Monday, March 31, 2014

Finally at home...

I just counted how many days Karly was in the hospital since Feb. 28...a total of 21 days 15 which were in the ICU. This wasn't much fun from anyone's perspective especially a 19 yr. old. However, Karly was so happy to be able to participate in the Campus Crusade Beach Evangelism. This brings a smile to her face amidst a long, tedious fight for survival. Whenever you get a chance, please ask.

Karly was presented in a large cardiology meeting on March 20. Although there remains to be many opinions about what is best for Karly, it was determined to stabilize her and get her to a heart and kidney specialist in Indiana. We had our one contact from Indiana who highly recommended the advanced heart failure specialist and vascular interventional radiologist specialist that we made contact with. They seemed willing to work with NIH and us in order to get Karly in the best shape we can and God-willing get her ready for the transplant.

The family (which includes Zach) drove Friday night and arrived Saturday morning to NIH. Karly wasn't having a very good day, but she was cheered up and smiley when they arrived. The plan became for Karly and I to fly directly from the NIH ICU to the Cardiac ICU in Methodist on Tuesday morning. The family made the 9 hour drive back to Indiana on Tuesday. Things moved rather quickly when we arrived to Methodist, and I was so grateful for how well the Methodist team received and worked on Karly. Wednesday morning, the vascular surgeon mapped her arteries and determined that ballooning both renal arteries would be best. He was able to successfully balloon both of her 90% blocked renal arteries and immediately got good blood flow into the kidneys. We have seen her BP(with the help of 3 blood pressure medications) hold at a nice pressure. Before, no matter how many drugs we were using her blood pressure wouldn't come down. Her creatinine has come down, and will hopefully keep coming down to a normal level. Her heart should be happier now, and we shouldn't see a worsening. We would love to see an improved heart over time. While all this is great news, it just means she is currently stable. We hope to see an improvement, so that she will qualify for her haplo-transplant. But, really what we hope for is a miraculous healing. No one is very excited about exposing her heart to more chemotherapy or her kidney to toxic drugs. Lord Come!

Now, let me tell you about all the exciting things we saw God provide. I will say that Karly and I were pretty nervous about leaving NIH. We have not had good experiences at other hospitals. When NIH wanted to send us some place else, we were expressively nervous, yet at the same time, gave it all to God. The Bible reading that day, said to "Trust Me and Don't Be Afraid" Okay, that is what we did. Sunday's reading was reminding me about my God of intricate details and overflowing abundance. I had no details, but said okay God has the details in the palm of His hand. The day before we are to leave our place of comfort, the reading was, "This is a time in your life when you must let go." Another reminder of what we do so often, but reminders help me to focus again. As we wait on our flight with 3 hours of delays, I'm reminded that delays are for a reason. Keep trusting. Once on our flight, Karly's tear duct tube all but comes out just as we are strapped in to take off. I'm not allowed out of my seat to find a mirror. I ask if she can just close her eyes and wait only to get no response which I know what that means. I lean over and ask two ladies sitting on the aisles across from me if they have a compact mirror and one does. They ask if everything is okay, because Karly looks visibly slumped over and in discomfort. I tell them a little of what is going on. They share with me that they are both nurses (not traveling together), but willing to help if needed. That is a relief. One of the nurses has just been speaking to Senators and Representatives to increase the funding at the NIH. Now isn't that neat! She also knew a friend of ours who just graduated from the School of Nursing at IWU. Isn't that neat! We finally get to Methodist and everyone is prepared for us...take us straight to her room and hook her up. We immediately are speaking to a doctor and getting a sense of what is going to happen. I had no idea that she was going to have the balloon/stent procedure done on Wed. morning, but knew that it was a possibility. We were just thrust into a whirlwind, but knew God was in control. I loved all the doctors and nurses we encountered...and that is saying something. I was pretty nervous about the procedure, but again God brought her safely out of it. While in the waiting room, a man gave me some insight about parking and staying on the campus. I asked where he was from only to find out that he was from a very small town that my grandpa and dad were from....unusual! This was timely because I had asked to speak to a social worker later that day, but didn't know what I really was after. Meeting this man helped me clarify what I was after. I met with the social worker that afternoon. She started by asking what kind of person Karly is. You cannot describe Karly without speaking about her faith. Immediately, the social worker says I knew it, "When I was in her room, I felt the Spirit of God." I described the trip that she had taken. Again the social worker is getting goose bumps. She had gone on a CRU beach evangelism trip in the 70's very similar to Karly's trip. They were able to share this experience. The social worker was able to get our family a room to stay in for as long as we needed. Fortunately, that was only 2 nights, but we were able to be all together. A friend of ours works at Methodist and got us lunch one day...what a treat! We had encounters with several Christian nurses building blocks of friendship and faith. We did not want for anything. God worked out ALL the details. I had told our people at NIH how nervous I was about leaving them, but was able to share all that God had done.

Karly is now at home. She is stable. Her BP is the best we've seen in years. We have an excellent team of doctors in Indiana now as well as in Maryland. We see her heart specialist every week at Methodist. We plan to travel to NIH on Sunday to get her Immunoglobulins replenished and repeat an ECHO. What marvelous news it would be to see her heart function return. Either way, we know that God has got this. Whatever His plan is for her, we are all in. Trusting God is the only way. May you find your complete trust in God also!


