Category Archives: Anniversary Posts

Real Time Reflections from Five Years Ago #20 (the last one)


“Everything’s Normal Again. Nothing Will Ever be Normal Again.” These are the words I wrote in a post one month after we had returned to Earlham after spending 46 days in the hospital and drawing very near death. This is the last installment of these real time reflections from five years ago. It has been a valuable investment of time and emotional energy for us.

As I think back now to those last 3 days (March 25-27th, 2009) at St. Marys Hospital in Rochester, MN I have many thoughts and emotions. We drove the four hours from Rochester to Earlham on March 27th the same day that Benj was celebrating his 15th birthday.

Having just spent 46 days in the Mayo Clinic hospitals and having nearly died these things permanently changed my DNA. It was all still very overwhelming to me on this day that we finally made it home. I was relieved to be leaving the hospital, yet at the same time very sad as well. I had developed a strange kind of dependence and comfort in being in the safe environs of the hospital.  To now leave this place that had forever changed my life was not comforting at all. In fact it was downright scary and discombobulating.

The therapists had become my second family during these intense days of rehabilitation. Many of my fellow patients whom I saw regularly in therapy had also made significant progress by this time. Many of them had been released. But it was not comforting to be coming home. I knew that this was what had to be. I wanted to come home and be reunited with my children and sleep in my own bed, but at the same time I didn’t want to come home. For I knew even then that the road back would be rocky and paved with difficulties.

I recognized even during those early days that Karla and I had just been through an intense war together and as such were about to enter into the same sorts of psychological life issues that real soldiers returning from combat experience. Post Traumatic Stress Disorder (PTSD) is a term that should not just be reserved for combat veterans. It can also be rightly applied in medical situations like ours. I have also asked numerous doctors about this idea because I had never previously come across it. All have agreed with the general nature of my comparison.

Reading through the list of PTSD symptoms was like reading our autobiography without even having written it yet.  I forewarned Karla that she would probably experience some of the symptoms of PTSD and she did. These things take some time and much talking to work through and I’m very happy to report that five years removed we are both doing very well spiritually, emotionally, psychologically, and in every other way.

Even though I am not serving as a pastor anymore and have no job, nevertheless I have a peace about the future. I am forty-nine years old and have basically no idea what the near future holds and yet I am at peace. Karla is at peace. Our children are still wild. No, strike that. Just checking to see if you were really reading this or not. Our relationships as a family have never been better.

To give you some idea of why I was a bit nervous to come home I will share some of Karla’s blog postings from the final few days in the hospital. And to help you understand exactly what level of functioning I was at let me tell you this. I posted on April 26th, 2009 that I estimated my right side movement at 50% of what it had been previously. Also, one month after I arrived home I was doing three pound arm curls with my right arm.

My speech was still coming back and word finding becoming less of an issue, but these things were all there lying in wait. One month after I had come back home I was already 100% independent so far as the tasks of daily living were concerned.

But so many things were on my heart and mind during those days. I was simultaneously trying to do the full time job of rehab including strength training, retraining my brain to learn stuff, thinking about my family and also the effect this ordeal might have on the church. It was all so overwhelming to me at the time.

Plus, to top things off I wanted to give the Easter message on April 12th, 2009, just 15 days after I had returned home. I did preach that message, brief though it was, and with a break in the middle so I could rest. We stopped in the middle and sang a hymn and then I continued. I didn’t preach again for six more weeks. I know that at one point during the stay I was down about 40 pounds or more…but even more than that just felt overall very weak still. Again, let me remind you that just prior to the surgeries I had been in the best shape of my entire life. I’m not sure what it was that propelled me to work out so intensely in those last few months leading up to the surgeries but I am certain that the condition my body was in was nothing but a big plus for my making it through all of this alive.

A friend of mine left the following encouraging comment on the blog during these days and I share it with you now, not to make much of me but to make much of the God I put my hope in during these tumultuous days when life seemed so ephemeral.

“Been through the fire” is certainly an appropriate image, and a Biblical one. Of the thousands of things God has been doing these days, one of them is lending Mike credibility as a pastor. When he stands next to a hospital bed and quotes Isaiah 43, no one will ever think, “Easy for you to say; you don’t know my situation.” In fact, as he recounts his own story, they will be massively encouraged that God’s promise is true: “When you pass through the waters, I will be with you; and through the rivers, they shall not overwhelm you; when you walk through the fire you will not be burned, and the flame will not consume you.”

