Wednesday, June 24, 2009
Discharged
Just a quick WAHOO! to say that we have been discharged from the hospital and are now resting comfortably at home. Just a day shy of 2 weeks. We'll be open for visits tomorrow. Kev loves to see folks, but a 10-15 minute stretch is about all he can handle right now. Give us a call if you'd like to pop over... 919-381-4637.
Tuesday, June 23, 2009
Instant Replay
Before events get too far ahead and the details begin to blur, it is probably therapeutic for me personally to throw out an instant replay version of the scariest few days of my life...
Around 11:00 on Thursday, our 15th wedding anniversary, Kev and Joe went for a jog. They had been working out together (along with Louisa at times) so that both kids would be in minimal shape for upcoming summer sports camps. Several days each week they either played soccer at the park, shot some hoops, or jogged through the neighborhood. On Thursday, Joe and Kev decided to jog. They jogged down to the park to run some sets of stairs. Joe ran 5, Kev did 10 then Joe says that Dad needed some water and to walk rather than jog back to Englewood Ave (our home street). Once they got to Englewood, they jogged uphill about three blocks and then decided to finish with a hard sprint from our drive way to the top of the block where Alabama intersects with Englewood. Joe remembers racing past his dad and getting to the stop sign first. He turned around and saw Kev slowly jogging, then stumbling, then collapsing.
A car drove by and told Joe to go get his mom, that he was calling 911. Joe ran the 100 or so feet to our house to get me. Another man was walking his dog and also called 911. Another man, Eric, was driving down Club Blvd on his way to get some more supplies for a job he was working on in the neighborhood. He needed to get to Hillsborough Rd, but instead of going all the way to Hillandale and then over, something told him to turn onto Alabama and cut through our neighborhood instead of his usual route. He turned onto Alabama and saw Kevin collapsed at the end of the block. Eric had just finished his CPR training. He dashed from the truck and began chest compressions. Joe entered our house screaming for me to come quickly, that Daddy fell down in the street and wouldn't get up. I sprinted to the top of the block where I could see a crowd forming and Kev lying in the road. As I ran up, Eric told me he had just finished CPR class. That Kev needed air but that he didn't know him and so hadn't given him mouth to mouth just compressions (exactly the right thing to do in that situation). I, however, did know him and began to alternate Eric's compressions with mouth to mouth. The whole time wondering if this was really happening.
EMT arrived from both the local fire department and the hospital after about 4 minutes (which seemed like an eternity). They took over CPR. Let me tell you, enthusiastic compressions is a definite euphemism. They cut off his shirt, applied the defibrillator paddles and shocked him. Eric took off both his hat and shirt to try and pad Kev's head from whacking the ground so hard. They shocked him 2 or 3 times with no response. Every body's shoulders seemed to drop, as they began strapping him onto the stretcher. "Can't you shock him one more time? Don't give up, yet." I pleaded. "We can't shock him again, right now." He had flat-lined. "We've got to get him to the hospital." EMT loaded him into the ambulance, and told me to follow them to Duke. The defib guy looked up and said, "I think I've got something." Kev seemed to take a very abnormal looking shallow breath. Three hands immediately tried to find a pulse. Nothing. "We've got to go." And they loaded him in.
John, one of our neighbors helped me get the kids back to the house (Joe, Nate and Savannah watched nearly the whole thing. Louisa was at camp.) I grabbed my keys, called my Mom and yelled at her to get here as soon as possible, hugged a sobbing Joe and assured him this was in NO WAY his fault and dashed out the door. Joe began e-mailing our teammates in Uganda and South Sudan to ask them to pray, and told John that he should call Nanny Rachel to come help with the twins. John let our church know what was going on.
I drove, sobbing the 3 minutes to Duke University not knowing whether Kev would be declared DOA (Dead on Arrival). I prayed that frantic generic "Please Help" prayer. Once I got to the ER a nurse said she would check to see whether he was alive, while I called Allan, our pastor and left and unintelligible message on his phone. I called WHM and they immediately started praying. I called my brother and he assured me he was en route. The nurse came out and told me he was breathing but in very serious condition and that I needed to go to a smaller more private room for the doctors to talk with me. I knew what this meant. This was the bad news room. This was the room you go to and they tell you that your husband has died. A social worker came in to help me deal with the situation and I'm pretty sure I told her the only help I needed was for her to find out if my husband was alive or dead. She came back moments later to say he was alive, but a lot of people were working on him. I asked her to leave so that I could pray. A few minutes later, Allan (our pastor) arrived with the doctors. We sat together, while they told me that Kev had been shocked in the ambulance and had regained a pulse, he had been breathing some on his own but not enough when he arrived at the ER. He had been intubated, but had struggled during the process (my only sign of hope during the next 24 hours). He was now on a ventilator. They were running tests to determine what had happened and had started a cooling procedure to minimize significant brain damage. They told me that the early CPR, especially Eric's chest compressions, had likely saved his life. BUT, and for the next 24 hours I was to hear this BUT after nearly every statement, Kev's brain had been without normal oxygen for 8-15 minutes. The chance that his cognitive function would never return was likely, which meant that they would also need a copy of our living will, especially as it pertained to being in a vegetative state.
