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. 

Day 87

Jim had his blood drawn this morning and although I don't know what his INR level was, he doesn't have to return to the lab for another drawing for a whole month! The exception is when he has oral surgery Aug. 31 - he has to stop taking Coumadin two days before and have blood drawn the day before. Otherwise, he will continue taking 4 1/2 mg Coumadin nightly until further notice.

Opportunities - Day 85

Today was my first full day at The Gazette office -- Jim took me and then drove to Central City to see Waldo, his hospice client. He has been visiting with him via phone since May. This is only the second day Jim has driven by himself.

Yesterday, Aug. 4, Jim had his consultation with Dr. Morio at Morgan & Morio Oral Dentistry re: pulling #18 molar. That event is now scheduled for Aug. 31. 

We have been attending Vacation Bible School this week at Immanuel.  Yesterday, just before supper we received a call from First Federated Church in Lisbon. It is non-denominational I think. They would like Jim to continue preaching - just to let them know when we wouldn't be available. What a journey the Lord has put us on this year. Up and down. And what a learning experience in faith and trust. 

We have 4 1/2 cases of Osmolite 1.2 cal nutrition drink that will be making its way to southern Illinois this weekend via friend Marla. She is taking it for possible use by her brother, Gene, who is battling stomach and esophageal cancer. If he's unable to use it and no one else is in need of it, she'll bring it back to us.

Doctor's visit - Day 83

Today Jim had an appointment with his primary care physician, Dr. Butler. His BP remains on the low side, at 74/44, but his weight appears to be increasing. Fully dressed, he weighs 135, so I'm guessing without his shoes, he's probably at 132 to 133 pounds. Up is so much better than down.
His INR from Friday's blood draw was 1.4, so he's to take 4.5 mg nightly and be rechecked on Friday.

Dr. Butler and one of his nurses said coumadin (warfarin) does not cause low blood pressure or dizziness, but Jim and I have both read articles where low blood pressure and dizziness can be side effects of taking it.

A link on EHealthMe may be found here: Could Warfarin Sodium cause Low Blood Pressure (Hypotension)?

His blood pressure was low before taking Coumadin, but not this low. And he did not have dizzy spells before either.

Jim's sister, Dianne, who lives in Ankeny, spent the afternoon with us. We had a picnic at Ellis Park, enjoying foil dinners of hamburger, potato, carrots, onion and zucchini. For dessert, we had sweet and goey smores, with those giant marshmallows. It was such a splendid afternoon, low 80s, no humidity.

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. 

Heart Catherization - Day 72

We got up shortly after 6 this morning  to allow time for Bible study, getting dressed and me to eat.

Abnormal results showed up on a stress test Jim had last week, so a heart catherization was scheduled for July 23 -- and that's today! 10:30 at St. Luke's Hospital in Cedar Rapids. Dr. Hajj (pronounced Hodge) from PCI Cardiology will do the honors. We're leaving the house at 8 for an 8:30 arrival.

We pray there is no blockage, but only God knows for sure, and He's not telling at the moment.

Your prayers are appreciated.

Will update later.

My devotional reading was from John 8:12 --

"Jesus spoke, saying, I am the light of the world. He who follows Me shall not walk in darkness but have the light of life." 

My writings --

Jesus is the Light of the world
When I became a child of the King
His Presence - as the Holy Spirit
came to live within me
and I His Light-bearer
brightening up the world around me
reflecting His glorious Presence
within me
to you.
(c) Cathy Orrick Luders)

The procedure was delayed by 1 1/2 hours - there was an emergency so the catherization wasn't started until noon. It lasted 45 minutes and there were no blockages! Praise the Lord!

I had this feeling there would be no blockage, that this was a test. I'm sure patience and trust are  definitely two things we are both to learn. I tend to think God will bring other tests and He, who is far more patient with us than we are with ourselves, will bring us through each difficulty with more of Him reflecting in us. I am thankful He never fails, never gives up on us.

Before the procedure was started, his blood pressure and weight were taken. BP was of course low - 95/52, but his weight -- he gained a pound! He's on the upward swing at 130.5.

An IV was started (took forever to find a vein) in his left hand/wrist area. Early on Jim was told he could leave on his underwear and socks. But somewhere along the way, it was determined he should have taken off his undershirt. Getting it off after you have IV tubes, etc., attached, is rather tricky.

Pastor Dan arrived at 11:15 - wasn't that a miracle! To come late, but just in time. Jim's sister, Dianne, called shortly before noon, but of course, Jim was just about to head down the hall to the OR.

