Questions - Day 153

We have more questions than answers re:  Jim's health care after three hospital stays and two surgeries.

Jim was released from UIHC at 4:45 p.m. Monday, Oct. 5, after a five-day stay for internal bleeding / bleeding ulcer.

In my readings,  I have found an ulcer is a hole generally in the stomach or small intestine, but can be anywhere in the gastrointestinal tract.  Jim's ulcer formed at the juncture of the esophagus (1-2 inches) and stomach, where he had his esohagectomy May 12.

His thoracic surgeon, Dr. Parekh, says the tissue is still new and fresh and not healed,  leaving it more susceptible to problems. His primary care physician, Dr. Butler, whom Jim saw Oct. 8,  says it's been 5 months ... it should be healed!

In our visit with Dr. Butler, he made these comments:
**Coumadin does not cause dizziness
**Coumadin does not cause bleeding. It can cause you to bleed more, but not to start
**You can have reflux from stomach back up even if you do not have heartburn, therefore, you should be on pantoprazole.
**An acid blocker could heal the ulcer
**Some other medicine Jim is on causes the dizziness, such as Flomax or Benedryl.

Our unanswered questions:
**Why did Jimmy have dizziness when on Coumadin (June - September), but since being off of it (Oct. 1), there is none?
**Why is dizziness listed as a side effect of taking coumadin if that is not so?
**Why has it been said coumadin can cause low blood pressure which can result in dizziness?
**Why hasn't the tissue area healed where the esophagus and stomach were sutured?
**Why is he on Pepcid, an acid blocker?
**Why is there no clear cut direction from more than one doctor re: pantoprazole?
**How do you know the ulcer is a result of acid ... is it not possible it is because of bacteria?
**What would an endoscopial ultrasound show? He had one in March before the cancer surgery.  He has had two endoscopies since Oct. 1. He is supposed to have an CATscan - is it not possible this would show ulcers or healing process?
**How do you determine normal readings for hemoglobin?  We've been told 10 is normal for Jim, yet before the May 12 surgery it was 13.5. After 2 pints of blood were given between Oct. 1-5, it remained stable at 8.8. The lowest reading was 6.8. Dr. Butler says 8.8 is still low, 10 is low.

On Oct. 8 visit with Butler, Jim's BP was 90/42, which is normal for him. Weight with clothes on was 133 pounds. No scale is the same.

The next appointment coming up is Oct. 23 when Jim sees a cardiologist for a second opinion at UIHC.


My writings:

Questions
So many
agreement
between
doctors
missing
Answers
not found
We listen
We read
Nothing consistent
What one says
is fact
another says
is not
Who are we
to believe?

Our minds
in a
quandry
confusion
and frustration
take hold
We are obsessed
with knowing
what is
true and correct

I remember
The Lord
said
He would be with us
He would bring us through it
He would guide us
not just part of the way
but every step
That means
even through
the complications
and in retrospect,
not just through Jim's cancer
and the various side effects
but even my own
health issues

No more
We have too much
Take it away
Take it away Lord
Yet God says
in His word
He will not give us more than we can handle
What does He know
What does He see

He is wirh us
He guides us
If we are close
closer to Him
We will hear
in the stillness
His Holy Spirit

The answers
we seek
we find
in the solace
of our Lord Jesus

He hears our prayers
He knows our concerns
He answers
but are we listening
did we hear His response
or are we unsure

Doctors do not agree
have not agreed
say this and that
and another

Jim has been off
the coumadin
12 days
There is no dizziness

Is this God's answer?

Coming Home - Day 146

One of us had a good night's sleep - and that would be me. Slept 6 1/2 hours through.

Of course that means Jim didn't have a good night's sleep, unless you count the time between 11 p.m. and 2 a.m. His roommate's IV started beeping at 2, and it took 20 minutes for anyone to come in and stop it. Then at 4, his nurse came in to get Jim's BP, which was 80/40. Decided that was too low, so they tried the other arm. Then they hooked him up to an IV, probably with salt in it to boost the numbers. IV was in for an hour, then it beeped. Then labs done. By that time it was 6 a.m.

But there was good news with the morning ....

**Hemoglobin remains normal at 8.8.

**He could have a full regular diet, starting with breakfast.

**He could cancel Oct. 23 2nd opinion appointment with cardiologist -- he would not resume taking Warfarin / Coumadin - and report would be (hopefully) sent to local cardiologist Dr. Li

**He  could come home early afternoon.

A few things on this list didn't quite happen as well as hoped.