Duke had in place a new, cutting edge cooling protocol to increase Kev's chance of recovery. Since he had been without a pulse and normal oxygen flow to his brain the chance that he would be in a vegetative state was high. As they ran more tests they did find that he had a mild to moderate aortic valve issue. They ruled out both heart attack and stroke. Within 2 hours he was up in the Cardiac Intensive Care Unit in critical condition, on life support and was being cooled to 33 degrees Celsius (91 degrees Fahrenheit). They would keep him at that temperature and in that condition (completely paralyzed to prevent shivering and under heavy sedation) for the next 18 hours. They would warm him back up slowly over 6-12 hours and then it would be another 24-72 hours before the drugs wore off and we could see if he would wake up. So, on Thursday night the best timeline they could give me was perhaps he might wake up by Saturday evening BUT the likelihood that he would remain in a vegetative state was significant. Nobody could predict how his brain would handle the lack of oxygen.
Most of that time is a blur, but what was significant to me was the way everyone seemed to wrap their arms around us. Multiple, multiple folks connected with Duke and us through either Science and Math or Blacknall quietly stood beside us. Nurses, doctors, so many people associated with Duke in one way or another made sure we were taken care of. Katie, our Sunday School Leader was by my side interpreting and explaining. Amy arrived shortly after Allan and stayed with me throughout those first two days. Mom made lightening fast time from Charlotte. Arriving to be my main emotional support. Doc was steadfastly calm and influential. Newland providing much needed hand holding. Cherie began coordinating meals. Beth made sure Joe and Louisa were okay for days. My sister and her husband Kevin took care of the twins and then took all four children back to her home in Belmont so that I could be with Kev around the clock. To my amazement Chris, the director of the Cardiac ICU was a friend we had just eaten dinner with at another friends 50th birthday party. My dad flew in from Nevada and some of Kev's sisters arrived in person as others kept up over the phone. We were surrounded by people who both knew us and cared deeply for us. Calls began to come in from Bundibugyo and Sudan. Christ School was in the middle of a school strike when they got the news of Kev's cardiac arrest. They stopped striking and began praying for their former headmaster. In Durham and all over the world (London, Spain, Tonga, South Sudan, Uganda...) people were praying for Kevin.
As I cried out to God, pleading with him to explain how this could possibly be him "being gentle with us" (my constant prayer this year as we sought his will for us and for our future) I began to understand more fully the dreadfulness of our situation. I know completely that God can be trusted, that He loves us deeply and yet that did not guarantee a positive result for Kev. Kev could die, would likely never wake up again, and I would be left alone with four small children and without my best friend. This was God being gentle? I ached and my heart was sore. I could only take a deep breath, trust, and continue on at the hospital. Watching Kev's chest rise and fall on the vent. Watching the nurses turn his body every 45 minutes. Listening to the doctors explain yet again the difference between normal cognitive function and wishful thinking. Knowing everyone was hopeful and yet seeing the doubt in my eyes reflecting in theirs.
As I continued to play out the events in my head I knew that God had given us no "if onlys". If only he hadn't been alone, or if only someone had given him early CPR... Kev was getting top notch medical care. He collapsed minutes away from one of the best hospitals in the nation. One of the few equipped with this new cooling procedure. Eric got to him almost immediately and had just finished his CPR training. Kev was running close to the house with Joe instead of in the woods somewhere alone (as was his more common practice). We weren't in BGO. We weren't out west hiking in the mountains or down in a canyon. We weren't even at my mother's house (45 minutes away from a top hospital). Kev's collapse happened within a very narrow window of near perfect timing to insure his best chance of survival. Would it be enough?
On Friday, they began bringing his body temp back up to normal. By 9:30pm the nurses turned off the paralytic drip and restrained his hands (so that if he did wake up he wouldn't yank out the vent tube). We settled in for a long wait. We were told Saturday evening would be the earliest he could begin to wake up, that Monday even Tuesday might be likely. He was very heavily sedated. I needed to "re-orient" him by talking to him loudly and clearly and consistently until he woke up. Telling him it was okay to enter into the pain and confusion that waking up would surely bring. Telling him it was safe to come back. Was Kevin even still in there? As the drugs started to wear off, I plugged in his I-Pod and played some classical music, then some of his favorite songs from our time in Uganda. As he began to involuntarily twitch, I continued to talk non-stop in his ear. "Don't you dare leave me. I love you. I can't do this by myself. We have four kids. I know it hurts but open your eyes and come back to me." And he opened his eyes. We gasped. No one said he could wake up so soon. We were only 30 minutes into the expected 24 hour talking marathon. "Can you squeeze your left hand?" A weak squeeze. More and more of the ICU staff gathered around as we cheered and talked to him. Withing 15 minutes he was breathing on his own. Katie asked him, "Do you want that tube out of your mouth?" He raised his eyebrows in the Ugandan non-verbal affirmation signal. After the tube was out, he asked "Why am I here? What happened to me?" He was clearly confused, but his cognitive recovery was assured.
