Anniversaries Part III

Day 13 of our marriage: 

Thursday morning and daytime carried on with some of the previous days' routine, poke me in the chest, be worried about how much pain, shoot me in the belly with Heparin, which was now resulting in bruising, take my vitals, take more blood. Now, my IV, placed in Tuesday night was causing so much pain that we decided to find a new spot. That took more poking in the afternoon. At this point I had been given the same day time nurse two days in a row, Lori. She had seen me through my feverish mess on Wednesday and we were getting to know her more and more.

Joseph finished school early and the doctor came by in late afternoon. He took a seat this time. Huh...that seemed different. He started to talk. He started to lay out what we were facing.

It wasn't clear yet if the antibiotics were working. He was honest. People die from this and my heart and lungs were at risk. If those tissues were damaged I was facing a major surgery to try to reduce the damage done and then a long healing process. I could need a PICC line which is basically a semi-permanent IV placed in your arm with a line up into the heart that would allow for IV antibiotics to be delivered for 6-8 weeks. If damage was done to my organs I was looking at months away from work and a long healing process. And on the better end of the spectrum I could get better in the next week or so. The surgeon would be in the next morning and he/she could determine if I needed invasive surgery to clean out the infection and repair damaged tissues.

WE WERE SCARED. Flat out, no messing around this was terrifying. Once the doctor left the room we began a flurry of discussion and phone calls. Thank goodness my head had cleared from how it was Wednesday. At the same time I was on enough pain killers that clarity of thought was not exactly easy. We knew we needed a game plan. Ketchikan, though it has a hospital, does not have a community of specialists. The whole town is 10,000 people and the only way off is a plane or a boat. Seattle is a two hour flight and the closest high quality medical care. Joseph began calling family, trying to get their ideas and my precious Aunt called my insurance to find out what was covered, what long term care could look like. He and I talked about what was our line to tell the doctors that we were going to Seattle. We decided that we would do the surgical consult but not allow them to do any major surgery. I would not have an invasive, anesthesia needed surgery in Ketchikan. We weren't exactly sure how it would work and after some inquires with nurses we knew that we could ask to be transferred and that I could board a plane with my IV's and go to Swedish Medical Center. At this point I was not "sick enough" to have a Medivac transport. If the surgeon had good news then we'd stay.

We settled into bed with a plan, all centered around what the surgeon would say in the morning. My body was aching from the terrible beds and days spent laying on my back. I wanted so much for just a short time to be on my stomach. So I got some pillows to try to cushion my chest and bared the pain and attempted to settle for a few minutes. Which is about when the small opening that had been made on Monday and pushed on all week began to expel the gunk...ah gravity. But it was a bizarre kind of hopeful moment. I went to get the nurse. I hoped that perhaps if we could get enough out to relieve some of the pressure I felt that I would get some pain relief. So I clutched Joseph's hand about 10 pm as she pushed and I wriggled and tried not to scream. And sorry for those who are squeamish but my liquified tissues came out. (That is the horror of this infection, it is considered flesh-eating) At least enough came out to make me not so miserable.

After middle of the night vitals and another dose of IV antibiotics I could not sleep and Joseph couldn't either. I began crying, he started crying and neither of us could say our worst fears except in short sentences. But what was going to happen? Would I die? Would I be sick for months? He started praying and saying scripture. Which soothed me enough to slow my tears. He found worship music on my computer and we both tried to let the songs ease our fears. It was a terrifying night, but I was not alone, my dear husband who was facing his worst fears, having to be in a hospital day after day, was staying beside me every night, no matter the nurses encouragement for him to go home and sleep. We were together and God was there and somehow we would get through each moment. I had never felt so close to another person in my whole life. There was a oneness in our fear, in our hopes and dreams for the future and in our resolve to get through it together.

Friday morning, day 13 of our new life as husband and wife. Joseph had gone up to school early in the morning to try to make up what he missed during the week. We had no idea what time the surgeon would come by and knew he had to get school work done. Lori, our nurse was aware of our plan and let us know that she would give us as much warning as possible about the surgeon coming. She gave me the heads up about 930, I called Joseph. He was coming. The surgeon came breezing in and wanted to get started before he arrived. I thought she would just be assessing so again the baring my chest, which at this point I had no modesty left, but the poking was so painful that I squirmed away. The surgeon scolded me with "stay still" and "it can't hurt that bad" To which I burst into tears shaking and unable to calm down. Thank God Lori was holding my hand on one side and within a few seconds Joseph came flying through the door.

