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?

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: 

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.

Day 95

I sometimes think, albeit wrongly, the road traveled is ours alone. No one knows the trouble I / we've seen, and perhaps that is true, but we all have known trouble, for God said it would be so. From the days when Adam and Eve lived in the Garden and chose their own way over obedience to the Lord, trouble has been a constant.

This morning I reviewed previous posts ...

• Today Jim commented his right elbow hurt. It has hurt before, not constantly, but now and then. The last time he mentioned it that I noted it was a month ago on July 15. Before any of the surgeries he complained of it too and his primary physician called it tennis elbow.  Who knows why it hurts. When sleeping, he keeps his arm on a pillow and that helps.

• The dizziness continues. That has been a bother since May 22 -- 10 days after his cancer surgery. Getting up from bed, from the chair, from the floor or just turning around can bring on dizziness. He has mentioned it to countless medical personnel, and although it is listed as a side effect of taking Warfarin (Coumadin),  no one seems to think it is any big deal. NOTE: Jim acquired AFib as a result of the May 12 surgery; his heart did not return to normal sinus rhythm until June 11, the day of his bowel obstruction surgery.  

•  In conjunction with the dizziness is the abnormally low blood pressure. Jim has always had a low BP, and when we first married, both of us had the same systolic reading at 110 (I don't remember what the lower number was). For the last 15 years or more, his readings have been in the 90s/50s. However, since starting on the Coumadin, his BP has been much lower, with the lowest reading taken at 68/30.  Of course Coumadim can't be the culprit. It doesn't cause low blood pressure -- that's what we hear!
  
  Just because these side effects are not common does not mean they should be buried and not considered at all.
   
• The tiredness remains. He needs to be mindful that recovery will take months, not just days or weeks. Often he will discover what his mind wants to do, his body is just not able. He needs to sit and rest. He thinks because he can drive again, he can go anywhere and do anything, but that isn't quite true. It was a blessing when we learned Ormal, Pat and Mike Williams were driving to Anamosa Wednesday morning to attend Art Baker's funeral service and that there was room for Jim. If Jim had gone by himself, the exhaustion he felt would have been much worse. As it was he slept much of the afternoon.
  
  Along those lines, I do wish he would be more specific of how he is feeling ... instead of  "just tired." 

Tomorrow, Aug. 16, will be week 3 at First Federated Church in Lisbon. It is a conservative Bible-preaching church with a small congregation, mostly age 50 and older.  Jim's sermon the Lord has given him is "The Blood of Jesus" from I Peter 1:17-25. Please pray for strength of body and voice.

Day 92

Jim is getting stronger, although still has moments of extreme tiredness and times when he doesn't sleep well through the night. The dizziness remains with him as does the lower than normal low blood pressure. So until one of his doctors believe his report that the coumadin is causing this (he didn't have dizziness and extra low blood pressure before he started taking this new medicine), it appears he is stuck with it.

Jim is back to cooking. On Saturday, Aug. 8, he froze 7 ears of sweet corn. When his sister came to visit on the 3rd, she brought a dozen big ears. We made our way through 5 ears and then decided we'd be tired of them before we got through the whole dozen. I suggested freezing them. So Jim did that while I did Gazette work. We should probably get some more, so we can have some this fall.

On Sunday, Aug. 9, Jim preached his second sermon at First Federated Church in Lisbon. It is not non-denominational, but rather Evangelical Bible. His message, taken from Hebrews 13: 7-16, was "Praise Be To God." We will be returning there in an interim role until the Lord determines otherwise.

For a couple years now we have talked about re-painting the garage door and other areas that needed it. On Tuesday, Aug. 11, it was finally accomplished through the efforts of Rocky and Christina. It was a busy afternoon, with the whole family here, working and playing.

Here are some photos:

Rocky and Christina painting first coat on garage door

 

Rocky and Jim scraping the trim by the front door; Austin is playing

Papa Jim (James) holding his adopted grandson and namesake, James

                                     

Papa Jim and firstborn adopted grandson Austin being silly 

The newly painted garage door. Looks great!  

On Wednesday, Aug. 12, Jim decided to buy some new jeans. For years he has worn size 33x36 or 34x36, but since he has lost so much weight since his May 12 surgery, he is now down to a 32x34. 