Praise God for his promise, and your lives as a visual image of His faithfulness for the rest of your lives.

Tim Trudeau”

The following are excerpts from the blog posts that Karla wrote during those final three days in rehab before coming home on March 27th, 2009.

“One More Day!” (March 25, 2009)

(Karla) “It’s hard to believe, but Mike only has one more full day of therapy.  He has opted to have some therapy on the day he leaves, so we won’t be heading home until about lunchtime.  He is not one to turn down a good thing!  He will also have several days off before starting up again, so he wants to be sure to get as much in as possible.

Today the therapists spent a lot of time going over therapies he can do at home.  We also discussed some areas that he will need to be especially aware of, like curbs and rough terrain.  That last part will be especially important when we head to baseball games in May!

The Mennonites just left after singing for us for the last time.  What a great group they are and what a great ministry.  There were 8 people here tonight, but 18 on Sunday night.  They sang “Victory in Jesus.”  Hearing of Jesus healing the lame has taken on new meaning.  It is far more personal now.  Mike then requested that they sing “How Great Thou Art,” which is one of his favorite songs.  I am hoping that next year at this time Mike will be able to play it on the piano again!”

 “This Has Been the Last Day in Rehab” March 26th, 2009

 (Karla) “This will be a quick post, because it is late and I need to be back here early.

Mike had a great day in rehab.  All of the therapists spent quite a bit of time discussing exercises he can do at home, as well as a lot of safety issues.  We feel very confident as we leave that Mike is ready to be home.  He did opt out of physical therapy for tomorrow, but will have an hour of speech therapy before we leave.

 I am having quite a wide range of emotions.  All of the therapists, nurses, and doctors are very excited for us to leave.  I wish I had kept track of every nurse so that I could thank them personally, but that would probably be too overwhelming anyway.  Last night, Randy, one of Mike’s first ICU nurses, stopped down.  That was very emotional for all of us!  He will keep following on the blog, and said that he is looking forward to listening to Mike’s first sermon back when it is up on the church website.  Several others have said that as well.  How encouraging!

 Most of all, we are thankful to God for sustaining us through this trial.  A couple of nights ago, I was reading Psalm 67 in the one year Bible.  The first two verses say this, “May God be gracious to us and bless us and make his face to shine upon us, that your way may be known on earth, your saving power among all the nations.”  That is one of the reasons He has been gracious to us in this trial, that His way may be known on earth.  We are still discovering ways He has been good to us and lessons we are to learn.  So, while we are heading home, the journey isn’t over yet!”

 I wrote the following post two days after arriving home.

 “Premature Reflections from the Other Side of a Great Trial”  March 29, 2009

“Since this whole drama began back in October of 2008, and since we (Sheila Streicher) were able to get this blog up and running about the second week of November, we have had just under 101,000 page views, with the busiest day being Feb. 27th…which must have been heart and lung clot day, when there were 5,449 page views.  All this to say that this drama has not been played out only locally.  This has been a wide spread God glorifying miracle.  But even if it had turned out very differently God would still be glorified.

For may I remind you all of my original posting where I confidently quoted Romans 8:28, which speaks of God causing all things to work together for good to those who love God and are called according to His purposes.  This does not mean that all things are good.  Not at all.  Bad is bad and evil is evil.  But it has been my firm conviction throughout this ordeal that this verse was true, as is all of  God’s Word.

So when I read in the comments recorded here (of which I have read every one) of a church on the north side of Atlanta, Ga. when a good report was given and the church broke out into applause…for a perfect stranger…or maybe we’re not so much strangers as we are divided by denominations and such…Oh well I’m sitting here weeping as I pluck away on the keyboard with one hand (for though the right side continues to improve it’s not strong enough to type).  And there are literally hundreds and thousands of you for whom this same tale could be told regarding smaller Bible study groups, etc.  Thank You!  This is about as close I can come to actually saying  the words “Words cannot express how grateful I am for all of you.”  Just give me some time though, and I’ll try to make things right with you all.”

