Christmas Day 2007 UPDATE

UPDATE
December 25, 2007

Last evening ‘twas the night before Christmas. Not a creature was stirring, not even Carolyn or Jack. I have not updated the report now for 2 weeks. Partly, because my schedule was/is so chaotic that I hardly had time to breathe much less sit down and write anything. There was no stirring last night because we were all exhausted and finally sleeping peacefully.

Not only have we been bombarded with 19.6 inches of snow this month but followed by sleet and ice. Coupled with managing the weather, I was visiting Jack 1-2 times each day between work and coping with many more people traveling happily about gathering their Christmas gifts. In the midst of that, I decided to fly to NC to help my siblings and parents celebrate my Dad’s 84th birthday. I told him that my presents were my presence. (Is it any wonder people struggle with English?). I might add that the Lord knew I needed that trip since it was the only day last week that it was either not snowing or Jack was not in crisis. I had called my Dad to wish him a happy birthday on the way from the airport while driving to see them. My Mother said, “I wish you could be here”. I said “me too”. It was a fun filled day most of which was the sheer shock of me showing up without my parents having a clue. I thought I was going to have to resuscitate my Mother. It was 12 well spent hours, the calm before a mighty storm that was to follow not only in the weather but with Jack as well.

Jack had been making steady progress for 18 days at NE Rehabilitation hospital that is an acute rehab environment. Since the medical team felt strongly that he was no longer medically acute, he was ready for the next phase that was sub-acute rehab environment in a skilled nursing facility in Winchester. The hope and plan was that he would spend 2-3 weeks there continuing to gain his strength in hope that home would be his next destination. Jack has not been home now since November 14 – 6 weeks to be exact.

In the event that some of you have never been a caregiver, the logistics alone are very exhausting. I am so thankful for the Lord’s daily supply of energy that is provided. It reminds me of the account in the Old Testament of the Lord supplying the manna to the Israelites when they were in the wilderness. Each day they were given just as much as they needed, except on the weekend, they were given a two days supply. I am learning to be so dependent on the daily supply of “manna”. It is a remarkable place to be. Trust me I have days, just as the Israelites did, when I remember having more than that amount of what is needed.

Jack was transferred to Winchester Nursing Center on Friday, December 21. I was with him for several hours. I was very impressed with the admission process and the apparent level of service and care that I was told he would receive. He was in the room with 2 other men with a transfer to private room promised in a couple of days. We were told that we were very fortunate to find a room so quickly because “male” beds are very difficult to obtain in these facilities.

Jack was in Winchester Nursing Center for about 18 hours. He had called me at 3:00 AM telling me that he was unable to sleep and again at 6:55 AM telling me that he needed some help and no one was attending to him. Jack seemed very agitated and hung up on me when I told him that he needed to contact the nurse that I couldn’t help him. I called the nurse’s station to let them know about his needs and I was advised that they would send someone to him. At 10:30 AM, I received a call from the attending physician, Dr. Kolb, at the Center telling me that he had called an ambulance for Jack because he did not look well at all and was very ill. He was throwing up, was nauseated, disoriented, and very pale. He was concerned that he was having a brain bleed. Needless to say, I headed to Lahey Clinic’s emergency room. Christmas traffic was horrific since the road to Lahey Clinic is the same road to the mall. I was moving at snail’s pace when I heard the ambulance. I was about ¾ the way to the hospital when the ambulance passed me. I put my flashing lights on, and followed in behind the ambulance. The ambulance drivers really scolded me when I arrived but I let them have their say. The good news was that I was there waiting for Jack when they opened the doors. Jack was very lethargic and responding poorly. They started running tests on him, x-raying him, and observing him. After he became nauseated several times, the Dr. decided to administer an anti-nausea medication. It made him feel better but also sleepier. A neurosurgery physician came in and ordered a CT scan. The good news was that his scan looked very good. However, what they did discover was 2 things: his sodium levels were dangerously low and he had pneumonia even though he did not have a temperature.