Updates - Day 81

More than a week has passed, being my last post was July 23, nine days ago.

On Friday, July 24, we received a call from First Federated Church of Lisbon re: pulpit supply. We learned the congregation's former pastor was let go because they could not continue to financially support him, and so were looking into other avenues. Hence, Jim was asked to preach Sunday, Aug. 2, and possibly future Sundays.  The worship service begins at 10:30 a.m. Jim's message is "The Knowledge of Salvation" and is taken from 1 John 5:10-21. When we returned this past Friday, July 31, from the Cedar Falls Bible Conference (CFBC), two of the 13 phone messages were from members of the church. One of them was an invitation to join them for dinner after the service.

We began 10 days of vacation on Sunday, July 26 (6 days off work). That day, before getting out of bed, we prayed the Lord would help us finish packing and be on the road by 9:30. We got that accomplished - the car was packed by 9:20 and we were on the road by 9:25! The morning service at the CFBC started at 11 and we arrived at 10:35.

Dizziness continued to be a daily problem through the week, but fortunately, it did not last long. He also had two episodes of indigestion after the evening meal - possibly because of either eating too fast or too much - but after a few hours, the problem subsided.

We stayed in a 2-story building called The Retreat Center, but it is like dormitory-living, and updating the mattresses is a slow process. So our room, with a double bed, had a very thin mattress, which made for rather sore backs.  The best part of our stay in the building is the fellowship. This is our third year to stay there and are among 11 residents. All of us are repeat attendees to the conference - I have been coming since 1989 or 1990 and Jim many years before that. Seven of us live in the Cedar Rapids/Marion area. Everyone brings their own food and also shares with others.

There was only one day (Tuesday, July 28) when the weather was very wet and very cold, which made the air-conditioning in the Tabernacle (events center) and at The Retreat Center seem even colder. Sweaters and sweatshirts were the garb of choice most of the time.

We enjoyed renewing friendships, making new friends and visiting with family - we had lunch with Jim's aunt Effie on Thursday, eating at the Golden China restaurant near where she lives.

Early on Friday morning, July 31, Jim complained of pain on his right side, so he moved to his back. He complained of the same early the next morning. We plan to wait and see if there are more episodes and if so, to possibly call the on-call thoracic fellow at UIHC to see if there is something to be concerned about.

We so enjoy going to the Bible Conference every year and are glad the Lord enabled us to do so this year. It runs for a full 7 days, Sunday to Sunday, and everything is accomplished through love offerings/donations. This year was their 94th year. I generally sing in the choir and this year was no different.

My chief complaint for the week was soreness - sore hip, sore thigh, sore low back, sore legs, sore shoulder, making balance issues front and center. Holding onto Jim's arm was of considerable help. I often wondered if I should return to using my cane or at the  very least, visit my doctor.

Our bunny, Bandy, stayed home during the week, and let it be known he was not happy we were gone. His aunt Jani came over nightly to take care of him and he was so contankerous - he refused to let her pick him up.

On Monday, Jim visits his primary care doctor, and then that afternoon, his sister, Dianne, is coming from Ankeny for a visit. On Tuesday, he finally sees Morgan & Morio Oral Surgeons for a consultation visit regarding another molar that needs to be pulled. 

Day 70

Four days have passed since my last post.
Jim continues to be tired in the midst of doing or not doing and has dizzy spells at least once a day. The dizziness comes whenever and wherever. He doesn't have to be on the floor or sitting; he could be on his feet and moving a different direction and the room would be spinning. One such episode happened Sunday at church when he went upstairs to deliver some Sunday School materials. He became dizzy and the pastor helped him downstairs. He also continues to not drink very much water.

On Monday, I had a much needed massage - wish I could afford to have one every day! - and after lunch, we took the Mazda 5 over to Firestone to see why the check engine light came on. That took the better part of the afternoon only to find the problem required a part to be ordered direct from the dealer and wouldn't arrive until late Wednesday morning.  So we left Firestone around 4, finished a few of our ongoing endless list of errands, had blood drawn for the heart cath on Thursday and went home.