A couple of days later I wrote another post:

“More Premature Reflections from the Other Side of a Great Trial” April 1, 2009

“Karla is the one who suffered the most in this trial.  Following the resection of my AVM I ended up spending 14 nights in ICU which seemed like 100 nights with the persistent sleep deprivation.  But my vote still goes to Karla for suffering the most trauma during our 46 day stay at Mayo.

But after watching me endure several seizures… for those of you that know her history…that must have have been very rough on her.  But then for her to have to endure the heart and lung clot scare and to face the very real possibility of becoming a widow (which she would have been if we had been anywhere other than Mayo or a hospital in San Diego where they perform this surgery) well those are the scenes in which nightmares can germinate.

A few minutes ago Dr. Sundt, the heart surgeon called.  We had asked him to stop by while we were still in the hospital.  I kept it short and simple .  I simply said “Thanks for saving my life.”  He made a few comments about how close it was.  Yesterday we received via email pics of all the clots after they had been removed.  Yuck.  I believe there were 22 in all.  The one that came out of my heart was 8 centimeters long… that’s 3.1 inches!  And it was beefy.      I don’t remember much about those days, but again… my wife does.  

Not only this, but she had to deal with the added stress of not being home for her 5 children much during this time.  This is why I say Karla had the more difficult row to hoe.  For the entirety of my rehab I mentally put my children on a shelf…knowing that that they would be better served in the long run by a daddy who gave himself 100% to rehabilitation.  And I believe that they are.  I gave it 100%  ALL the time I was in rehab.

Once we compiled all of my get well cards into a single pile I think it is 7 inches high!  To think that each and every one of these cards was hand picked…in person for me is humbling.  Thank You!  I’ve just begun to read through them all again…for there are some I don’t even remember reading!  They are all on my nightstand so that they are the last thing I read before falling to sleep.

After Moses successfully led the Israelites out of captivity there was a song offered up to God.  Parts of it include the following… “Then Moses and the people of Israel sang this song to the LORD, saying ‘I will sing unto the LORD for he has trumphed gloriously the horse and rider thrown into the sea.   Later in verse 11 Moses wrote “Who is like you, O LORD, among the gods?  Who is like you, majestic in holiness, awesome in glorious deeds, doing wonders?” Indeed.

Thanks be to God and all of you as well!


April 1, 2009 Marla Smith blog comment

“I agree Mike……….Karla’s one great gal!

Yes, several times I couldn’t bear to think of Karla being a widow. She was completely oblivious (in my opinion) to the “things floating around in Mike’s heart” when she was first informed and, I had imagined myself hugging her at your funeral service, Mike. (Sorry for the honesty here). I am so glad you are home! I know God has kept you here for HIS purposes! Glory to God!

Keep working as hard as you can with your rehab, you’ll see the results!

We love you! Steve & Marla”

April 2, 2009 Randy Anderson blog comment

“Dear Mike and Karla,
Mike you are no doubt right. For much of those 46 days you had little idea what was really going on and what the issues and possibilities really were; these were blessed days to be ‘in the dark.’ Karla on the other hand was left to stare at it all with enough clarity and understanding to be often troubled and at times truly terrified by what was happening.

However you are different people now — I can’t but believe that you are more compassionate and caring people now and countless others will be more helped by you than they might have been apart from these terrifying days.

Mike Mason in his book on ‘The Mystery of Marriage’ has a chapter on ‘Intimacy’ that came to mind as I read your blog this morning. Confirming your remark as to Karla’s suffering in this — it relates to the intimacy and oneness of husband and wife. Married couple’s he argues ‘own each other’ more truly than they own anything else on earth; houses, cars even children; after all even the children are supposed to eventually grow up and move away — but the two of you own each other as long as you live — we are each other’s most precious possession by far. Karla, as you note, stared losing her most precious possession square in the face — contemplated losing her most precious possession and being left in that sense ‘alone’ to deal with it all, yes with Jesus help, but still….’

May the seas you sail remain, much , much calmer for a long , long time — this is my prayer for you both (and your children as well).


April 5th, 2009 Randy Anderson blog comment:

“Dear Mike and Karla,
I usually don’t read other people’s mail to you but for whatever reason as I scrolled down to post this I cause the lines from your friend Wendy and found them profound. ‘Nothing in our lives is wasted….God uses it all.’ I know this. I believe this, but I don’t see it as clearly as I should and I certainly don’t live it out with anything like consistency, but if I did how much calmer I would be.