One, we really need to keep the Oct. 23 appointment with UI cardiology, and
Two, early afternoon became early evening - we left UIHC at 4:45 p.m.

Differing opinions between doctors

We have heard a differing of opinions again between doctors. Can't seem to get everybody on the same page. So who do we listen to?

**One doctor said Jim should be off Coumadin, he should cancel the second opinion appointment with UI Cardiology.

**Zachary Smith, the gastro-intestinal doctor who has been treating him these past few days, said he is to be off aspirin and Coumadin until his appointment with his primary care physician (Dr. Todd Butler, Oct. 8), who is to make the determining decision.

Dr. Smith believed Jim should be on a blood thinner because of stroke in 2012 and because of being in Afib. He is under the mistaken belief that Jim has had multiple strokes, when he has had only one mini stroke.

He also thought Jim should be on omeprazole or pantoprazole because of acid reflux.

**Dr. Parekh, the surgeon, weighed in with his opinion.
I had called Joan, the thoracic coordinator, soon after visiting with Dr. Smith and asked her a couple of questions to speak to Dr. Parekh about:

1. What caused the ulcer? How did it form?
2. Why would omeprazole be prescribed when the cancer surgery did away with the need for it?

His answers --
The ulcer formed where it did - at the juncture of  the reattached esophagus and stomach (esophagectomy) - because the tissue is still new (4+ months), fresh and healing. The bleeding was brought on by the Coumadin. Symptoms from the loss of blood (which could have been revealing itself for some time since Jim has complained of dizziness for months) reared its head big time on Wednesday, Sept. 30, when shortness of breath, extreme dizziness, extreme tiredness and weaknesss and black stools were evident.

Dr. Parekh  reiterated what he indicated at the one-month clinic visit on July 1 - with the esophagectomy, there should be no heartburn or acid reflux problems. Taking omeprazole or pantoprazole will not change anything.

We are inclined to go along with his thinking. Why be prescribed medicine for a problem that was corrected in May? Jim did have acid reflux and Barrett's Esophagus, but he doesn't anymore.
He was put on Coumadin because he acquired Afib as a result of the May 12 surgery. By June 11, when he had the second surgery, Afib was no longer a problem, yet ....  Coumadin remains a problem.

The GI doctors want another endoscopy performed to see how the ulcer is healing.
When Jim has his 3-month check-up with Dr. Parekh, he also will need a CATscan.

Stable - Day 145

Jim called at 7:15 to wake me from an unrestful sleep. His BP was normal. Blood was drawn for the hemoglobin, but results weren't known until 8:50 a.m., when he called again. It is 8.5 - still good. It would appear the bleeding has been stopped. The doctors were in. He may be able to eat regular food - he is eager to have breakfast. Said apple juice just doesn't do much for his appetite... lol.

It's shortly after noon now - still on liquid diet. Didn't have anything for breakfast because nothing appealed to him. Did take a shower, and had some shortness of breath, which could be attributed to the fact he didn't haven't anything in his tummy. He'll order chicken broth for lunch. 

Up and down - Day 144

Jim called at 7:30 a.m. His phone kept cutting out, so we didn't have a very clear connection. He called 3 times to finish one call.

He said another blood draw was taken a couple hours after the transfusion was complete - that must have been around midnight. At that time it was 9.2. But when it was checked again a few hours later, it was back down to 7.  Based on those readings, there is internal bleeding somewhere - we need to figure out where and stop it.

He is waiting for doctors to come in.

My thoughts:

Do not do
the natural thing
Do not
let your feelings
define you

Trust in the Lord
He who will lift you up
up above
the difficulties
you fight to conquer

Be thankful
for what you have
for where you are

Follow His lead
Do not run ahead
He gives us
what we can handle - not more,
although we tend to disagree,
- and not less
He knows what we can do
with His guidance

It is His guidance
we need to rely on,
not our own
We will falter
every time
if we look
to ourselves
for the answer

"His blood will purify our consciences from useless rituals, so that we serve the living God." ~ Hebrews 9:14b

Is it perhaps uselessness
on our part
when we do
what we think we must

Perhaps God is trying to show us
something different
and we just don't see it

He gives us rest
He instructs us to rest

We think we have no time
We have much to accomplish

So He brings about
a situation

God wants us to recuperate
to rest
to look to Him
and not everywhere else

He gives us opportunities
to serve,
but not to go overboard

Look to Him
Seek Him
with your questions
and wait for His answers

Don't fall down
and fail to look up!
(c) Cathy Orrick Luders


It's 10 a.m. and Jim called. Hemoglobin just checked again and is now 8.8. A good sign. He is to be moved to a regular room and have something to eat. Hemoglobin will continue to be checked throughout the day. If it is stable, we are moving in the right direction.