The next few days were a blur for both of us. He suffered from significant short term memory issues for the first 24 or so hours as the sedatives cleared his system. We lovingly refer to that time as his "Dori-Day" (from Finding Nemo). During that time we also learned that his aortic valve was severe rather than mild/moderate. The choice was simple. He had to have open heart surgery to replace his faulty valve with a new mechanical one or die. I like to say that on the Thursday of his collapse it felt like someone shoved us off a steep cliff unexpectedly into deep water. We weren't sure we could even swim. On Tuesday, we stood at the edge of the same cliff. Held hands, told each other "I love you," and jumped into the water. Of course, with life boats waiting at the bottom. Still very scary. But with the strong sense that God was watching, as an active participant and that we were surrounded by people who knew what they were doing professionally, medically. We were within a community of loved ones supported by their prayers and emotional support, rather than alone.
Kev came through the surgery like a champ. He has a new carbon valve that should dramatically improve his heart's ability to pump the needed blood throughout his body. His life long heart murmur now replaced by a mechanical clicking sound. Days later he received an internal cardiac defibrillator (ICD). While his doctors are 99% sure that his valve was the real issue and cause for the cardiac arrest, the ICD is his insurance policy. If his heart ever begins to enter a life threatening rhythm again, this device will try to pace him out of it while it charges up. If the pacing function doesn't work it will then deliver up to 6 shocks... although 1 should do it... to shock his heart back to a normal rhythm. Just like the paddles used by EMT except that these "paddles" are transmitted through a wire straight into his heart muscle. Totally fascinating and reassuring.
How do we explain that Kev will walk out of the hospital only weeks after he coded on the street? Even with all of the favorable conditions surrounding his collapse the odds still were not in his favor. Both doctors, extremely experienced, have told us that they have never heard of someone surviving what happened to Kevin. The best theoretical odds with the new cooling protocol gave him only a 30%-40% chance. (Fortunately this is information no one shared with me last week.) Everyone wants to shake his hand. To meet the man who survived.
We can only hold forth that God was good and gentle with us. Not that this recovery was "payback" for years of service in Uganda, nor that it points to some special future work that would have gone unfulfilled with Kev's death. There are certainly many people out there for whom death was the outcome, whose worthy, amazing lives were cut off too short. Why did Kev survive?? Surely that is a question we won't have answered this side of eternity. Yet while we have no answers, no cliche pat response, we do feel that Kev's recovery is a sign. A big neon, beautiful glaring sign of God's power and faithfulness. A sign that points to a time when God's Kingdom comes to earth in full power. When death is no more. When evil is overcome. When horrible sickness and loss are abolished and God's glory abounds. When crying turns to laughter, and sorrow to joy. When our loved ones open their eyes and come home. Obviously that world isn't here yet. Problems abound and suffering is persistently tenacious. But there are signs, miracles if you will, that point to another reality, to a future hope of something far different. Kev's recovery from death stands as one of those pointers.
Kev should have died on our anniversary, yet he lives today. We're continuing to plan for our upcoming move to Exeter, rather than for a heart-wrenching funeral. We give thanks to God. We thank Him for the skilled hands who took care of us here at Duke and for the many, many people who lifted us up in prayer and surrounded us with love.
Around 11:00 on Thursday, our 15th wedding anniversary, Kev and Joe went for a jog. They had been working out together (along with Louisa at times) so that both kids would be in minimal shape for upcoming summer sports camps. Several days each week they either played soccer at the park, shot some hoops, or jogged through the neighborhood. On Thursday, Joe and Kev decided to jog. They jogged down to the park to run some sets of stairs. Joe ran 5, Kev did 10 then Joe says that Dad needed some water and to walk rather than jog back to Englewood Ave (our home street). Once they got to Englewood, they jogged uphill about three blocks and then decided to finish with a hard sprint from our drive way to the top of the block where Alabama intersects with Englewood. Joe remembers racing past his dad and getting to the stop sign first. He turned around and saw Kev slowly jogging, then stumbling, then collapsing.
A car drove by and told Joe to go get his mom, that he was calling 911. Joe ran the 100 or so feet to our house to get me. Another man was walking his dog and also called 911. Another man, Eric, was driving down Club Blvd on his way to get some more supplies for a job he was working on in the neighborhood. He needed to get to Hillsborough Rd, but instead of going all the way to Hillandale and then over, something told him to turn onto Alabama and cut through our neighborhood instead of his usual route. He turned onto Alabama and saw Kevin collapsed at the end of the block. Eric had just finished his CPR training. He dashed from the truck and began chest compressions. Joe entered our house screaming for me to come quickly, that Daddy fell down in the street and wouldn't get up. I sprinted to the top of the block where I could see a crowd forming and Kev lying in the road. As I ran up, Eric told me he had just finished CPR class. That Kev needed air but that he didn't know him and so hadn't given him mouth to mouth just compressions (exactly the right thing to do in that situation). I, however, did know him and began to alternate Eric's compressions with mouth to mouth. The whole time wondering if this was really happening.