‘Nothing in our lives is wasted…God uses it all.’ Even, or maybe especially, the things that break our hearts and lay us low.

Karla, I hope your hair quits stressing out — and I pray that Mike will be therapy champion in all three categories of his therapy — we are settling for nothing less than the trifecta — only for your trifecta we are not predicting ‘first, second, and third, but first, first and first — really the therapy triple crown. May the Lord soon have you preaching, piano playing back packing with big John in the Big Horn mountains.

Love you both,


April 10, 2009 Randy Anderson blog comment:

“Mike and Karla,
On and on and on the trials go and where they stop nobody knows. David knew something of this, he must have or he never would have or could have written Psalm 13,

Psalm 13:1-3 How long, O LORD? Will you forget me forever? How long will you hide your face from me? 2 How long must I take counsel in my soul and have sorrow in my heart all the day? How long shall my enemy be exalted over me? 3 Consider and answer me…

But by the grace of God you can finish your cycle of trial with the confidence that David finished his… for what was true of David is true of the two of you as well.

Psalm 13:5ff But I have trusted in your steadfast love; my heart shall rejoice in your salvation. 6 I will sing to the LORD, because he has dealt bountifully with me.

What a deal — an all but resurrected man preaching on resurrection Sunday — but some day a truly resurrected man will walk the new heaven and the new earth with middle of the night runs to the hospital forever, and ever, and ever behind him. Such is the promise of Easter — such is the promise of God for us in Jesus.


April 11, 2009 (the day before Easter)

(Mike) “Our prayer through all of this has been “Lord, however you can be most glorified…do it.”  Karla even confided with me through tears last night that as I went in for open heart surgery [to have the blood clots removed from my heart and lungs] she prayed “Lord, please save him…but if you don’t it’s all in your hands anyway.”   It takes an amazing amount of faith to utter such words….”  

“If we could see into the future we never would have chosen this path.  But we cannot see into the future.  The future things are the secret things that belong to the Lord.  Some of you, no doubt, are just days away from finding out some bit of news that is even worse than we heard on October 23, 2008.   But until you get that news, and even after you get that piece of news I want to encourage you to obey Philippians 4:6-7  “The Lord is at hand, do not be anxious about anything, but in everything by prayer and supplication let your requests be made known to God.  And the peace of God , which surpasses all understanding, will guard you hearts and minds in Christ Jesus.” 

One day before I had been home one month I wrote the following post:

“Everything’s Normal Once Again. Nothing Will Ever be Normal Again.”  April 26, 2009

Now, as far as processing all of the events of the past few months.  Some of you have confided in me that you too are having difficulty processing these things as well.  The church that I shepherd nearly lost this undershepherd.  My friends, I encourage you to begin processing these things for yourselves by taking a good hard look at  Romans 8:28-29 once again: “And we know that for those who love God all things work together for good, for those who are called according to his purpose.  For those whom he foreknew he also predestined to be conformed to the image of his Son…”  All things for good.  It’s what the verse clearly says.  Even so, I feel like we’re all, especially Karla and me, experiencing some of the symptoms of post traumatic stress syndrome!

Everything is so normal once again, yet nothing will ever be normal again.”

April 28th, 2009 blog comment by Randy Anderson

“Dear Mike and Karla,

All things work together for good. It is remarkable what is inside of those simple words ‘all things’ isn’t it? You would think that minus the catastrophic sorts of things that the two of you have been through people like myself by hearing your story and watching it from a safe distance might more easily count our blessings and move through our ‘catastrophe free’ daily challenges with relative ease; but it is not so for some reason.

 I will pray for your physical therapy regimen that you would persevere with discipline and be blessed with progress. Just think, some day you will have a resurrected body — this will be a ‘therapy free’ body that runs like the wind and who knows what else — someday — but not yet. However, ‘now you are a child of God already…’ (1 John 3). We are from God little children… (I John 4)

What a thought. May the grace continue to be with you both.


Well, this is the last “official” installment of this project “Reflections in Real Time from Five Years Ago.” It has been a very emotional experience to have gone back and relived each of those forty-six days. Some information from these 20 installments will be included in the book I am currently writing.  We have written 280 posts over the past 63 months. More than 1,200 people have  left comments and precisely 157,959 page views have been registered in this same period of time…from 50 or more countries.