1:05 p.m. - Jim has been moved to a regular room - he is on the 6th floor - Room 6058 - Bed 1. Phone number is (319) 353-9711. If you visit, take Elevator D.

Jim called at 4:15 p.m. He was having jello and lemon ice, which made him cold, so he had more blankets piled on. He's planning on having chicken broth for supper. He said the doctors want to see how he tolerates food - liquid, soft and regular diet, and of course, he has to have a regular bowel movement. There have been no further checks of hemoglobin throughout the day because there are no signs indicating it necessary. He has had no shortness of breath and for the first time since forever, was able to stand without dizziness.  He said they may do a hemoglobin re-check yet today or tomorrow and they may do another scope.  It appears the bleeding was a result of the ulcer and nowhere else. The doctors are looking at a likely Monday release date. Hallalujah!

I made it down to see him by 7:40 p.m. It was a busy day workwise and after work, had lots of calls on the landline and the cell phone from folks who wanted to know how things were going. His BP was checked shortly after 8 and it was 106/57. He continues to be able to get up without dizziness. The hemoglobin will be rechecked in the morning. He is looking forward to going home on Monday. Pray that is God's plan as well as ours.

Waiting Game - Day 143

Jim didn't sleep well. He couldn't receive anything to help him sleep, had a headache (was given a Tylenol suppository for that) and numerous folk coming in and out throughout the early morning hours.  He called me at 7. Of course I didn't sleep well either. Took 2 hours to update yesterday's blog post and then when I went to bed, woke intermittently. Even in sleep, we do better together.

His hemoglobin continues to go up. His blood pressure was down some - 88/40. Doctors came and went and discussed the endoscopy, but no exact time was given for the procedure to move forward.

At one point I called the unit and asked if the procedure was underway, but the unit clerk I talked with, wasn't very helpful. He couldn't answer my question, couldn't find a nurse and couldn't patch me through to Jim. Geeze!

At 11:15 a.m., Jim called. Procedure remains yet to happen.

At 2:05 p.m., Jim called again. If it wasn't for him calling me, I do believe I would know nothing. He had the procedure - around noon or therafter.  He was groggy. I called back to the unit desk and talked to a nurse (not his though), who said another endoscopy followed right after Jim's. She assured me the doctor would call me when they were done with the second patient.

The ICU Fellow (I have no clue as to what his name is, other than I can't pronounce it), who did the procedure, called at 2:30 p.m. He said the ulcer is not currently active, but it may rebleed. To help prevent rebleeding, they put 2 clips in. Jim will stay in the MICU today and possibly tomorrow - he will be monitored for signs of possible rebleeding - the symtoms he had earlier - low hemoglobin, black stool. Also will monitor his blood pressure. If he remains stable, he may be able to return home early part of next week. If his hemoglobin drops again, another endoscopy will be done and go from there.

We request prayers for the hemoglobin to continue to increase and no black stool or any other telltale sign of rebleeding going on. We pray there will be no more complications, that Jim be on the mend toward complete healing, strengthened in body and soul.

At 3:30 p.m., nurse practitioner Dana Fowler called and gave me more complete information re: the procedure. She said the doctor clamped the blood vessel with 2 clips to prevent the ulcer from rebleeding. Jim will be watched for 48 hours, will remain in MICU today, and probably will be moved out on Saturday. His hemoglobin at last check was 8.2 and normal for Jim is 10. She said he was doing well. The hemoglobin will be checked again at 4 p.m.

Learned at 5:15 p.m. Jim's hemoglobin had dropped to 6. He will be given another unit of blood and have hemoglobin redrawn. They are not sure the 6.0 figure is correct. If the second draw still shows low, it is possible he will go to interventional radiology to determine where else the bleed may be. When talking to his sister the nurse, she thought perhaps the scope didn't show enough detail.