The surgeon wanted to open me up right there, in the room. Since I was infected, there was no need for a sterile environment, just clean equipment and minimizing exposure to more bacteria. She was describing a couple inch incision to clean out the infection and check for tunneling.  She had already called for morphine when I was crying out at her poking. Joseph and I talked very quickly and felt that this minor procedure could be done but if she wanted to do anything more extensive and we would say no thanks and head to the airport. The surgeon had left to get some gowns on and the staff started filling the room, I was given morphine. Joseph was made to leave by the surgeon. He didn't want to but Lori, thank goodness, kept assuring him that she would be with me and it would be okay. He stood at the door, held back with a nurse. Once the morphine was on board I was somewhat better, although I got a second dose before the procedure which eased me into a very hazy state. Shots of Lidocaine around the site and she completed a two inch incision and began exploring. Thank goodness for the medication. I didn't notice most of it. Her verdict was the infection had most likely stopped progressing. There were two small pockets on the edge of the main cavity, which needed to be watched and there was no entry into my ribs, or the protective lining between flesh and my lungs. The final step was filling the cavity with sterile gauze. Three feet of quarter inch wide gauze tape was packed into the opening.

The surgeon stated that tomorrow morning the gauze would need to be removed by Lori and she needed to visually inspect the cavity. If there were no signs of further tissue loss then we could be fairly certain that the infection had ceased. So for Friday we held onto hope. We knew that the situation was looking better and by Saturday morning we would have an even greater degree of certainty about making a full recovery.

Anniversaries Part II

Tuesday, day 11 of our marriage:

The Dr Liljegren saw me that morning and I had taken two doses of antibiotics. She cleaned me out again and drew on my chest to mark the areas of redness and told me if I felt flu like, my fever went over 100 or if the redness spread to call or go to the ER. I assured Joseph I would be fine and made him go off to school after the appointment. I spent the day on the couch. I had a good size bandage on my chest and thank goodness for the pain killers because I would start watching the clock each time a dose was wearing off. I was moving slowly and had soreness down my left arm but desperately wanted a shower that evening. As Joseph began to help me, I was unsteady with the fever and pain. He pulled off the bandage and we both looked and the area of redness had clearly grown.

I remember first looking into his eyes as he stood close to me in the bathroom and there was this moment when we shared the fear...this sense that this was NOT good. After taking a breath and both saying it out loud we decided that a shower would still be a good thing before returning to the ER. It was about 830 pm at the time. We dressed me carefully, as the pain had increased since earlier in the day and drove the mile to the ER. I can't forget that ride, the vibration of the car caused shooting pain that took my breath away and the dread of this being bad grew.

Our favorite ER doc Ernie Meloche was on that night. Relieving some of the stress especially for Joseph. He knew he could trust Ernie's judgement. As the hours passed in the ER I was feeling worse. At the time I thought I was sleep deprived. By midnight I was being formally admitted to the hospital. An IV was started in the ER and I vaguely remember being wheeled upstairs, a nurse letting me have more painkillers and some discussions about getting Joseph a chair he could sleep in in the room, despite the nurses encouragement that he go home. He kept telling them that he would not leave me alone.

Of course there's the early morning blood draws and vitals check that wake you no matter what. I awoke in pain and so fuzzy in my brain. We had a decision to make. We both knew he needed to be at school. He had missed one day this week. We had invested thousands of dollars into this program and were counting on this Welding program being part of the financial stability we wanted for us as a family for the future. I told him he had to go. I had nurse's and CNA's and I would be fine. I remember him calling my boss that morning, leaving a message before we opened, saying I was in the hospital and I was very ill and we didn't know when I would be back at work.

 Day 12 of our marriage:
 
That morning, the hospital doctor came in and wanted to look. I couldn't tolerate the poking and prodding. And gasped and burst into tears with the smallest pressure. He expressed significant concern about how much pain I was in. He told me I was on Vancomyacin and that the levels in my blood would be checked to be sure they were getting high enough. I had started shots in my belly, Heparin, twice a day, to be sure that I wouldn't get blood clots from being in a hospital bed and it seemed like as soon as I got to sleep that day people came in to draw more blood. My IV site was tender and the Vancomyacin going in would burn. My veins and body seemed so sensitive. The antibiotic dose usually can flow at a rate to be completed in 2.5 hours but the burning sensation meant they had to slow it to a rate of 4-5 hours. I woke for lunch and vaguely remember calling a few family members to tell them I was in the hospital and to spread the news. I simply said at that point that I had an infection on my chest, under my breast and that I was on strong antibiotics. I could barely sit up, raise my arm, or maneuver myself for the pain and probably sounded like a wreck on the phone. Silly me actually called my boss and spoke to her. She assured me I needed to focus on getting better and all was fine at the office. I returned some texts from work that afternoon. I think I was grasping at some normalcy.