It is all so vivid to us still. Well, for me there were several days where I was completely out of commission. But Karla was never out of commission. She pressed on through it all like a real live Rock of Gibraltar. But we all know who the real Rock in this whole drama was and still is.

After safely delivering roughly two million Israelites across the Red Sea from the hot pursuit of Pharoah’s armies, Moses writes of God in Exodus 15:11 “Who is like you, O LORD, among the gods? Who is like you, majestic in holiness, awesome in glorious deeds, doing wonders?”

Indeed. God worked a few wonders in this whole ordeal and Providentially arranged for all of the intricate pieces of this complex puzzle to be arranged in such a way that I remain alive today.

None of us knows what tomorrow will bring. James 4:14-15 tells us that as human beings we are but a mist that appears for a little time and then vanishes. Instead we must be ready and open to whatever the Lord brings our way at any and every moment in time. Thanks for joining us in this journey!





Real Time Reflections from Five Years ago #16


“All the sudden I could bend my right knee in bed yesterday!   And  I could raise my arm about 12 inches…12 inches more than yesterday! ” Mike

Picture to the left is of Golgotha, “the place of the skull” in Jerusalem, one of two possible sites where Jesus was crucified. Karla and I had the opportunity to visit Israel in February 2011.

March 14-15th, 2009

Karla (Saturday March 14, 2009)

As I was driving into Rochester at 8:30 this morning, I received a call from Luke asking where I was.  I told him I was almost to the hospital and he said that he was already there!

One of the missionaries we support is briefly back from Paraguay and really wanted to see Mike.  So a group of 3 adult (although I did ask them how old they are) men and Luke arrived at the hospital at 6:30 this morning for a two hour visit.  It sounds like they had a great time, although Mike may need to recover from all the laughing!  His chest still hurts quite a bit when he laughs.  They also used all his best words for the day.  I’m hoping I get some after he has a nap!

Mike had a great day yesterday.  I was able to attend most of his therapy sessions.  It is amazing that physical therapy works.  I still don’t get it.  They started by telling Mike to look at his hand and think about moving it.  Then they had him move his left hand while they move his right.  Eventually he was able to move on the right.  It makes no sense.  That it is pretty much how everything has worked.

Yesterday he was working on walking from side to side.  He held onto a windowsill and a bar and moved both directions.  In the morning, the therapist had to help his right foot move.  In the afternoon session, she didn’t.  I am definitely going to have to research this to figure out how it works!

Several people have expressed concern over his hand not working as well as his leg.  He was up and walking on March 4th and his arm did not start to work until March 9th.  We were told that usually the leg works first and then the arm, and this is the pattern that Mike has followed.  So, while others were worried about this, I was not.  Of course, we don’t know what the final result will be, but progress usually continues through the first year following AVM surgery….

Next week will be the first week that Mike has a full slate of therapy.  They held off on some of the non-essentials (recreational therapy) to give him time to heal from the cardiac surgery.  He still has pain with laughing and some movements, but is doing much better in that area.

I am hoping to get some good talking time in today!  He only has two therapy sessions today, so hopefully he’ll be more awake.  I am heading home tomorrow to spend a few more days at home.  Mike may be posting sometime this weekend, so stay tuned!

Mike’s post from March 14th,2009 (first post post-open heart surgery, which was on Feb. 26th. I posted once on Feb. 24th after the brain surgery and blood infection, naively thinking that that would be as bad as it would get. Ha!)

  • “Thank you to all of you who have joined us on this roller coaster ride.  Strap your seat belts on and join in the great adventure!  I am eternally grateful for every last one of you!  After all, if the prayers (of just one) righteous person are powerful and accomplishes much, then there is surely much more power in the prayers of many.
  • The brain is more than just a machine that one turns on…it is a vastly complex interworking of muscle groups, neurons, etc.  that I think God largely hides from man.  The intricacies of modern science have allowed access to all of the major organs of the body…except the brain.  “Who has known the mind of the Lord or who has been His counselor?  Who has ever given to God that God should repay?  For from Him , through Him, and to Him is everything.  To God be the glory forever and ever….”
  • Progress is being made every day.  All the sudden I could bend my right knee in bed yesterday!   And  I could raise my arm about 12 inches…12 inches more than yesterday!  Various leg motions heretofore unrecorded, practically dry my tears.  It’s about getting systems working again.