I arrived at Jim's bedside at 6:45 p.m. He had just started receiving another pint (unit) of blood - it takes 3 hours, so around 10 (which is what it is now that I'm back home), the transfusion should be completed. Two different labs were actually taken of his hemoglobin around 6 p.m. - one was 6.8 and the other, 7.1. Lower than the 8.2 taken earlier, but certainly not as low as the 6.0 taken at 4 p.m. Around 11 p.m., his hemoglobin will be checked again. Jim called at 10:30 p.m. to tell me the hemoglobin was checked a little while ago in a different vein and numbers remain low - at 6.8. It should have been up, given he had just received new blood. Doctor was in, suggesting Jim may need more units of blood. Hemoglobin will be checked again at 4 a.m. Saturday, if not sooner. If still low or lower, he will be heading to interventional radiology to see where another bleed may be.

It would be good if there is no new bleed and that hemoglobin numbers go up and stay up. He may be able to start a liquid diet on Saturday. His blood pressure has remained stable, in the 90s.

I lucked out with free parking in the ramp tonight. The ATM was down and since I didn't have $3 in cash to pay, I got free parking. How nice.

On the Hilltop / In the Valley - Day 142

After our weekend in Northeast Missouri, Jim returned to Wilton Baptist Sept. 20. He is going through the book of I Peter. His message was "Be All That You Can be" from I Peter 1: 10-16.

On Tuesday, Sept. 22, Jim visited his lone hospice client in Central City, and the following night, took grandson Austin to Awana / Cubbies while we went to Bible Study / prayer.

Friday, Sept. 25, dizziness and lightheadedness were still a constant, although he did mow the back and front yard, with rest and lunch inbetween.

Sunday, Sept. 27, Jim's message to the fine folk of Wilton Baptist was "The Precious Blood of Christ" from 1 Peter 1: 17-25. A business meeting was held following the service and among items discussed / considered was asking Jim to be interim.

Monday and Tuesday, Sept. 28-29, were days off for me and busy for both of us. On the 28th, a hot, sunny day, we drove to Central City so Jim could visit with his hospice client and I could take his wife to a doctor's appointment in Marion. Later in the day we picked up the Cooks - Christina, Austin and James - Austin played for awhile at the playground at Noelridge Park and then all of us went to the Farmers Market. We came away with a huge head of cabbage, zucchini, white sweet corn, plus Christina bought six pumpkins. On the 29th, it was rainy and much cooler. Jim complained of his legs feeling weak, but thought perhaps it was just the weather. We drove up to Waterloo to visit Paulette Titus and get some tomatoes, red and green delicious apples, a hubbard squash and a few peppers - mostly for us, but also to share with the Cooks. We also had a good visit with Jim's aunt Effie. We stopped at Family Christian and Jim purchased a NKJV that he thought he would preach from at WBC.  Then he drove home. He was only normal tired. And we saw the movie "War Room" too.

On Wednesday, Sept. 30, everything changed. Jim complained of shortness of breath. Just getting up from a sitting position, he was worn out. His dizziness was more extreme, as was his weakness and tiredness. He commented he had black stools. (He said they started on Monday; he was telling me about them today.) He was cold, so we turned the furnace on in the afternoon. I didn't go into the office, deciding it was better to work from home. We thought it was a 24-hour bug. He slept throughout the afternoon. We went to Awana that night, taking Austin. Many commented Jim looked pale. Pastor Dan annointed us with oil and prayed for both of us. When we got home, we took his blood pressure, which was normal. His pulse was high, just below 100. We thought perhaps he was in AFIB.

Today, Thursday, Oct. 1 - we got up at 6 a.m., decided we would go to the ER at St. Luke's Hospital.
We got there around 7:15 a.m. Did labs, an EKG - he was not in AFIB. After the doctor heard all the symtoms - the black stool was apparently a telltale sign - it appeared he had a bleed and it was thought to probably be an ulcer. His hemoglobin (red cell count) was low - 7.5 and that had dropped 3 points just in a short time. The need for a blood transfusion was a definite posibility. He had lost weight - with clothes, 128.5 pounds. The doctor said he would discontinue taking warfarin/coumadin as that puts him at high risk for bleeding.

I left to go home shortly after 9 a.m., since I had to work. When I next talked to Jim, it was almost 11 a.m. He was on fifth floor in the Critical Care Unit and was getting plasma. I learned from Jim's sister, Dianne, the RN, that plasma reverses the INR, which has to do with coumadin. (Later, after he was admitted to UIHC, I was told his INR had been 3.9.)