EMT arrived from both the local fire department and the hospital after about 4 minutes (which seemed like an eternity). They took over CPR. Let me tell you, enthusiastic compressions is a definite euphemism. They cut off his shirt, applied the defibrillator paddles and shocked him. Eric took off both his hat and shirt to try and pad Kev's head from whacking the ground so hard. They shocked him 2 or 3 times with no response. Every body's shoulders seemed to drop, as they began strapping him onto the stretcher. "Can't you shock him one more time? Don't give up, yet." I pleaded. "We can't shock him again, right now." He had flat-lined. "We've got to get him to the hospital." EMT loaded him into the ambulance, and told me to follow them to Duke. The defib guy looked up and said, "I think I've got something." Kev seemed to take a very abnormal looking shallow breath. Three hands immediately tried to find a pulse. Nothing. "We've got to go." And they loaded him in.
John, one of our neighbors helped me get the kids back to the house (Joe, Nate and Savannah watched nearly the whole thing. Louisa was at camp.) I grabbed my keys, called my Mom and yelled at her to get here as soon as possible, hugged a sobbing Joe and assured him this was in NO WAY his fault and dashed out the door. Joe began e-mailing our teammates in Uganda and South Sudan to ask them to pray, and told John that he should call Nanny Rachel to come help with the twins. John let our church know what was going on.
I drove, sobbing the 3 minutes to Duke University not knowing whether Kev would be declared DOA (Dead on Arrival). I prayed that frantic generic "Please Help" prayer. Once I got to the ER a nurse said she would check to see whether he was alive, while I called Allan, our pastor and left and unintelligible message on his phone. I called WHM and they immediately started praying. I called my brother and he assured me he was en route. The nurse came out and told me he was breathing but in very serious condition and that I needed to go to a smaller more private room for the doctors to talk with me. I knew what this meant. This was the bad news room. This was the room you go to and they tell you that your husband has died. A social worker came in to help me deal with the situation and I'm pretty sure I told her the only help I needed was for her to find out if my husband was alive or dead. She came back moments later to say he was alive, but a lot of people were working on him. I asked her to leave so that I could pray. A few minutes later, Allan (our pastor) arrived with the doctors. We sat together, while they told me that Kev had been shocked in the ambulance and had regained a pulse, he had been breathing some on his own but not enough when he arrived at the ER. He had been intubated, but had struggled during the process (my only sign of hope during the next 24 hours). He was now on a ventilator. They were running tests to determine what had happened and had started a cooling procedure to minimize significant brain damage. They told me that the early CPR, especially Eric's chest compressions, had likely saved his life. BUT, and for the next 24 hours I was to hear this BUT after nearly every statement, Kev's brain had been without normal oxygen for 8-15 minutes. The chance that his cognitive function would never return was likely, which meant that they would also need a copy of our living will, especially as it pertained to being in a vegetative state.
Duke had in place a new, cutting edge cooling protocol to increase Kev's chance of recovery. Since he had been without a pulse and normal oxygen flow to his brain the chance that he would be in a vegetative state was high. As they ran more tests they did find that he had a mild to moderate aortic valve issue. They ruled out both heart attack and stroke. Within 2 hours he was up in the Cardiac Intensive Care Unit in critical condition, on life support and was being cooled to 33 degrees Celsius (91 degrees Fahrenheit). They would keep him at that temperature and in that condition (completely paralyzed to prevent shivering and under heavy sedation) for the next 18 hours. They would warm him back up slowly over 6-12 hours and then it would be another 24-72 hours before the drugs wore off and we could see if he would wake up. So, on Thursday night the best timeline they could give me was perhaps he might wake up by Saturday evening BUT the likelihood that he would remain in a vegetative state was significant. Nobody could predict how his brain would handle the lack of oxygen.
Most of that time is a blur, but what was significant to me was the way everyone seemed to wrap their arms around us. Multiple, multiple folks connected with Duke and us through either Science and Math or Blacknall quietly stood beside us. Nurses, doctors, so many people associated with Duke in one way or another made sure we were taken care of. Katie, our Sunday School Leader was by my side interpreting and explaining. Amy arrived shortly after Allan and stayed with me throughout those first two days. Mom made lightening fast time from Charlotte. Arriving to be my main emotional support. Doc was steadfastly calm and influential. Newland providing much needed hand holding. Cherie began coordinating meals. Beth made sure Joe and Louisa were okay for days. My sister and her husband Kevin took care of the twins and then took all four children back to her home in Belmont so that I could be with Kev around the clock. To my amazement Chris, the director of the Cardiac ICU was a friend we had just eaten dinner with at another friends 50th birthday party. My dad flew in from Nevada and some of Kev's sisters arrived in person as others kept up over the phone. We were surrounded by people who both knew us and cared deeply for us. Calls began to come in from Bundibugyo and Sudan. Christ School was in the middle of a school strike when they got the news of Kev's cardiac arrest. They stopped striking and began praying for their former headmaster. In Durham and all over the world (London, Spain, Tonga, South Sudan, Uganda...) people were praying for Kevin.