On Tuesday, I received a phone call from Dr. Li's office (cardiology) to tell us Jim's thyroid levels were still somewhat elevated. I was surprised by this particular phone call and asked the nurse why thyroid levels were checked. He was supposed to get labs for the heart cath on Thursday. Somewhere along the line, MedLabs didn't pull the correct report. Thyroid levels were to be checked the end of August, not July. And then of course, Dr. Li's office did not have the report sent earlier in the month from Dr. Parekh's office at UIHC about discontinuing the Amiodarone. It had been faxed July 6 and refaxed again today.

This morning, Jim decided he wanted the grass in the backyard to be shorter than it was, and since it was much less humid than in previous days, determined he was going to mow it. It took him an hour to do it, in addition to trimming weeds. He spent the afternoon resting. It is probably not the smartest decision, but it was his.

On Wednesday morning, we will get moving a tad earlier - take the car to Firestone for them to repair it, then come home so I can do Gazette work, then pick up the car before it closes - hopefully, there'll be someone who can give us a ride over there. Jim is still not driving by himself. 

New dilemmas - Day 65

I made two calls this morning - one to Jim's primary care physician, Dr. Butler, and another to the Center for Digestive Diseases at UIHC.  It was too bad the nurse from UIHC didn't call first, because now I've had to call Dr. Butler's office a second time.

Jim is scheduled to have a colonoscopy next Tuesday, July 21, per orders from Dr. Parekh, his thoracic surgeon.  We didn't have prep instructions, thus requiring a call.

We have plans to attend the Cedar Falls Bible Conference July 26-31 (reservations were made and paid earlier this year), but now I question the reality of those plans.

So the nurse from the Center for Digestive Diseases called back late morning.

This colonoscopy is not your typical procedure, with prep being done the day before.

Prep begins:

•  today - no corn, popcorn, iron or multivitamin. No Problem!
• Friday (4 days before procedure) - he is to stop taking Coumadin - unless of course the doctor managing this med thinks otherwise.  Hence, my second call to Dr. Butler's office to find out if indeed he is to stop 4 days ahead, when he is to restart, and what to do about the INR  re-check currently scheduled for July 24. 
• Sunday, July 19 - after supper, he takes the bottle of clear magnesium citrate.  Nothing red.  No jello.  Begins clear liquids and continues on that through Monday.
• Monday, July 20 - between 3 and 4 p.m., drink the jug of lovely tasting stuff (not!) - Nothing after midnight

And then we received a call before 1 p.m. from PCI Cardiology - Dr. Li's office,with results of the stress test Jim took on Monday and Tuesday of this week.  The nurse said it was abnormal.  She didn't say what specifically was abnormal, only that it was.  She asked if Jim had had any chest pain and he said no.  A cardiac catherization aka angiogram is to be scheduled, and she hoped to have called us back today with a date and time, but that didn't happen.

If there is blockage, a stent will be put in.  The nurse said if there is no blockage,  the procedure would last 30 minutes;  otherwise, it could take up to 1 1/2 hours.  He would need to be at the hospital two hours before.

Then I called the nurse coordinator for Dr. Parekh at UIHC because we thought it a good idea if he received the stress test result report and any other information.  I wondered if the surgery could have caused this problem.  We haven't received a call back from her either.

So I stayed home and worked, waiting for return phone calls.  Tomorrow morning we will have to get up earlier and make phone calls earlier as well.

Jim and I went grocery shopping after supper and we were talking about things Dr. Parekh said during our 4-week clinic visit with him July 1.  When we got home, I started looking through previous notes.  At that clinic visit Jim had an EKG and results showed normal sinus rhythm but abnormal left anterior fascicular block.  Nobody seemed to know what the latter meant, but results were to be sent to Dr. Li,  Jim's cardiologist.

So I did a google search on Left Anterior Fascicular Block.  I found the following of interest:

• It is a medical name indicative of scarring or other blockage that causes portions of the heart's left ventricle to shrink or constrict. 
• Lifestyle choices and genetics may have much to do with why the blockage happens
• Chest pain is not always present
• Dizziness can be a symptom of a defect in cardiac function.  Unconsciousness may occur.
• Stay away from refined carbohydrates

Dizziness ... has been bothering Jim since taking Coumadin, which can lower blood pressure,  and Jim's BP is definitely dropping. 

Refined carbs ... we have one doctor who tells him to eat whatever you want, need to add fat.  And we have another doctor who tells him to avoid foods high in carbs and starch. 