I had an unexpected visit today from 4 friends and my 16 year old son (son is included in friends) who left Earlham today at 3:30 A.M.! (posting took 1 hour).”

Mike’s take on this post. What was I thinking when I wrote that the brain had muscle groups? I was a biology major right? Well, tonight five years later, I checked it out. And it turns out that my original statement is not that far from reality. No, of course the brain is not a muscle. It is an organ…a very important one.

And actually there is a physical connection between the brain and muscles. It is called the neuromuscular junction and chemical exchanges that happen at this junction are the key to our ability to move. However, it is like a muscle in that the more individual parts of the brain are used the larger it will become. London taxi drivers for example have very large hippocampi because that is the part of the brain that deals with spatial mapping. Also, like muscles, the more one uses a particular part of the brain the more blood is pumped to that area to provide energy. The more you use it the better it works.

One scientifically oriented site I looked at today suggested thinking of your brain as a muscle. So I guess technically I was not correct in suggesting that the brain is a muscle, but it is intimately related to what any individual or group of muscles does.

I also continue to stand in awe of the human brain. It is an amazing three pound organ that God has uniquely given the capacity to adapt and rewire itself, even into old age. Brain exercises are important!  As I read my own words from five years ago “Progress is being made every day.  All the sudden I could bend my right knee in bed yesterday!   And I could raise my arm about 12 inches…12 inches more than yesterday!” Prior to March 13th, I had never moved my leg or raised my arm at all. Unless you have experienced a temporary or permanent paralysis in a part of your body you cannot understand what a joyful moment it was to comprehend that some movement was returning! It was invigorating. I hope that you will never be able to relate.

I was also surprised by some early morning visitors yesterday five years ago. My son Luke and three other friends from Earlham stopped in on this Saturday morning and stayed for nearly two hours. It was a great visit and a good surprise! I remember it well, because of the ruckus in the room early on a Saturday morning.

It was good to laugh although it was also physically painful. I think it was worth it. To see my son Luke and company just made my day. Then as quickly as they had appeared they disappeared…for another four hour ride home.

I hadn’t intended on putting Karla’s entire summary of the events thus far, but I thought she did such a nice job summarizing the saga in this article for our local newspaper, the Earlham Advocate, that I decided to include it in its entirety. And again I would reiterate what Karla mentions in this article regarding the support we received from the Earlham community and church.  It was great. After returning home, Connie Ramsey quietly drove me to my outpatient rehab appointments at Methodist Hospital in Des Moines several times a week for the better part of three months.

By Karla on March 15th, 2009

“We were asked to write an article for the local newspaper and I thought it might be a good recap of what has gone on.  Obviously it does not have all of the details, but I found it good to go back through the whole ordeal thus far and see how far we have come! So, here it is…

Having lived in Earlham for twelve and a half years, I have come to appreciate many of the benefits of living in a small town.  What first bothered me as everyone knowing my business now encourages me, as so many who “know our business” care about what is going on in our lives.  Many of you know that my husband, Mike Evans, went to Mayo Clinic for the surgical removal of a large arteriovenous malformation (AVM:  mass of intertwined arteries and veins) from the left frontal lobe of his brain.  The surgery took place on February 12th, and by medical standards was a success, as the AVM no longer exists. 

However, you cannot do such significant surgery on the brain without some repercussions.

Prior to heading up for surgery, we had anticipated being home by February 19th.  In our pre-surgical meeting with the neurosurgeon, Dr. Fredric Meyer told us that he expected Mike to come out of surgery with some deficits that would hopefully be temporary but would require inpatient rehabilitation.  This did turn out to be the case, with Mike not being able to talk or move his right side at all.

We were relieved when he spoke his first words two days after surgery.  Physical therapy started immediately and we were hoping for quick progress.  Those of you who know Mike know he is very driven, which we were assuming would serve him well as rehabilitation started.

Unfortunately, things did not go as we had planned.  Mike spent seven nights in the neuro ICU before moving to a general neuro floor.  After his first night there, he had a seizure do a temperature spike caused by a blood infection.  This took him back to the neuro ICU for another four nights so that they could get the 106 degree fever and infection under control.  This involved long periods of time on a cooling blanket while covered with ice bags and very strong antibiotics.  He was on antibiotics for 21 days and there is currently no indication that the blood infection is still there.