After receiving the plasma, Jim received a pint of B- blood (we have the same blood type) and then the endoscopy was done right in his room at St. Luke's. The nurse called at 12:30 p.m. and I talked to the surgeon. He said there was a big ulcer at the juncture of the stomach and esophagus where he had had the cancer surgery in May. It was currently not bleeding. He said the ulcer was not a result of the May surgery, but a complication, and he prefers to refer Jim to UIHC and Dr. Parekh, the doctor who performed the original surgery.

At 2:50 p.m., Jim was transferred to UIHC via ambulance. He arrived around 4 p.m.and by 4:25 p.m. was situated on the Medical ICU unit, 5th Floor East, Bed 5. The MICU does not have room numbers, but bed numbers. This location is only temporary. But for now, if you want to talk to him, call (319) 356-3441 and ask for him or Bed 5. It is a private room with a view (but not of Kinnick Stadium)!

I arrived shortly after 6 p.m. Jim will have another endoscopy in the morning to see what the ulcer is doing, to determine further steps. It is possible nothing will be done and they'll let the ulcer heal on its own. Jim's hemoglobin is up - from 7.5 to 7.7, a good sign, although still low. I learned his weight (with just a gown on) is even lower - 125 pounds! It took him so long to add weight, and how he's lost 8 more pounds. He is to have his hemoglobin checked again at midnight.

Tomorrow I believe Jim also will talk to a cardiologist about staying off of the warfarin. He was to have a second opinion visit Oct. 23.

It is also possible Jim may be released on Saturday. But I'm not going to hold my breath there. We've heard that line before.

I will be working again tomorrow from home so it will be evening before I will get up or down to see him. I'll update blog, Facebook or send an email as I'm able.

I've made countless calls today, and had many return them. Pastor Dan came by this morning and called late this afternoon. We are being prayed for all over the country, including in Tanzania. We appreciate the sentiments that God heal Jim without surgery. We appreciate every prayer lifted up on his and our behalf. I read to Jim an email received from Lorraine Kappmeyer - the line we aim to try and remember is "Every setback is a setup for a comeback!" God has this covered. We should never forget.

Onward we go - Day 130

As Jim gets better (still has occasional dizziness and gaining weight is a very slow process), I have gone the opposite direction, trying to get out from under so much that is keeping me feeling rather poorly.

We enjoy the time God has allowed us to be at Wilton Baptist Church. We don't know how long that will continue, being the congregation does have need of full-time pastoral leadership.  During September Jim has preached there the 6th and will again the 20th. He is hopeful for following weeks as well as he already has sermon ideas. We plan to visit some of the folks in the hospital or recuperating at home in coming weeks.

In thinking of all the places where we have served and of all the events of this past year, I jotted down this prayer request -- "To be sent wherever God leads. To be used wherever needed. To recognize needs. To be open to staying places and filling roles for however long the Lord desires. To have those who desire our aid to be open, not hiding, not pretending, not being false or fake."

Jim was rather listless over Labor Day weekend. He has watched the Jerry Lewis Muscular Dystrophy Telethon for years - last year it was on TV only 3 hours and this year, not at all.  He didn't quite know what to do with himself. On Monday, Sept. 7, he remembered a DVD he put together last year from episodes that were on youtube.com and watched it.

AWANA at Immanuel began Wednesday, Sept. 2 - we started coming Sept. 9, bringing grandson Austin to participate in Cubbies, the preschool class, to learn about Jesus. I go in to work earlier and get off by 5:30 so we can all get to church on time and have supper too.

We took our second mini-trip to Northeast Missouri (LaGrange and Hannibal) Sept. 12-14, and it was enjoyable as always. We stopped at HLG and visited with Jim's friend, Ray Carty, who is vice president of something (LOL). He gave us a personal tour of the new science building that opened the end of August. We bought gas in Hannibal for $1.99, a huge decrease from the $2.29 we paid in Cedar Rapids before heading south.

On Tuesday, Sept. 15, Jim got a flu shot at HyVee Drug Town, and it apparently made him very tired, as he slept much of the afternoon, and we both went to bed early that night.

On Thursday, Sept. 17, Jim and I and Christina and our grandsons, Austin and James, went to Waterloo to attend the Cattle Congress fair. We weren't sure how the day was going to end up, being it was raining in Waterloo in the morning, then raining here and still raining when we headed north at noon. Fortunately, the rains stopped and the skies remained dry, although a little cloudy, the rest of the day and into early evening. We saw lots and did lots of things, everybody (except James) got in lots of walking ... and Jim has more stamina ... and I think Austin had fun. I'll include some photos at the end of this post.