Wednesday, March 19, 2014

Karly keeps us on our toes...

Since my last post on February 27, a lot has happened. On Feb. 28, she went for a test called Lower Extremity Arterial Doppler(by the way that was normal). After lying down 30 minutes for the test, she sat up to leave and noticed that it was difficult to tie her shoes, walking to the car, etc. She took a couple breathing treatments at home with no improvement. We called our NIH doctor describing the symptoms, and she sent us to the ER. In the ER, she was put on oxygen, and eventually a CT was done. She had 1 liter fluid around and in her lungs, with an infiltrate present in her lung. They determined that this could resolve on its own and were going to send us home. Our NIH doctor wanted her observed overnight, so we stayed. She was started on some lasix to remove the fluid. Our NIH doctor wanted an ECHO, but BMH wouldn't do an ECHO. After thinking about what could be causing Karly's symptoms and BMH not thinking this was anything beyond an infection, our NIH doc decided she should fly to NIH. She seemed improved, enough so that on Sunday morning, March 2, we could fly to NIH. We are thankful that the fluid was coming off nicely on lasix. After arriving at NIH, a follow up chest x-ray showed there was still some fluid but it was coming off. An immediate ECHO showed she had Congestive Heart Failure. Her Ejection Fraction(EF) had dropped from 50% on January 1, to 35% on March 2. Again, we are so grateful for our team of doctors here for getting to the issues quickly. Our goal that week was to make sure the fluid was off, adjust her meds to control her BP better, and get her to Panama City Beach, Florida with Campus Crusade for Christ. Meanwhile, we were waiting on some tests to determine a possible cause, what role her existing renal insufficiency is playing, and what do we do next.

Panama City Beach was an awesome experience for her. She learned more about God, made awesome friends, and I'm quite sure God used this trip and Karly's story in the lives of many. She had a very difficult time breathing. She couldn't go to some things, had to stop and rest a lot, and learn to cope with breathing difficulties. By the end of the week, she was pretty shot. She was flown directly from PCB to NIH. After assessing her, she was sent to the ICU. Her Ejection Fraction(EF) had dropped to 15-20% in 8 days. Nobody expected that. It is quite curious as to why this is happening. We only have speculation and are still looking for a cause. Meanwhile, this is a long haul. Her fluid overload is HUGE. Her kidney function is severe. Her prognosis unknown. Here comes a big BUT....

On Monday evening the ICU attending told me that one number they had seen earlier was back to perfect. He was rather impressed because this was unexpected. On Tuesday, they put in a Swan-Ganz Catheter which goes through her right atrium, her right ventricle, and into the pulmonary artery. This gives them precise numbers, so they can adjust medications and removal of fluid better. While the fluid level was more than they thought, the heart was better than they thought. In fact, an ECHO was done after the Swan went in, and the EF had come back to 33%. This got a "WOW" from the ICU attending. He said clearly he doesn't understand Karly and this situation. She has also been able to reduce the amount of oxygen she needs. She is still bed-ridden, sore, in pain from severe headaches(probably from high BP and BP medication), and really very sick. We don't know much beyond day to day right now. We do know that her numbers are trending in the right direction. Praise God! I was reminded today to read Psalm 139:

You have searched me, Lord,
    and you know me.
You know when I sit and when I rise;
    you perceive my thoughts from afar.
You discern my going out and my lying down;
    you are familiar with all my ways.
Before a word is on my tongue
    you, Lord, know it completely.
You hem me in behind and before,
    and you lay your hand upon me.

Such knowledge is too wonderful for me,
    too lofty for me to attain.
Where can I go from your Spirit?
    Where can I flee from your presence?
If I go up to the heavens, you are there;
    if I make my bed in the depths, you are there.
If I rise on the wings of the dawn,
    if I settle on the far side of the sea,
10 even there your hand will guide me,
    your right hand will hold me fast.
11 If I say, “Surely the darkness will hide me
    and the light become night around me,”
12 even the darkness will not be dark to you;
    the night will shine like the day,
    for darkness is as light to you.
13 For you created my inmost being;
    you knit me together in my mother’s womb.
14 I praise you because I am fearfully and wonderfully made;
    your works are wonderful,
    I know that full well.
15 My frame was not hidden from you
    when I was made in the secret place,
    when I was woven together in the depths of the earth.
16 Your eyes saw my unformed body;
    all the days ordained for me were written in your book
    before one of them came to be.
17 How precious to me are your thoughts, God!
    How vast is the sum of them!
18 Were I to count them,
    they would outnumber the grains of sand—
    when I awake, I am still with you.
19 If only you, God, would slay the wicked!
    Away from me, you who are bloodthirsty!
20 They speak of you with evil intent;
    your adversaries misuse your name.
21 Do I not hate those who hate you, Lord,
    and abhor those who are in rebellion against you?
22 I have nothing but hatred for them;
    I count them my enemies.
23 Search me, God, and know my heart;
    test me and know my anxious thoughts.

24 See if there is any offensive way in me,
    and lead me in the way everlasting.

God knows what is happening; we intercede for her; we trust God.  He is good.
He is trustworthy. Thank you for remembering us in prayer.