Just after lunch about 2ish the staff that entered my room looked different. They were wearing long yellow gowns, gloves, face shields. Obviously I asked what was going on. The nurse said my culture that was done on Monday had come back and that I had MRSA, Methicillin-resistant Staphylococcus aureus. It's a super-bug. Now I was actually familiar with MRSA, one of our staff had it on their arm a few months before, missed a few days of work and in our due diligence to be sure we were keeping staff and kids safe we had done some research. There are various strains, community acquired being less dangerous and hospital versions being the most deadly. I had a community acquired strain. I refreshed my memory on MRSA via my computer that hubby had dropped by at lunch and knew that this was not good but was optimistic. At this point my fever had broken and the two doses of Vancomyacin were probably working and I was coming out of my hazy, fuzzy brain status.

Joseph showed up about 3 to check in on me and I apprised him of the MRSA. The nurses encouraged him not to touch me, to which he laughed and expressed that he wasn't going to abide by that. They at least implored him to wear a gown. He responded with I was pressing on that infection all weekend, I've been around her for days, if I'm going to get it the damage is already done.

I had a lovely Quarantine sign posted on my door and had a room to myself. The doctor came by that evening and wanted to poke again. Though my brain had cleared my pain had not. At that point I was taking some kind of heavy duty pill and was thankful for it. He started talking with us and said that he was concerned about the pain. He told us that MRSA likes to "tunnel" meaning it doesn't grow in a nice little circle that it fans out through the tissue in little pathways. The location of my infection, with the proximity to my heart and lungs made him concerned that the tunneling could get into those organs. There were signs of tunneling as the pain had made a path up my sternum. He said he expected that after two doses of Vancomyacin that I would be feeling better. The ER doc had drawn a line on my skin of where the redness was twelve hours earlier and it covered the size of a hand on my chest. The area had not grown but it hadn't shrunk either. He told us both that he would order a surgical consult and said that in the morning after another dose of the Vancomyacin we would have a better idea.

About the same time as the doctor was there more blood gets taken. We spent the evening in the hospital room, watching tv, talking and making phone calls to family.

Late that night, maybe 10 pm, the nurse comes in with a much bigger bag of antibiotics. We ask why and she said that the blood tests indicated that the level of the medication in my blood stream is not high enough and I need a bigger dose. That was not encouraging.

Anniversaries Part I

It's been a long hard week... This week last year I was facing death. I just looked over this blog and there's a huge chunk of last year that never got posted. Even now I'm still early in the blogging thing and far from consistent. But it's time to tell the story. Publicly. I think I'm finally ready. I think I finally need to.

Joseph and I began dating the first week of 2011 by late April we were talking about a life together. In mid June I selected a new rental that would be able to accommodate Joseph, Donovan, Joseph's step-daughter, Madison and me, whenever this "family" all came together.

On June 24th while Joseph and I had coffee before work together he knelt down and proposed. He called me Abigail as he had taken to doing. He told me he loved me through his tears and asked me to be his wife. The man who never thought he would marry again. In just a few months God had made us both so certain that He choose us for each other. It didn't take any thought I knew without a doubt. I've known without a doubt. The most amazing thing about my husband is that he walks with God. He hears God's voice, everyday, he checks everything and anything with God and above all else that is what I had prayed and hoped for in a husband. I knew that we could get through any challenge together if we could both walk closely with God's voice.

In August of 2011 Joseph and I traveled to Arizona. He needed a medical procedure and the best doctor for it was in Tucson. We had stopped on the way to visit my sister. We had been talking for weeks about when we would get married. I had been looking at economical ways to have a wedding. We both desperately wanted to have our family and friends together with him in a tux and me in a dress and Donovan and Madison close by. The struggle was that all of these friends and family would have to travel from all over the United States, we knew many could not afford the cost of travel to Alaska, I thought about other locations that people could drive to, and nothing was affordable. Especially since we had accumulated a big medical bill with the procedure and were taking out a student loan for him to do a year of welding school. Accumulating more debt did not sit right with either of us and for weeks it seemed like God had been rather silent with us regarding a wedding. During the trip we prayed and talked and after setting aside our dream of a wedding, God spoke. Since a big to do was out of the question God made it clear 9-10-11. Just about three weeks from the Wednesday morning the we were discussing and praying about timing. We made calls to have a dear friend preside over the ceremony and we each asked a couple that we were close to to be witnesses. It seemed a bit rushed but the peace that God had chosen the date presided over the disappointment of not having the big celebration. In my mind, God was up to something.

