isn't enough money in the world for every person in this country to receive this much care.  Fortunately, most people never will need this much care.  It's easy to see the conundrum that we face, however:  how can we afford enough care for everyone?  

Goals, One Day at a Time

I'm home for the weekend, and I needed to be.  God used this time for Pete to see a breakthrough for Joel in terms of understanding what's going on.  Yesterday we asked for prayers for wisdom and discernment for Joel on when to "tough it out" and when to listen to his body saying, "That's enough."  Today his chest X-ray showed more clogged areas so the doctor put a PIC IV tube into his chest and started antibiotics.  This is a setback - another tube into his body instead of tubes being removed, as we had this week.

The doctor, nurse and respiratory therapist all agreed:  "If you don't do these breathing exercises, sit in the chair and generally move around more, you will keep getting pneumonia."  His lungs are more susceptible because he's had pneumonia recently.  I am praying that the antibiotics help him feel better immediately so he has more energy with which to tough it out.

I think I was getting comfortable in the hospital, with an idea of "I can do this" instead of the desperate crying out to the Lord which we need to continue until full recovery and wholeness returns to Joel and our family.  Now we will try "One Day at a Time" goal-setting; Pete did this with Joel today and he was motivated to reach the goals by accomplishing the tasks.

Thanks be to God for continued "Yes!" answers to prayers, and granting patience to wait through the "Not yet!" answers.

Pete Writes about his Surgery

I am so so thankful for good medicine and all that goes with that – nurses, doctors, facilities, knowledge – I am so thankful. Several times I have been shaken with the thought of having this accident happen in another place in the world or another time in history. I most certainly would be an invalid.

When I found out I could have a spinal block instead of general anesthesia, I took it in hopes that it would not have the same side effects of my past surgeries, when I could not wake up, had urinary issues, etc., etc. So when I got done with surgery and woke up, I was totally alert and very thankful. But when hours later I still had not gone to the bathroom and I started to feel nauseous and throwing up and the nurse could not get  the IV started and the pain blocker started to wear off the knee and the catheter was too big so the nurse had to pull it out and start over and my body itched all over (the anesthesiologist warned me that a side effect of the anesthesia would be itching in the chest. He was wrong about the chest - it itched like crazy in another place which I could not access because of the catheter).  .  .  And they made me stay overnight in the hospital; I was flirting with discouragement.

In a matter of minutes, several things happened. My wife delivered a signed softball from the Svea teams; my children were along for the visit; the nurse gave me anti-nausea medicine and adjusted my knee.  It is so ironic and telling and kingdom-revealing that out of the worst of circumstances comes the deepest of praises.

Mini-quiz:  Which foot belongs to the leg which received the surgery??

Health Care

We are having an unhealthy year!  Daniel broke his arm (a compound open fracture) in November, so had surgery on Thanksgiving Day and follow-up visits in January, February and March.  Pete discovered a blind spot in his eye and an examination revealed retinal bleeding.  In January he received the first shot in his eye; a drug has almost stopped the bleeding and the doctor thinks it will heal completely.  It may or may not stay healed.  You can imagine the cost of a visit to a retina specialist; Pete has been there 3 or 4 times now.  Sarah had an appendectomy on Palm Sunday.  I have been to the chiropractor 5-10 times recently for a "frozen shoulder" or possibly just inflammation - the treatment is the same.  Now I've started physical therapy.

This will cost us our $5500 deductible for last year and this year; it will cost our insurance company a lot more.  But think of the results - a healed arm, a healed eye, a removed appendix with very little "down time," and (Lord willing) a healed shoulder.  A hundred years ago Daniel would probably have a crooked arm; Pete would have a blind spot and maybe lose his sight completely in that eye; Sarah could have died when her appendix ruptured; and I would have a painful shoulder for who-knows-how-long.

We complain a lot about the high and rising cost of health care.  But consider what we get!  If we choose to do all this stuff to make our lives longer, healthier or pain-free, shouldn't we expect to pay for it?  Remember the tragic story of the woman who had spent her life savings on doctors trying to heal her hemorrhaging?  Turned out not to be a tragic story, because Jesus healed her for free.  But the pathos of the initial introduction is not because she spent her life savings but because it didn't work.  If she had spent her life savings and gotten well, it would have been worth it to her.

I don't know when we'll (as a nation) run out of money to spend on health care.  I don't know if it's right for us to have treatments for retinal bleeding and frozen shoulders when children across the globe die for lack of a simple antibiotic.  But I do know that I'm not going to complain about the money aspect of health care, because it's worth every penny.

An Unexpected Appendectomy

Last Saturday Sarah had stomach pain all day; when we finally called the insurance nurse help line at 5pm, the nurse advised us to bring her in within three hours. At the emergency room in Olivia, I sat with Sarah (a much more comfortable Sarah with an IV for hydration and pain medication) until 11pm, when they performed a CT scan on her abdomen and discovered that her appendix was, indeed, infected and needed to be removed. In the meantime, I posted on Facebook and emailed the families asking for prayer. Pete had attended the Svea Wild Game Feed where Dad Stadem gave the message, but by midnight (after erroneously going to the Willmar emergency room) he arrived and I went home to get some sleep before the Palm Sunday service.