As I cried out to God, pleading with him to explain how this could possibly be him "being gentle with us" (my constant prayer this year as we sought his will for us and for our future) I began to understand more fully the dreadfulness of our situation. I know completely that God can be trusted, that He loves us deeply and yet that did not guarantee a positive result for Kev. Kev could die, would likely never wake up again, and I would be left alone with four small children and without my best friend. This was God being gentle? I ached and my heart was sore. I could only take a deep breath, trust, and continue on at the hospital. Watching Kev's chest rise and fall on the vent. Watching the nurses turn his body every 45 minutes. Listening to the doctors explain yet again the difference between normal cognitive function and wishful thinking. Knowing everyone was hopeful and yet seeing the doubt in my eyes reflecting in theirs.
As I continued to play out the events in my head I knew that God had given us no "if onlys". If only he hadn't been alone, or if only someone had given him early CPR... Kev was getting top notch medical care. He collapsed minutes away from one of the best hospitals in the nation. One of the few equipped with this new cooling procedure. Eric got to him almost immediately and had just finished his CPR training. Kev was running close to the house with Joe instead of in the woods somewhere alone (as was his more common practice). We weren't in BGO. We weren't out west hiking in the mountains or down in a canyon. We weren't even at my mother's house (45 minutes away from a top hospital). Kev's collapse happened within a very narrow window of near perfect timing to insure his best chance of survival. Would it be enough?
On Friday, they began bringing his body temp back up to normal. By 9:30pm the nurses turned off the paralytic drip and restrained his hands (so that if he did wake up he wouldn't yank out the vent tube). We settled in for a long wait. We were told Saturday evening would be the earliest he could begin to wake up, that Monday even Tuesday might be likely. He was very heavily sedated. I needed to "re-orient" him by talking to him loudly and clearly and consistently until he woke up. Telling him it was okay to enter into the pain and confusion that waking up would surely bring. Telling him it was safe to come back. Was Kevin even still in there? As the drugs started to wear off, I plugged in his I-Pod and played some classical music, then some of his favorite songs from our time in Uganda. As he began to involuntarily twitch, I continued to talk non-stop in his ear. "Don't you dare leave me. I love you. I can't do this by myself. We have four kids. I know it hurts but open your eyes and come back to me." And he opened his eyes. We gasped. No one said he could wake up so soon. We were only 30 minutes into the expected 24 hour talking marathon. "Can you squeeze your left hand?" A weak squeeze. More and more of the ICU staff gathered around as we cheered and talked to him. Withing 15 minutes he was breathing on his own. Katie asked him, "Do you want that tube out of your mouth?" He raised his eyebrows in the Ugandan non-verbal affirmation signal. After the tube was out, he asked "Why am I here? What happened to me?" He was clearly confused, but his cognitive recovery was assured.
The next few days were a blur for both of us. He suffered from significant short term memory issues for the first 24 or so hours as the sedatives cleared his system. We lovingly refer to that time as his "Dori-Day" (from Finding Nemo). During that time we also learned that his aortic valve was severe rather than mild/moderate. The choice was simple. He had to have open heart surgery to replace his faulty valve with a new mechanical one or die. I like to say that on the Thursday of his collapse it felt like someone shoved us off a steep cliff unexpectedly into deep water. We weren't sure we could even swim. On Tuesday, we stood at the edge of the same cliff. Held hands, told each other "I love you," and jumped into the water. Of course, with life boats waiting at the bottom. Still very scary. But with the strong sense that God was watching, as an active participant and that we were surrounded by people who knew what they were doing professionally, medically. We were within a community of loved ones supported by their prayers and emotional support, rather than alone.
Kev came through the surgery like a champ. He has a new carbon valve that should dramatically improve his heart's ability to pump the needed blood throughout his body. His life long heart murmur now replaced by a mechanical clicking sound. Days later he received an internal cardiac defibrillator (ICD). While his doctors are 99% sure that his valve was the real issue and cause for the cardiac arrest, the ICD is his insurance policy. If his heart ever begins to enter a life threatening rhythm again, this device will try to pace him out of it while it charges up. If the pacing function doesn't work it will then deliver up to 6 shocks... although 1 should do it... to shock his heart back to a normal rhythm. Just like the paddles used by EMT except that these "paddles" are transmitted through a wire straight into his heart muscle. Totally fascinating and reassuring.
How do we explain that Kev will walk out of the hospital only weeks after he coded on the street? Even with all of the favorable conditions surrounding his collapse the odds still were not in his favor. Both doctors, extremely experienced, have told us that they have never heard of someone surviving what happened to Kevin. The best theoretical odds with the new cooling protocol gave him only a 30%-40% chance. (Fortunately this is information no one shared with me last week.) Everyone wants to shake his hand. To meet the man who survived.