I talked to Jim's sister, Dianne, the RN.  She suggested we call Dr. Gerke's office in the morning and reschedule the colonoscopy. Take care of the heart first. Also to call the cardiologist and find out exactly what was abnormal about the stress test. 

I know the Lord is in control.
I know He will take care of us.
He is taking us down paths for His purpose.
He will bring us through it.
We must stay strong in Him,
because without Him, we are so weak.
Sometimes our weakness overwhelms us
We seek His guidance.
We seek the prayers of His followers across the seas.
We seek a place of quiet refuge
to be comforted by the One
who knows us so well.
(c) Cathy Orrick Luders   

Dizziness - Day 64

Today I forgot it was July. A month behind I am.

Jim had his blood drawn today at MedLabs. Two people tried 4 times total before success came. A patient man. I would not be so. I can't handle needles ... once is too much for me!

He still talks about being off coumadin and hopes his cardiologist calls sometime soon with results of the Stress Test taken Monday and Tuesday. He wants to discontinue coumadin. He doesn't see his cardiologist until the end of September.

I was thinking today ... The Lord knew this was coming - the complication of AFib, the medicine to take, the blood draws. What is the purpose? Why did, does He allow it? What are we to learn? There is something. God always has something for us to learn. We are to trust Him, no matter what. He'll never steer us wrong.

Jim is improving daily. I pray that continues. He took the trash out to the curb today and started a load of laundry .. things I had been doing before this week.

He needs to be careful though. When he was downstairs, he said he was on the floor and in getting up, was dizzy, the room spinning. Perhaps he should begin taking his cell phone with him (turned on, of course), in case he happens to fall because of low blood pressure, or if he finds himself unable to get up. I probably shouldn't be thinking about this, but instead praying it won't happen, that the Lord will give him needed strength.

The doctor's office called around 5, Jim said, and his INR reading was 2.6. He's to continue with 3 mg coumadin nightly. He told the nurse he has been dizzy, but that didn't seem to faze her.

My writings ...

You walk with the Lord
-- you read and study and meditate
on His word daily
-- you listen to His instruction
and strive to be obedient to His command

The Lord carries you along paths
He has purposely chosen for you

He asks that you stay close to Him
to not become disenchanted
and follow your own thoughts, ideas and plans
Stay close
Look to Him for strength and direction
where He takes you will bring glory to Him

Perhaps we think
we don't need to be where we are,
but God has allowed it
He knows something we do not.
He has a reason

Someday He will share the reason
but not yet, not today

He wants us to learn something
perhaps obedience
no matter what crosses our path

Discard the anxiety, the frustration
Follow Him
Do as He directs
Seek wisdom and He will give you
what you need
you are weak, you are tired
Ask Him for strength
Ask Him for stamina
He will give you what you need
But you must ask
All that He has for you
remains hidden from you
when you do not ask or seek.
(c) Cathy Orrick Luders

"...My strength is made perfect in weakness.  Therefore most gladly I (Paul) will rather boast in my infirmities, that the power of Christ may rest upon me. Therefore I take pleasure in infirmities, in reproaches, in needs, in persecutions, in distresses, for Christ's sake, for when I am weak, then I am strong."   (II Corinthians 12:9b-10)

Recovery Continues - Day 45

The morning was uneventful.  Bathroom duties continue to have good results. Blood was drawn this morning and later in the day, Dr. Butler's office called with INR readings - which are up again at 3.3. Another recheck on Monday morning. A weekend reprieve.

Dizziness struck mid-afternoon, the first time soon after he talked to his sister and then again, about an hour later. I thought maybe his blood pressure was low, but when he took it, the reading was 90/59, which is normal for him. He thought maybe he just got up from the recliner too fast. Don't know. Hasn't happened since.

We had pasta for supper with cheese bread. At some point, Jimmy got a tummy ache. I think he might have ate too fast. He said it didn't feel the same as before when his tummy was cramping. I drink ginger tea when digestion gets the best of me. Perhaps we should get some ginger ale for him - he doesn't like tea. Pray the tummy ache eases and he can get a good night's sleep.

It appears Craig, our house guest, did not leave today. He doesn't quite have everything done he needs done before his departure.