After this time in the ICU, it was back to the general floor to prove he was ready for rehab.  On the first night there, Mike was complaining of pain in his right leg which led to the discovery of a very large blood clot.  Usually this would be treated with blood thinners, but since Mike had just had brain surgery they did not want to risk a bleed.  Instead a filter was placed above the area where the clot was to prevent it from going to the heart or lungs where a clot can be fatal.

After two days he was ready for rehab!  The first night he experienced two seizures that were determined to be caused by low levels of the anti-seizure medication.  He had a great first full day in rehab, even walking on that first day.  The worst crisis was yet to come.  He awoke after the second night to have a small seizure, followed by a much larger one.  Thankfully I was in the room and was able to call a nurse immediately. 

During this seizure Mike coded and the nurses started CPR.  Mayo is an amazing place.  The neurosurgical fellow was there immediately, as well as a critical care doctor.  They got Mike stable enough to transport him back up to neuro ICU.  His blood pressure dropped and they were having a hard time keeping the heart beating strong enough to get oxygen to the rest of the body.  An ultrasound of the heart showed a large blood clot. 

The options were few.  We now know that most of the doctors did not expect Mike to live.  We believe it is God who had other plans.  Dr. Meyer came and told me that he had told the cardiac doctors to do whatever was necessary to save Mike’s life.   I signed the consent for open heart surgery and Mike was in the operating room within minutes.  The doctor who specializes in this surgery was on call that day and was not already in the middle of a surgery, so he was able to operate immediately.  This surgery is only done in two places in the country:  Mayo Clinic and somewhere in San Diego.  The surgeon was able to remove a 7 cm blood clot from the heart, as well as 20-30 smaller clots from the lungs. 

No one knew how long Mike’s brain had gone without oxygen or how far he would be set back.  When he woke up, his left side moved normally, which was a good sign that the right side of his brain was fine.  We were hoping that the same was true of the surgical side.  He started talking again shortly after coming off the ventilator, which was also a good sign.  As you can imagine, Mike was shocked to wake up and figure out that he had had open heart surgery.  He was not able to fully understand all that had happened until about five days after the surgery.  Six days following this surgery, he was back in rehab.

Mike re-entered the inpatient rehabilitation unit on March 4th.  There have been no bumps in the road so far.  He basically entered at the same point he had after the first surgery, so he had some ground to make up.  It has been quite a bit more difficult, given that he is recovering from open heart surgery and has pain from that.  He has lost a lot of weight, much of it from muscle loss.  Lying in a bed for three weeks is not good!

We are both people who like to do things quickly and rehab is slow.  He has been there twelve days and made much progress.  He can walk, although he cannot yet lift his leg.  His right arm started moving last Monday and he can now lift it slightly.  Progress is measured in small amounts.  On Saturday he was able to move his toes for the first time.  On Sunday he was able put his leg down flat on the bed when it was bent.  There is something new every day.

Mike’s speech also continues to improve.  He is still having trouble with word finding, but that is coming along better.  Last week he wrote a blog post in two hours and this week it took one hour.  That’s a huge improvement!  Of course, he wants everything back to normal now, but he understands it is a slow process.  We are hoping that Mike will be home within the next few weeks.  At that point he will begin outpatient physical therapy.

In Mike’s blog post this weekend, he put this Bible verse:  “Who has known the mind of the Lord or who has been His counselor?  Who has ever given to God that God should repay?  For from Him, through Him, and to Him is everything.  To God be the glory forever and ever….”  We both think that God has kept many things about the brain hidden from people lest they think too highly of themselves.  We do not at all understand why all of this has taken place as it has.  It is certainly not as we had planned.  But we are trusting in God, who understands, and created, Mike’s brain.  We give Him credit for keeping Mike safe through all of these complications and we do want all the glory to go to God!”

Real Time Reflections from Five Years Ago #14

March 8-10th, 2009

Where is God when liDSC_2264fe hurts? This is the 14th in a series of Real Time Reflections from five years ago today as my family and I were in the throes of an F5 tornado. Some of these reflections will be included in the book I am currently writing regarding our experiences five years ago up to the present time.

Before I write about what occurred on March 8th-10th , 2009 I need to back up to Saturday March 7th when the children all came up to visit me.