We can only hold forth that God was good and gentle with us. Not that this recovery was "payback" for years of service in Uganda, nor that it points to some special future work that would have gone unfulfilled with Kev's death. There are certainly many people out there for whom death was the outcome, whose worthy, amazing lives were cut off too short. Why did Kev survive?? Surely that is a question we won't have answered this side of eternity. Yet while we have no answers, no cliche pat response, we do feel that Kev's recovery is a sign. A big neon, beautiful glaring sign of God's power and faithfulness. A sign that points to a time when God's Kingdom comes to earth in full power. When death is no more. When evil is overcome. When horrible sickness and loss are abolished and God's glory abounds. When crying turns to laughter, and sorrow to joy. When our loved ones open their eyes and come home. Obviously that world isn't here yet. Problems abound and suffering is persistently tenacious. But there are signs, miracles if you will, that point to another reality, to a future hope of something far different. Kev's recovery from death stands as one of those pointers.
Kev should have died on our anniversary, yet he lives today. We're continuing to plan for our upcoming move to Exeter, rather than for a heart-wrenching funeral. We give thanks to God. We thank Him for the skilled hands who took care of us here at Duke and for the many, many people who lifted us up in prayer and surrounded us with love.
Well on our way
The ICD procedure went very well... although the surgeon did tell me that Kev flat lined for about 12 seconds unexpectedly during the procedure. Everything was under control and the surgeon pushed forward rapidly attaching the wire to Kev's heart and restarting a good rhythm. Thanks for your prayers. I'm glad I knew nothing about that until the end. The ICD is functioning well now and has already helped me get a good night's sleep (well, except for the late night blood draws, blood pressure and temperature checks). It will pace his heart down if it beats faster than 200 beats a minute and "thump" him if his heart goes into another V-Fib. Now we are just waiting for his blood levels to adjust to the coumadin and we can be discharged. I can hardly believe that we are at this point. Praise God. To Him be the glory.
Monday, June 22, 2009
ICD
Kev goes in this morning to have his ICD put into his chest. This internal cardiac defibrillator functions like a pacemaker and will provide an internal shock straight to his heart if he should need that in the future. It should be a simple procedure, but is not without risk. They will need to thread a wire down a vein and screw it into his heart. Then his EP team will have to put his heart into V-Fib (the same life threatening situation that caused him to flat line) and allow the device to shock him out of it. So although the team says that compared with what he has been through this should be a "walk in the park", I remain a bit nervous and am praying. Would you please join me?
Thursday, June 18, 2009
Doing Laps
Today my wife and I visited Kevin and JD at the hospital. Kevin has been moved out of the ICU to cardiac rehabilitation. This was my first time seeing Kevin since his fall last Thursday, one week ago today. It is remarkable at how far he has come, and how fast. I joked with Kevin soon after greeting him that I had missed my narrow window of beating him in a math competition, hoping I might have caught him three days earlier when the effects of heavy sedation were still wearing off. Without missing a beat, Kevin replied with his characteristic wit, "What window?" and proceeded to tell his Celsius to Fahrenheit conversion story.
We talked about this experience, recounting how over the past several years he had noticed marked decline in his aerobic performance, wrongly attributing the effects of poor aortic flow from the valve defect to age or lack of training. With hopeful hearts, we spoke of the new potential for life after this surgery.
Soon into our visit, Kevin's nurse came in to tell him it was time for his exercise, but first asked Kevin to rate his pain (I assume on a 1-10 scale). She asked, "About a three?" And he discreetly put his thumb up, and raised his eye brows in unison to gesture, "Higher." But Kevin is never one to complain, and he is persistent in the face of challenge.
Kevin got situated behind a walker, and with JD at his side, proceeded to make 3 laps around the floor, about 1/4 mile of walking within one day of heart surgery. Jane and I stood by near his room, holding out the watch and pretending to be timing his splits, noting that each lap was faster than the previous. Kevin gladly participated in our game.
After saying goodbye, Kevin back down for a rest, I left with a new found thankfulness for friendship, health, and life. As I left for Chapel Hill to run an evening track race, I silently dedicated the effort to Kevin.
I am thankful for these days we've been given, and for the eternal home we're promised in Christ. In many ways after Kevin makes his full recovery, it may appear that nothing has changed. But, I believe for all of us, we can live life with a poignant reminder of the daily gift that this life is for each of us.
Show me, O LORD, my life's end
and the number of my days;
let me know how fleeting is my life.
and the number of my days;
let me know how fleeting is my life.
Psalm 39:4
(The blog posts from the past week have been written by Scott Ickes, friend of the Bartkovichs and former Christ School teacher)
Wednesday, June 17, 2009
Successful surgery!
The valve replacement surgery went extremely well today! Kevin did well through the surgery and is recovering faster than expected. Tomorrow is expected to be a hard day with pain following the operation. So please pray for Kevin as he presses on through that. And please pray for the family, especially JD, to get some rest.
Praise the Lord for this successful surgery, and for His abundant mercies on Kevin and the Bartkovich family!
Tuesday, June 16, 2009
Prayers for surgery on Tuesday
After reviewing some tests, Kevin's physicians decided to do a valve replacement surgery tomorrow (Tuesday) in the late morning. This is a common, yet serious, procedure, and we appreciate your prayers through the process.