Today is Saturday, Sept. 19. A nice sunny day, a bit on the cool side, but considerably better than Friday's downpour. This morning Jim and Rocky worked for an hour or two on cleaning the garage -it's a vast improvement.  Jim printed off his sermon - 11 pages - guess God gave him much to talk about!  His message for Sunday is "Be All You Can Be" and Scripture is I Peter 1:10-16.

 Upcoming appointments: 

• Friday, Oct. 23 - 3 p.m., Jim meets with Dr. Bailin, a cardiologist at UIHC, for a second opinion re: use of coumadin for surgery-related afib.

• Tuesday, Oct. 27 - 10:30 a.m., Jim has colonoscopy with Dr. Gerke at UIHC

• Friday, Oct. 30 - 9:30 a.m., Cathy meets with Dr. Gerke re: digestive issues begun Aug. 5

Photos taken at Cattle Congress in Waterloo: 

Improvements continue - Day 115

How the days fly by ... 115 days now since Jim's cancer surgery.  He is getting stronger and he does not have as many dizzy spells.  Perhaps the Coumadin is more agreeable to his system  -  he has been taking it for nearly 4 months.  But of course he still has the lower than normal blood pressure.  We have not yet heard  from UIHC re: seeing a cardiologist there for a second opinion.

Tuesday, Sept. 1, was a tiring day  -  probably all those pain pills he took following oral surgery  -  so he slept, and when he wasn't sleeping,  he worked on his sermon.

Wednesday, Sept. 2, was the first night for Awana at church and they were offering a group for grandson Austin's age group  -  Cubbies.  We were hoping to take him, however, a few things prevented that ....

One, my sister, Helen's mother-in-law, Lorraine Snell, passed away on Sunday, and we decided to go to the visitation Wednesday after I got off work.

Two,  I had a sore on my right hip area that opened during the day.  So after visitation, we went to Urgent Care in Marion.  The doctor diagnosed it as a yeast infection, possibly a result of the antibiotics I have been on since Aug. 27 (for digestive issues) and the heat.  I have a cream to use twice a day.  After the first day, I noticed improvement.  But just because it is better doesn't mean I'm to stop taking it.  (On a side note, re: the digestive concerns, my primary doctor is working on getting me an appointment with Dr. Gerke,  the gastroenterologist at UIHC.)

Jim was really feeling better on Wednesday  -  he made meatloaf, mashed potatoes and veggies and homemade rolls (partially using the bread machine) for supper that night.

Jim will be preaching this Sunday at Wilton Baptist.  He has prepared a Labor Day message, "Laborers for Christ,"  taken from Ecclesiastes 5:18-20  and I Corinthians 3:8-10.  Communion will follow.

We are planning a 3-day trip to Northeast Missouri Sept. 12-14,  but  it may have to be postponed. We'll find out on Thursday, Sept. 10.  A co-worker's mother-in-law is having a procedure done in Indiana that day to shock her heart back into rhythm.  She has a heart condition and also cancer, and the cardiologist apparently won't allow the surgeon to operate until her heart is stable.

Prayers for that situation and for Jim and of course, probably me too, are very much appreciated.

God is good all the time -- Days 110-111

Sunday, Aug. 30, was Day 110.  We had a good night's sleep, most beneficial, especially when it is a day you are to deliver God's message to His children.  We hadn't been at Wilton Baptist since March 15, but were finally able to return today.  It was such a blessing for us and for them to see each other after such a long absence.  These are among the many who prayed for us, sent cards and visited while Jim was in the hospital.

Jim's message, from Hebrews 10:19-39, was "Are you a FAT Christian?" - FAT stands for Faithful,  Available and Teachable.

His sore throat, a result of summertime allergies, remained with him, although as he continued preaching, his voice got stronger.

A potluck was held after the service.  Such a tasty meal.  Afterward we were both ready for naps, but only one of us had the opportunity.  I drove back home and Jim, tired from preaching and eating, slept from Tipton to Cedar Rapids.

We are returning next Sunday, Sept. 6.  Jim is planning a Labor Day message, plus we will have communion.

Wilton reminds us of Immanuel, especially its friendliness.

