Updates - Day 183

We'll start with Wednesday, Nov. 4 - Jim had his infected tooth that was diagnosed Nov. 2 removed this morning. Has had no problems with it since.

The following Wednesday, Nov. 11 - Jim had a CT scan of his chest, followed by a 3-month followup visit (even though it has been 6 months since the cancer surgery) with Dr. Parekh at UIHC. Results of the CT scan were good - no apparent reoccuring cancer. That is a blessing. His blood pressure is improving - 97/52. He is to return in 6 months and after that, yearly visits.

Today, Nov. 12 - he had an endoscopy to see how the ulcer was healing. Dr. Gerke said it was not healing, and it may never heal, but he was not overly concerned about it. It's not bleeding either, and as long as it stays that way, good. Perhaps this is what you call an inactive ulcer? He recommends Jim stay on 40 mg of Pantoprazole, once a day, to help it heal.  

Another infected tooth - Day 173

Today, Monday, Nov. 2, Jim had a dental appointment. There was no indication it would be anything but normal, but something was wrong when the hour appointment stretched into 1 1/2 hours. When he returned home, he said he had another infected tooth - upper right this time. Jim said they took 21
x-rays. The tooth needs to come out soon, so we are having a consultation with Dr. McGrane at 2 p.m. Tuesday to determine exactly what to do and when to do it. Another expense.

We spent a good share of the day in Wilton, where we visited with Ron and Jim had an interview with a reporter from the weekly newspaper, Wilton-Durant Advocate News.

Last Tuesday, Oct. 27, Jim had a colonoscopy. He had one tiny polyp, which Dr. Gerke removed. He is to return in 5 years.

He has reduced the frequency of taking the Midodrine (which raises his blood pressure) from three 1/2 tabs daily to one 1/2 tab. He thought the medicine was causing a decrease in potty flow. It appears this plan has helped as the BP has remained good, with no dizziness, and potty flow has increased.

In addition to the 3-month clinic visit with Dr. Parekh on Nov. 11, Jim is scheduled to have an endoscopy Nov. 12 to see how the ulcer is healing.

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.

The Race Before Us

Today's Bible reading led me to Hebrews 12:1-2a, which says
"Let us run with endurance the race that is set before us, looking unto Jesus, the author and finisher of our faith."

I thought I would keep a journal of this new journey that my husband, Jim, and I are taking and title it "The Race."

The specifics are more about him and what is going on inside him, but because we are husband and wife and in this together, it is about us. 

PRELIMINARY STUFF

• OCTOBER 7, 2014  ... Jim has Barrett's Esophagus. He has had problems with digestive issues for several years and he continued to be in distress while at the Cedar Falls Bible Conference in late July/early August. A visit to our friendly neighborhood gasterenterologist Dr. Gary Weinman determined it was 2012 when he last had an endoscopy, so another was scheduled for Oct. 7 at St. Luke's Hospital in Cedar Rapids. A tissue sample was sent to University of Iowa Hospitals and Clinics in Iowa City. 

• OCTOBER 21, 2014 ... Jim received a call from Dr. Weinman's office. The tissue sample showed high grade dysplasia related to the Barrett's Esophagus. Having Barrett's Esophagus means there is a chance cancer could develop and high grade dysplasia meant a greater chance. We were under the mistaken thought that cancer was present.

• OCTOBER 27, 2014 ... Jim and I met with a physician assistant at the Center for Digestive Diseases, UI Hospitals, and also met specialist Dr. Gerke, a tall langly man of German descent.  We were told there was no evidence of cancer. An endoscopy procedure would be done with ablation (burning) or cutting off tissue. Dr. Gerke suggested this be done every 3 months. 

• NOVEMBER 18, 2014 ... Endoscopy with ablation was accomplished in the afternoon by Dr. Gerke. The procedure went well, but recovery was slow and painful for Jim with eating and drinking. Thanksgiving Dinner was not very enjoyable for him and he lost 20 pounds. Fortunately by mid-December he was much improved and with eating Christmas goodies, was able to gain back weight lost. 

• FEBRUARY 16, 2015 ... The second endoscopy procedure was scheduled for 9:45 a.m. This time the doctor chose to cut off the tissue. Afterward, he said there was not as much scar tissue as hoped from the first time around. Since this time they cut tissue instead of burning it, a biopsy was sent to the lab. Dr. Gerke wanted Jim to come back again in three months. A stronger dose of sedation medicine, called proposol, would be used next time. An appointment was scheduled for May 6.

THE CALL

• FEBRUARY 19, 2015 ... Today between 8 and 8:30 a.m. Jim received a call from Dr. Gerke. Today we learned the tissue biopsy indicates cancer.
  
  Today appointments were scheduled:
  
  9 a.m. Tuesday, March 3, bloodtests
  
  9:45 a.m. Tuesday, March 3, PET/CT scan
    This procedure will determine if the cancer has spread to the lymph nodes. It is the hope of all that it has not. Dr. Gerke said the cancer was caught in the early stages, so that is a good sign. The doctor also said because Jim is relatively young at age 66 and in pretty good health (no lung or heart issues), recovery would be better.
  
  10:30 a.m. Tuesday, March 31, Endoscopial ultrasound
  
  Everything will be done at UI Hospitals. 

FACEBOOK COMMENTS

Jan Baxa We'll keep praying

February 25 at 12:06am · Like

Paulette Titus

February 24 · 

Jim was our interim pastor for several months and I've known him for many years.

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  Heather Wilson So sorry to hear this.Will have to say prayers.

  February 24 at 10:56pm · Like · 1
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  Claudette Ferrie What happened to Jim?

  February 25 at 1:30pm · Like · 1
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  Paulette Titus He's had Barret's for awhile and has now been diagnosed with esophageal cancer. They are going to test lymph nodes next. They could really use everyone's prayers.

  February 25 at 2:58pm · Like · 1
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  Claudette Ferrie Consider mine along with all the others I know will be headed his way. He was so considerate to preside over Mom's funeral.

  February 25 at 3:08pm · Like · 2
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  Olive Smith I believe at your mothers funeral was the only time we met him but he was extremely nice. I am so sorry to hear his health is worse and I am sending prayers his way. Thank you for letting us know.

  February 25 at 3:33pm · Like · 2
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  Sue Fuhrmann Is this Jim Luders?He looks so much different than he did 35 years ago.I will keep him in my prayers.

  February 25 at 5:16pm · Like · 2
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  Paulette Titus Yes, Sue. It is him. We all look different than we did 35 years ago, lol. He lives in Cedar Rapids.

  February 26 at 1:26pm · Like
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  Sue Fuhrmann yeah,you're right ,we do.It's just kind of a shock to see someone after so many years who looks so different.This is sad.

  February 26 at 5:22pm · Like · 1
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  Claudette Ferrie Everyone but Paulette looks different after 35 years. The only thing that's changed with her is her hair color. Still a knockout, don't you think?

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  Paulette Titus HAHAHAHAHAHAHAHAHAHAHA!

  February 27 at 8:01am · Like
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  Cathy Orrick Luders Jim does not look different, other than he's sweeter, kinder, handsomer, funnier, etc.

  February 28 at 4:10pm · Like
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  Cathy Orrick Luders and more in love with me!

  February 28 at 4:11pm · Like