For the procedure itself, a catheter was inserted into his right wrist (incision was the size of a pin). Contrast dye was injected through the catheter so that X-ray videos of his valves, coronary arteries and heart chambers could be created and the doctor could see how well the heart was working.  Jim was not knocked out for the procedure, just the area the doctor was working on. It was amazing to see Jim conscious and talking.

After the procedure, but still in the OR, an inflation/deflation band was placed over his wrist -- the band holds pressure on the incision site so it doesn't bleed. Once he was back in his room, air was removed from it every few minutes until the band was eventually removed (2:15 p.m.).
Once the band was taken off (he could theoretically leave the hospital an hour later), an immobilizer was put on. It has to stay on at least 6 hours, but he could leave it on overnight, or he could leave it on all 5 days. He has elected to leave it on at least overnight and perhaps longer, because it reminds him of what he shouldn't do - no bending or twisting of wrist, no using his hand to get up, etc. He can't even use the cane in his right hand.  

Dr. Hajj said Jim had the heart of an 18-year-old. How nice to have some part that is young! No blockages, everything is fine. He said about 10 percent of the time the abnormal readings showing on stress tests are wrong.

He said Jim could not lift anything over a gallon of milk (about 10 pounds) for 5 days.
He can resume taking the Coumadin tonight -- he would still like to get off this medicine. He has follow-up appointment with Dr. Li at the end of August, so perhaps his concerns can be addressed then.

The Nassif Heart Center provided heart-healthy sack lunches for both of us around 1:30 p.m. and Jim was released from the hospital at 4 p.m. 

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. 

Tests scheduled and rescheduled - Day 66

I made the last of 4 phone calls to various medical agencies by 8:40 this morning and all but one had called back before 9:30.

The colonoscopy scheduled for July 21 at UIHC is rescheduled for Oct. 27

The heart (cardiac) catherization (also called a coronary angiogram) at St. Luke's Hospital is scheduled for Thursday, July 23

What is a heart catherization?
According to WebMD,  it is an invasive imaging procedure that allows the doctor to "see" how well the heart is supplied by blood vessels. A long, narrow tube, called a catheter, is inserted into a blood vessel in your arm or groin and guided to your heart with the aide of a special X-ray machine. Contrast dye is injected through the catheter so that X-ray videos of your valves, coronary arteries and heart chambers can be created.
(I was born with a congenital heart murmur and had this procedure done when I was 12 years old. The catheter was inserted into my right arm.)

What is purpose of a heart catherization? 

• To evaluate or confirm the presence of heart disease, such as coronary artery disease, heart valve disease or disease of the aorta
• To evaluate heart muscle function
• To determine the need for further treatment, such as interventional procedure (stent placement) or bypass surgery.

Dr. Butler's office is to call and let us know when to stop and restart the coumadin before the upcoming heart cath procedure.  PCI Cardiology said usually you stop the coumadin 3 to 4 days before.  Dr. Butler's office did not call, so we decided to go with the recommended stop time.

Instructions from PCI Cardiology ...
Jim is to start taking baby aspirin today.  Labs to be done Monday afternoon,  July 20.  He is not to eat or drink anything after midnight Wednesday, July 22, except for morning meds with a sip of water.  We need to be at the hospital at 8:30 a.m.,  2 hours before the procedure.

PCI Cardiology also said the abnormal results of the stress test reveal a large reversible defect.  It could be related to the left anterior fascicular block showing abnormal on the EKG taken July 1 at UIHC.  When Joan, the nurse coordinator for Dr. Parekh (Jim's thoracic surgeon),  returned my call, she said it is doubtful this new heart problem is related to the May 12 surgery,  because Jim was monitored throughout and there were no problems.

My writings today ...

Stop!
Listen!
You are Mine
yet you withdraw from My Presence
presuming yourself
more knowing
than anything
I have to say

You are weak
and you will remain weak
until you put your selfishness
behind you
and settle your focus
on Me

You live in the world
yet the world is not your answer
You run toward it
eager for something new
yet the world does not provide
what you need

I AM the Answer
I AM what you need

When will you return to Me
When will you stop running away

I have given you what you need
Why do you fail to believe
you have the best
There is nothing better
than to sit at the feet of My Son,
Jesus

Be filled with My Presence
Open your heart
to all and every blessing
I have set before you

See the good around you
instead of every wrong.
(c) Cathy Orrick Luders

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