Today is Monday, Aug. 31 - Day 111. Jim has oral surgery this afternoon to remove a molar, after complaining of left jaw pain on May 26.   His dentist said his left lower molar was internally dying and needed to be pulled.  It is good the pain of the first few days decreased and there has been no pain for months. The pain came after the tooth was pulled. From about 3:30 to 10 p.m., there was bleeding. He used gauze and moist tea bags to try to get it to stop and at one point, called the dentist, who said if things were not better in the morning, to come in and they'd have a look. He took hydrocodone Acetaminophen for pain.

Dr. Butler's office called. Jim's INR (blood drawn Saturday morning) level is 2.6. He is to continue on the Coumadin for 4 weeks, then have blood drawn again.

God is good, so good, all the time, even during those times we fail to see His goodness. 

Updates: Days 96 - 109

Sunday, Aug. 16, was Day 96.  Jim preached at First Federated Church in Lisbon for the third week in a row. Then we were told someone else would be coming Aug. 23 and it was unknown about Aug. 30. When we received a call from the church in July and again after the first service on Aug. 2 when we met with the pulpit committee, we were only told to let them know if we could not come.

Don't know what that is/was all about, but of course God does. Have to let Him control the reins and lead us in the way He would have us go.

So we called Ron at Wilton Baptist. Jim has preached there before, off and on, since last fall, and had called Ron in July letting him know he would be available to preach by August. Ron had called earlier in August asking, but by then, we were committed to First Federated. So we called him back, since we had August dates open. We were invited to come Aug. 30.

Thursday, Aug. 20, was Day 100.   Today was a day of rest. Jim went to the pet store and got dizzy just getting out of the car. He spent most of the afternoon sleeping.

Wednesday, Aug. 26, was Day 106.  Jim worked in earnest on his sermon for this coming Sunday. His message will be "Are you a FAT Christian?" FAT stands for Faithful, Available and Teachable. Scripture is from Hebrews 10:19-39.

Thursday, Aug. 27, was Day 107.  Jim had an early morning appointment with his cardiologist, Dr. Li, at PCI. His blood pressure was 80/46 and his weight, 132.3 pounds. His weight seems to fluctuate within a pound every time he sees any doctor. Who knows what his real weight is. Also had an EKG. He told Dr. Li he wanted to get off Warfarin/Coumadin. Her recommended alternatives to being off the blood thinner was to monitor blood pressure and pulse rate daily.

Side effects Jim has from taking the Warfarin/Coumadin are dizziness and lower blood pressure. Dr. Li said it is rare for Coumadin to lower BP. She suggested drinking more water (60 ounces verses the 24 ounces he currently drinks - and that is more than he has ever drank!) or gatorade and increasing salt intake would help to raise his BP.  She said the dizziness could possibly be prevented if he moved his legs up and down before walking.

We both believe the Coumadin is the primary cause of these problems. He didn't have dizziness before taking it and his blood pressure was usually in the 90s to 100s, never as low as 80 or less.

Dr. Li said we could get a second opinion. Jim told her no, it wasn't necessary, but when we talked later, he said he was going to looking into it down at UIHC in Iowa City. We are currently waiting for a return call on a referral.

Thursday evening, after I got off work, we had dinner with a friend, Joan. Jim took care of her husband, Bill, more than 8 years ago when he worked for St. Luke's Home Care / Hospice. It was a very enjoyable evening.

Saturday, Aug. 29, was Day 109.  This morning when Jim woke up he complained of a sore throat. His voice has been deeper in the last couple days and apparently his throat was somewhat sore during the week, but this morning it was more bothersome. At first we thought he had developed a cold. But then I remembered his allergies were not just seasonal, but also mold and mildew (which is present indoors and outdoors) and we have been around mold much of this week.

Since he had to go to MedLabs to have blood drawn  (he has to stop Coumadin today because he's having oral surgery on Monday), I suggested he also stop at Urgent Care in Hiawatha. The result of that visit indicated he didn't have a cold or strep throat, but allergies. Allergies that cause sore throats, as mold and mildew can. So he has two meds - Flonase nasal spray and a mouthwash that he says tastes awful. Worse than the hot tea (Throat Coat) with slippery elm, licorice, etc., with a teaspoon of honey in it that I gave him this morning. He says the Flonase appears to be helping.

Our prayers are for answers to the Coumadin issue, getting that second opinion, getting necessary rest, gaining weight and more strength in body and voice.