These events made for a very long night. Jack became delirious and incoherent. He was fighting everyone and trying to get out of the bed. I am very surprised that his entire right side is not sore from his struggles. He was extremely agitated which became much worse after a new anti-nausea medicine was given. This lasted for about 10 hours. He was so severely different that I decided to stay all night with him after they admitted him.
During all of these events, Viktor Vejins, Jack’s company CEO, called to say he was on the way to the emergency room. I think he must have GPS on Jack. No one knew we had gone to the emergency room except the children. Viktor had gone to NE Rehab to visit Jack to find out that he had been transferred to Winchester Nursing Center. When he arrived there, they told him that Jack had been sent to the emergency room. Thank you Viktor for “showing up” in our time of need. (Remember the “manna” analogy). It is one more example of our every need being provided.

Around 4:00 AM, Jack called out to me. He thought he was at Winchester Nursing Center. He had no idea where he was, how he got there, or why he was there.
During the night the nurses gave him an antibiotic drip via IV. Jack’s temperature increased over night but was normal in the morning. He slept most of Sunday and Sunday evening. I talked to him early Monday morning. He has absolutely no memory of the weekend. I was so thankful for that miracle.

Currently, Jack is improving. They determined that he was not dehydrated, so they have withheld liquids from him – he only has one quart/day of fluids – in hopes that the sodium would start binding so he would begin feeling much better. They determined that he was not dehydrated since hydration did not improve his sodium levels. The pneumonia has cleared and the sodium levels have increased for that we are most thankful. I stayed with him until mid-morning on Sunday prior to Megan and Jonathan coming to stay with him for a few hours. He has no memory of us being there. One of things they tried to put together was why his sodium levels dropped so low. Jack had begun taking Zoloft, a serotonin antidepressant, to counteract the post steroid depression symptoms. We were told on Monday, by a Lahey Clinic endocrinologist, that brain cancer or brain surgery patients should never take serotonin drugs. One of the side effects is reduced sodium. I think endocrinologists and psychiatrists should have a conversation. Also, pneumonia can cause reduced sodium levels. The combination almost killed Jack. I truly wonder how many people die each year from a drug reaction. Most of us probably do not want to know that much information.

As we wait on the Lord for our daily strength, we are now back to waiting on the medical team to decide when they are ready to discharge him. As most of you know by now, I try, by God’s grace, to find beauty in the moments that we are given. One of those moments came when Dr. Cosgrove, chief of neurosurgery who removed Jack’s tumor, came by to check on him on Christmas Eve. As he was examining Jack, he noticed that his sock was not straight. He stopped what he was doing and put Jack’s sock on so that he was comfortable. It is truly in the little things that you come to know so much about another human. My thoughts were that we truly have a great person for the medical head of Jack’s team.

We met Jack’s neuro-oncologist, Dr. Lloyd Alderson, on December 14. We immediately were impressed with him. We are somewhat biased but correctly we believe. He not only has his medical degree, he also has a PhD in neurochemistry from no less than MIT. He also is very impressive in his warmth and caring. His comment to us is that they are very enthusiastic about the surgery outcome. Dr. Alderson would like to resume the chemotherapy, Temadar. We discussed waiting until Jack is stronger and he agreed that it would be a good idea to give Jack several more weeks of surgery recovery. We are also still waiting for the outcome of the various chemotherapy tests being done in CA on Jack’s tumor.

As we traverse the roller coaster ride of Jack’s illness, I came across a verse that I have embraced. It is Psalm 51:10 “Create in me a pure heart O Lord, and renew a steadfast spirit within me”. The word steadfast has been a stronghold for me as I pondered the steadfast ways of the Lord’s provision to us, most of all the provision of His Son, our Lord and Savior, Jesus Christ. Our prayer for all of you who continue to pray for us, uphold us, and lift us up to our Lord that you would be blessed in the coming year with a greater love for our Lord and for your friends and family.

The greatest gifts to us have been the steadfast spirit that all of you have toward us during this difficult challenge. We so appreciate your abiding love and care and the many expressions to us in your cards, letters, emails, flowers, and gifts. We can never thank you enough for the many ways you demonstrate your love.

We wish all of you blessings in the coming new year,
Carolyn