Saturday 9-10-11 at Ketchikan City Park Jessica Mathews presided over our vows, which we wrote together earlier in the week. We had, Jim and Katie Parrot and their children, Lisa, Rodney, and Megan Dial and Jessica Mathews, back to the house for cake and they spoke a few words and celebrated with us. Then Joseph, Donovan and myself went to lunch at Cape Fox. The day was sunny and beautiful and of all silly things we spent the afternoon at the shooting range and then came back to the house and watched a movie.

Day 7 of our marriage:
Next Thursday evening as I was getting ready for bed I noticed what I believed was a white head at my bra line, on my chest slightly left of my sternum. I popped and snuggled in with my husband. By morning it was irritated and I thought dang it a zit is really forming. I went to work and as the day wore on it became more tender and red and by the end of the day I went home and rushed to get my bra off which seemed to be making it worse. As the evening passed I was more uncomfortable. Being September it was football season and I felt bad enough that instead of going with Joseph to our friend the Heck's house I stayed home. I wondered what was going on did some internet searching and thought I had a "boil". Now I know that sounds medieval but people still get them. It's a skin infection that is red and various bacteria cause it. I had trouble sleeping that night because it was so tender and couldn't lay on my stomach.

Day 8 of our marriage:
Saturday morning I got up to do chores and go grocery shopping. It was tender and I think I treated it with a hot cloth that morning, as that was a suggested treatment. Joseph had gone off to do some work. He was trying to do side jobs since he was in school four days a week and we needed extra bits of income. His school schedule was such that missing a single day of class could jeopardize the National welding certification that he wanted to have by the end of the two semesters. In Wal-mart about 11 am I suddenly felt so much pain from the location that I had to stop and catch my breath and I got a little light headed. I knew it was best I head home and momentarily thought that perhaps I shouldn't drive and should call Joseph.

I arrived home, took some Tylenol, tried treating with a heating pad and Joseph arrived home a bit later. We tried to press on it hoping to push out some of the infection. I decided to rest and figured if it didn't improve I needed to see a doctor first thing on Monday. But it's just a stupid "boil" right? Joseph went to the Heck's for evening football. I stayed home, he called often to check on me and I assured him not to worry and that I wanted him to enjoy the game. I didn't sleep well the spot was getting redder on my skin and I had trouble laying down or getting up from the pain.

Sunday morning I knew I wasn't going to church, continued the Tylenol and knew first stop on Monday morning was the docs. I couldn't bear the thought of going to the ER for a stupid boil, nor did I want the expense. We don't have urgent care up here so ER costs for an infection seemed silly.

Monday morning I woke with a fever. I began throwing up breakfast at 7 am. Joseph was worried. I was worried. We called the primary care clinic the minute they opened and were told to come in at 845 to see Doctor Lilijegren, complicated name, but good reputation, though I had never seen her before. Joseph called his professor and begged his way out of class that day. The walk into the clinic from the car was hard and the minute I sat down I was throwing up into the trash can in the lobby. They immediately brought me back and laid me in a room. The doctor came quickly and she looked closely and her face said it all this was serious. She pushed on the area, trying to squeeze out the infection and I cried out in pain as I squeezed Joseph's hand. She suggested that she could get me IV fluids and antibiotics there in the office and went to speak to her nurses. Upon her return she said that it would be best to take me to the ER, which is the building next door. I was loaded into a wheelchair and she personally walked with us over to the ER. I was reminded in the moment of the nice things about being in a small town. How many docs would make sure you got right into the ER, for a stupid skin infection...

Now don't forget the location I'm dealing with here and by the time the ER nurse had looked and the second doctor of the day not only was I in pain but feeling like quite the exhibitionist. The ER put me on IV fluids and after some visual inspection the doctor thought it best to get a culture and try to get some of the infection out. I was draped in the room, numbed with Lidocaine and he made about a quarter of an inch incision to give him some room to get the stuff out. Then he began pushing and pushing, keep in mind you have a sternum and ribs and cartilage right there, none of which take kindly to a 200 pound man bearing down on them. After some pain meds, and a full bag of IV clindamyacin. We were sent home about noon with a prescription for Bactrim, pain medication and clear instructions that if the area of redness spread we needed to return to the ER.