Dad Norling called just after I woke up, and wondered how everything was. When I called Pete, he said Sarah was walking around and would be home that day. Dr. Maland performed the surgery laparoscopically, so she has only three fingernail-size incisions.

After Sunday School Opening Exercises, I prepared the praise team stage and recruited Julie Gatewood to substitute for Sarah as a singer. While playing the prelude, I looked up and saw Pete enter our pew! He'd brought Sarah home and she felt good, so he came on to worship.

Praise God for great medical care. We shouldn't be surprised if we have to pay a good portion of our incomes, considering the almost endless list of procedures that improve our lives and health.

Successful Surgery

Dr. Lister feels confident that everything was put back the way it should be in Daniel's forearm. He did find bone in the skin, so it was good that they did the surgery on Thursday instead of waiting. Daniel's on an antibiotic now for a couple of weeks. He's been very lethargic since Sunday evening, and I thought it was a side effect of the drug, but now he's getting better and coughing a little, so it was probably a virus that he caught in Sioux Falls. He came with us but didn't participate in the wonderful Compline service that the Stadem clan led at St. John Lutheran (the Stadem grandparents' church).

We were also concerned because he couldn't bend his thumb or feel part of it, but that is improving as well and the orthopedist said it's normal. So altogether a successful post-op appointment and a good report.

I was very impressed with the emergency room people Wednesday night - their calm cheerfulness and patience. And I was even more impressed with the gracious responses of the surgery crew on Thanksgiving Day - you would think they had nowhere else to go, but most of them were on their way to family gatherings after Daniel's surgery. They were kind, cheerful and competent. Although Daniel had the reaction to anesthesia we've come to expect from certain members of our family - it took over eight hours for him to feel well enough to come home - it was altogether a good experience. Hats off to Rice Hospital!

Giving Thanks (in all circumstances), part 2

We had just returned home from a lovely church service, pie and fellowship aftewards, and an excellent health report from a family friend, when Pete's phone rang and Joel announced, "Daniel broke his arm!" Apparently he'd been swinging from the ceiling at First Covenant Church and went too far, almost horizontal, so when he dropped and put his arm out to break his fall, it did and it broke. We agreed to meet them at the emergency room and when we got there Rocky, the youth group leader, and several friends who had been at the church were there. We went through into the room where Daniel lay, his arm taped to a board and looking odd. He was in a lot of pain - kept gritting his teeth and swallowing hard. The nurses had just finished taking X-rays and were putting pain medications into him through an I-V.

Over the next two hours we waited, the pain lessened as the meds started to work, Dr. Hussein (the ER doctor) informed us that both bones had broken into pieces, requiring surgery, and that Dr. Lister was willing to do it on Friday morning. Pete felt uneasy and asked why wait? Dr. H. explained that everyone should enjoy their holiday. He went on, "Of course, if it had been an open fracture, where the bone went through the skin, it would have to be done right away." I said, "It's bleeding." After he checked it further, he determined that it was an open fracture (had gone through the skin), so we couldn't wait until Friday but needed to have surgery as soon as possible to reduce the risk of a bone infection .

Dr. Hussein proceeded to "reduce" Daniel's arm - straighten it out by shaking his hand and pulling the bones into place as best he could. Oh, that hurt - Daniel was very brave, and only grunted. They had given him a much stronger medication in advance of this. The team wrapped the arm in various bandages, then put a temporary cast in place and held the arm bent and across Daniel's chest while it hardened.

Now the doctor mentioned that because of the complexity of this surgery, we might want to consider an orthopedic traumatologist instead of the orthopedic surgeon. After talking with Dr. Mark and with Dr. Lister himself, Pete came in and we decided that if St. Cloud had a traumatologist, we would go there, because that type of specialist would have more experience with this particular problem, though it sounded like Dr. Lister would be perfectly competent. Obviously, going to St. Cloud would be a much bigger hassle, and who knows for how long or how many follow-up appointments and therapy and such? We prayed that if Dr. Lister could do the job, it wouldn't work out to go to St. Cloud. Eventually, we found out that there are no traumatologists there, so we decided to stay here.

I'm currently in the surgery waiting area while Daniel undergoes the hours-long procedure. Pastor Mary's sermon last night was about the ten lepers, and how, although God was at work in all of their lives, only one saw it and gave thanks. She challenged us to look at our lives in terms of how the Lord is working. Here are the ways I see Him having worked in this event:

1. This is the best day of the whole year to sit in the hospital. We have no commitments; the family gathering isn't until Saturday; a guest we had invited for today wasn't able to make it; I had already planned to cancel school because Michelle & David are home.

2. Dr. Hussein said what he did about the open fracture, and I thought to say what I did about the bleeding; otherwise, it's possible we'd have dealt with a bone infection.

3. We didn't go to St. Cloud, and I believe God guided that decision.

4. We prayed with the kids before leaving home, and have called people to pray.

5. Daniel landed on his arm and broke it, not on his back and broke it.

I pray that Daniel will be able to see what the Lord is doing in his life during these next weeks of recovery, and to give thanks even in these circumstances.