We thank God for where He has placed Kevin during this time: in the hands of some of the world's most skillful physicians. Please pray for them as they operate tomorrow, and for Kevin's body during the procedure.
O LORD, you have searched me
and you know me.
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 know it completely, O LORD.
You hem me in—behind and before;
you have laid 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,
even there your hand will guide me,
your right hand will hold me fast.
Psalm 139:1-10
Mathematical prowess
As a demonstration of his full mental function, Kevin performed two not-so-normal math feats today. First, he beat JD to 100, counting by prime numbers! Second, he converted the temperature that his body was lowered to from Celsius to Fahrenheit faster than a Blackberry calculator. Depending on how well you know Kevin, this may or may not surprise you. Needless to say, we're grateful that that math wiz is sharp as ever. Thanks be to God.
Monday, June 15, 2009
Up and at 'em!
Kevin and JD are happily together at Duke, and will remain there for the next few days as Kevin gets some tests done. The first being a heart catheterization, which will take place on Monday. Kevin has made remarkable progress today: he walked around, talked to the whole family and other visitors, and showed his mental sharpness more and more as the sedatives wore off. Even the lapses in short term memory have been improving. All of this is miraculous news, and we're filled with thanks for Kevin's life, and for the strength and support of the Bartkovich family, friends, and church.
Please continue to pray for the Bartkovich family as things settle and medical decisions get made (possibly) this week. As you can imagine, there is likely to be quite an emotional toll from looking back over these last four days.
Sunday, June 14, 2009
Hospital Food and Hope!
Some more great news on this Saturday evening. Kevin was awake and doing well today. He continued to talk with JD and the family, cracked some jokes, and ate a meal...and even managed to comment that it was not so tasty, which is a great sign! (Though we are hoping he gets some better meals down soon!)
Some of the sedation drugs are still wearing off, so his interactions are still somewhat colored by the medications. We're still asking for prayer as the drugs become metabolized and a clearer picture of his prognosis can be seen. As we look towards the next few days of tests and continued recovery, we're very hopeful, and extremely grateful at this fast and strong progress.
Please continue to pray for continued healing, for rest and recovery for Kevin and the family, and for wisdom for the physicians. To God be the Glory!
Saturday, June 13, 2009
Praise the Lord!
Kevin has regained consciousness!!!
This evening, after the sedatives wore off, Kevin regained consciousness, opened his eyes, asked questions, and sustained breathing. This is amazing news, and we're grateful to the Lord. As to be expected, Kevin was tired and is sleeping through the night. Tomorrow will be a busy day of talking with the cardiologists and probably running several tests.
We covet your continued prayers for Kevin. There is still uncertainty about his prognosis, but we are filled with Hope. Please pray for his full healing, and for his energy and memory to come back readily as he regains strength.
With joyful hearts, we thank Jesus for his death-conquering love.
Friday, June 12, 2009
Friday Afternoon Update
Kevin remains in critical but stable condition at the Duke Cardiac ICU. We learned that he did not have another arrhythmia during the cooling procedure, which is very good news. After 18 hours of cooling, the doctors are now allowing his body temperature to raise back up to normal. Sometime this evening they will take him off of the sedatives and paralytic medications. After the medications wear off, Kevin may start to come around within the next day or so.
The Bartkovich children are staying with close family friends in Duham and are doing well, despite the circumstances. The family is being well loved by family and friends who have come from all over to offer support.
Please focus your prayers for:
Please pray without ceasing.
The Bartkovich children are staying with close family friends in Duham and are doing well, despite the circumstances. The family is being well loved by family and friends who have come from all over to offer support.
Please focus your prayers for:
- Miraculous healing for Kevin, for minimal or no brain damage and full recovery
- Sleep for JD. Beginning tonight, she will likely go for 2-3 days without much rest
- The children as they struggle through the uncertainty of their father's health
Please pray without ceasing.
Urgent Prayer Request
Dear Friends who Pray,
We desperately need your prayers. Today around lunchtime Kevin and Joe were out for a run and Kevin collapsed from ventricular fibrillation, causing cardiac arrest. Kevin is now in the cardiac intensive care unit at Duke. To minimize inflammation, Kevin is receiving a cooling therapy whereby his body temperature is lowered by about 8 degrees. He will be under heavy sedation until Saturday, and there are many unknowns while he remains in critical condition.
Please pray for Kevin's healing, and for the Bartkovich family: JD, Joe, Louisa, Nate, and Savannah.
"He is before all things, and in him all things hold together." Colossians 1:17
Tuesday, June 9, 2009
Jam
One of my life long goals has been to make home-made jam. I find there is something elemental about picking the fruit and then "putting it by" for later use. Plus, just like knitting, the whole process is addictive. I love the abundant piles of fresh fruit. The nagging question, "What are we going to do with all of these strawberries, raspberries, peaches, blueberries... Can we possibly eat all of this?" I love the gleaming, steaming jars of fresh jam lined up on the counter after an afternoon of work. The hot sudsy water, the sterilizing, the peeling, the cutting and dicing, the enormous amounts of sugar, the stirring and timing, the testing and adjusting and finally the filling and wiping and processing. My family loves the jam and squeals or sighs with delight. Especially when homemade bread is rising and baking in the oven at the same time. PB&J's are a life staple for our family. The whole house smells delightful and I get a deep sense that all is right with the world. Odd, I know.