My dear husband at this point is being stretched beyond his sanity. When he had a job injury in spring of 2011 he had told me all about his anxiety related to doctors, hospitals and expressed that he didn't know if would be able to handle me ever spending days in the hospital. He said outright that I might have to go it alone, cause he just wasn't sure he could deal with the stress he associates with hospitals.

In the meantime I had called in sick to my office. I don't make a big deal out of what I do but to really understand my story you need to know that in my position I oversee 3.8 million dollars in counseling services. There are over 50 employees and 10 contractors that report directly or indirectly to me. We had enrolled at the time about 90 child clients over 150 square miles. The 90 clients are part of 90 families and so the impact of what we do is far reaching. I take this position very seriously. I am very cognizant that solid leadership is important and as I was only two years into the position we were still in transition, building up staff, creating solid processes and working towards internal stability. At the same time the staff are tremendous, my Executive Director has been there over a decade and when I've traveled and been out of the office before everyone comes together and gets things done. Nonetheless the organization was fragile, but resilient.

I didn't feel much better for the rest of Monday.

(More Tomorrow)

Life without Hope

In our world now there are so many ways to get your inmost thoughts out into the public eye. The beautiful thing about blogs, and twitter, and facebook is that you can be connected to so many people's stories. Their struggles, pain and God's glory can be easily read, followed and digested. I was browsing a blog tonight and I was holding back tears reading about this mother's pain. Her baby boy of three years was diagnosed with cancer and died 8 months later. She continues to write to him over a year after his death. Her anguish is palpable. As I read posts it was so clear that she has so little hope. There's no hint of God's redemption of this tragedy. She signs her posts "I hope you are safe". And that killed me. See I have to believe that as young as he was that he's waiting for her in heaven. There's no hint that she has any idea he is there. That she can be with him again someday. And she's hurting so bad and you can tell that she despairs because she has no hope of a reunion.

I cannot fathom living without the hope of heaven.

I got on a float plane this morning to come over to Prince of Wales Island. I have an incredible group of staff here that minister to children and families on the island. I call it ministry. We are not a Christian agency but I know that the things the staff do is ministry. There is only one source of love in this world, even if you don't yet know that source. Anyways, the weather was horrible, the planes fly visual flight rules, which means that you can only fly if you can see where you are flying to. You have to have a certain amount of visibility above and below. I knew we were pushing those limits. The rain was coming down, the clouds were hanging low and the wind was blowing. There is a moment with these flights that I know Alaska has more small plane accidents and deaths than any other states. We also have more flights than any other states. I know there are risks. But the momentary concern is so easily dismissed. I know what will happen to me if I'm not here. I'll be with God in heaven, Yippeee!

Admittedly I want to be here. I am crazy about my husband. I beam just thinking about the hopes and dreams we have for our lives together. We are just 369 days into our married life and it's been incredible. Amazing. I did not know marriage was so indescribably wonderful. I am looking forward to every moment of each day God gives us together. I want to be here for my son. The boy I adopted in my heart a little over four years ago and legally two years ago is actually finally accepting me as his family. He is investing in being a family member. He says out loud that Joseph and I are his family. He is asking for our advice and wants to be around us. I mean, talk about a change. It was three and a half years of heartache and struggle to parent him. Thankfully God sprinkled in enough precious little gift moments over those years to give me hope that he might embrace his adoption some day. And he has...and the hope is bearing fruit...and I am excited.

As I read this mommy's words tonight. I ached and prayed that somehow, someone would lead her to the healer of broken hearts and the giver of hope.

Blessings in the right direction

I'm not sure what exactly God is up to but I am super excited about more blessings that he poured out on my workplace this week. About ten months ago I was at the end of my rope. I was so tired of keeping on at my job. Leadership was taking it's toll and every time we got a break it seemed like something else would fall apart. I had to make a mental shift. I had to choose to be in my job. I had to decide that I was not stuck, I could leave at any time and find other work but that I wanted to be there. I started making clear plans. What needed to happen to relieve the pressure of leading? What help did I have to find? What kind of hires needed to happen or positions created. Since then there have been steady steps to structure more leadership positions into the program, allowing me to share the challenges and decision making. Really solid staff has come into the program and it just keeps getting better. This week someone came looking for a job and happens to be a great fit for the program and the whole organization. Another blessing and I didn't even have to plan or seek this one out. It just seems clear that God is really up to something. And my stress continues to go down...and that is the biggest answer to prayer. 

It makes me wonder how often God is waiting for me to mentally shift or take a different perspective. I recently got a letter from Ransomed Heart Ministries and John wrote about asking just this question: How do you want me to see this Lord? What if we paused long enough to ask how God sees a situation rather than our human perspective?