This past week we went down to Traveler's Rest, SC to celebrate Lydia and Gabe's wedding. What a nice time. A breathtaking outside ceremony filled with deep blue skies on a grassy hillside, overlooking lush green mountains. A beautiful couple, supported by a whole host of family and friends and capped off by delicious food, good conversation and lot's of glass tinkling kisses by the newlyweds. My mom graciously agreed to keep the kids and so Kev and I had a wonderful weekend away. We sat mesmerized by the new Star Trek movie and ate wonderful Indian food in downtown Greenville. We walked along the river and talked. We saw some friends from our week at Sonship last October, and hugged the necks of many friends and former teammates from Uganda at the wedding. And along the way we stopped at a little road side stand and bought a whole big basket of local peaches. Pounds and pounds of peaches, an abundant "what are we going to do with all of these peaches" amount. So yesterday I bought myself an early anniversary present...an official canning pot. No more hot water splatters as I try to fit the right amount of jars into a too small pot. Wahoo! I spent a truly relaxing day in the kitchen, surrounded by the smells of peaches and challah bread. Using the right equipment, with mostly good recipes and lot's of laughter and fun. And as I went to bed last night the counter top was lined with peach/strawberry jam, peach syrup (the first attempt at jam- a hilarious mistake) and peach butter. Yum.
This past week we went down to Traveler's Rest, SC to celebrate Lydia and Gabe's wedding. What a nice time. A breathtaking outside ceremony filled with deep blue skies on a grassy hillside, overlooking lush green mountains. A beautiful couple, supported by a whole host of family and friends and capped off by delicious food, good conversation and lot's of glass tinkling kisses by the newlyweds. My mom graciously agreed to keep the kids and so Kev and I had a wonderful weekend away. We sat mesmerized by the new Star Trek movie and ate wonderful Indian food in downtown Greenville. We walked along the river and talked. We saw some friends from our week at Sonship last October, and hugged the necks of many friends and former teammates from Uganda at the wedding. And along the way we stopped at a little road side stand and bought a whole big basket of local peaches. Pounds and pounds of peaches, an abundant "what are we going to do with all of these peaches" amount. So yesterday I bought myself an early anniversary present...an official canning pot. No more hot water splatters as I try to fit the right amount of jars into a too small pot. Wahoo! I spent a truly relaxing day in the kitchen, surrounded by the smells of peaches and challah bread. Using the right equipment, with mostly good recipes and lot's of laughter and fun. And as I went to bed last night the counter top was lined with peach/strawberry jam, peach syrup (the first attempt at jam- a hilarious mistake) and peach butter. Yum.
Wednesday, June 3, 2009
27 Fling Boogies
One of my online mentors is the FlyLady. Several years ago while still in Bundibugyo, I started shining my sink and organizing my house into zones. With four kids, it doesn't take long to live in CHAOS (Can't Have Anyone Over Syndrome) and for the house to be completely cluttered. I realize this sounds like a walking billboard for the FlyLady (I apologize) but I do believe that she is on to something when she compares the clutter in our homes to the cholestral in our veins. Both clog up our lives. And as much as I hate cleaning, I hate cleaning up clutter even more.
The 27 fling boogie is a 15 minute or so challenge. Basically, you run around the room, or dig through a closet and you toss into a box as many things as you no longer need, want, or can use. You know those shampoo bottles that are 2/3s empty, lotion from 5 years ago, masacara that is dried up... or how about (for me personally) the shoes that the kids have outgrown but that still end up scattered all over the front entry way. 27 items being the goal. I stop no matter what at the 15 minute mark. Once you have your box you can look at the items and decide, "Could this bless someone else?" If the answer is yes, give it away or take it to Goodwill. We've been blessed abundantly by people this year! If no, toss it in the trash and move on.
Before we begin packing our boxes this summer, we are all taking the time to boogie. As we attempt to declutter we are keeping the words of William Morris in mind:
"Have nothing in your house that you do not know to be useful or believe to be beautiful." Now there's a challenge!
The 27 fling boogie is a 15 minute or so challenge. Basically, you run around the room, or dig through a closet and you toss into a box as many things as you no longer need, want, or can use. You know those shampoo bottles that are 2/3s empty, lotion from 5 years ago, masacara that is dried up... or how about (for me personally) the shoes that the kids have outgrown but that still end up scattered all over the front entry way. 27 items being the goal. I stop no matter what at the 15 minute mark. Once you have your box you can look at the items and decide, "Could this bless someone else?" If the answer is yes, give it away or take it to Goodwill. We've been blessed abundantly by people this year! If no, toss it in the trash and move on.
Before we begin packing our boxes this summer, we are all taking the time to boogie. As we attempt to declutter we are keeping the words of William Morris in mind:
"Have nothing in your house that you do not know to be useful or believe to be beautiful." Now there's a challenge!
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