Regarding the 7th Karla wrote:

“Mike and I both thought that Saturday was a very good day!  It started after a good night’s sleep for Mike and ended with me getting home for a couple days with the kids.

What a joy it was to have the kids up to visit Mike!  They were all relieved that other than being much thinner, Dad is looking pretty good.  We reserved the dining room so that we could all eat pizza together.  We decided that Mike needs to eat pizza more often because he eats a lot of it!

Then it was off to physical therapy where everyone was impressed that he was walking and going up and down the short set of steps.  The girls were at the gift shop when Mike started, so they didn’t know he was walking.  As they were coming down the hall, you could hear Elisabeth say very excitedly, “Look!  Dad’s walking!”  He was also able to hold a large size dowel and work on picking it up and down.  He ended that session by walking from the therapy gym back to his room.  Quite amazing!

PT was closely followed by occupational therapy.  Mike was pretty wiped out after that, so we got ready to head for home.  He was so happy to get to see the kids!  Luke even played the songs from a piano performance we had missed, which Mike thoroughly enjoyed…”

Later on the 9th regarding the Saturday visit by the children:

“…Mike still has his sense of humor, but some of the nurses don’t.  As the kids and I were getting ready to leave last Saturday, Mike was overconfident in his newly acquired skills and thought he could get from the wheelchair to the bed by himself.  He was not at quite the right angle and was leaning too far toward his weak side and fell over on the bed.  He landed on the heart pillow all open heart patients get so that they can hug it when they cough.  This apparently helps with pain.  Mike just laid down, saying with a smile, “I’ve fallen and I can’t get up.  Goodnight!”  We all got a good chuckle out of it.  We did need to call the nurse in to help.  We managed to get him upright before she came in.  She asked what he needed, to which he replied, “I’ve fallen and I can’t get up.”  Saying that he’d fallen got quite a rise out of her!  We assured her he hadn’t and was just joking.  She really did need to have a sense of humor!

On a more serious note, Mike said he had another productive day of therapy.  They added another session of speech therapy, which pleased him.  He would like to see things improve more quickly in that area.  He was also able to lift his arm for the first time.  He had not even done that prior to open heart surgery day.  I talked to him at around 8 tonight and he was exhausted.  I am glad he is able to get good sleep now!  I am anxious to see the improvements he’s made when I get back there on Wednesday.”

Why? Why? Why? Safety even in doubt and despair.

 Mike’s first post, post-emergency open heart surgery: March 8, 2009

“After going through serious brain surgery for the removal of a peach-sized brain AVM, experiencing sleep deprivation for what seemed like 100 days on end, a blood infection, at least 22 blood clots in my lungs…one of which was 7 centimeters in length, open heart surgery, and who knows what else (I haven’t even read my own blog for nearly 25 days)  I can honestly report to you all that the  LORD is still my strength and my song.

And that my wife Karla is precious beyond compare!  Not only for enduring all that she has had to go through, but also for updating and informing all of you at the tail end of many rough days.

I am still largely “out” on my right side, meaning I have very little movement there.  The substance of my right side movement is a slight movement in my thumb.  While I cannot yet lift my leg, I can somehow walk…. even unassisted!   I also have good resistance strength.  I am able to resist one way yet not in others.

Anyway keep praying! (posting took 2 hrs)”

As I read these words five years out I think to myself how could it possibly have taken me two hours to write just 184 words? That’s just over 1-1/2 words per minute! I try to choose my words carefully, but that is ridiculous. And it’s not as if I was distracted. I was sitting in a chair focusing all of my mental and emotional energy on this post after an exhausting day of therapy. I think this was the first time that I had really stepped back to take a clear look at the realities at hand. I had just been through brain surgery and massive complications that nearly ended my life, and was just coming to terms with these facts. And they were overwhelming to me. I remember the tears streaming down my cheeks as I wrote this post.

Seeing the children on Saturday had been a huge encouragement for me. But now once again I again had to put them on a shelf emotionally so I could focus on giving them the best possible dad with the best possible functioning when I would be going home in what would turn out to be less than 3 weeks (on the 27th of March). If I let my mind go toward my children I would have been an emotional wreck.

Physical trials and sufferings not only weaken otherwise strong and proud people physically, but they also weaken them emotionally as well. I had no idea how weak I could be. Karla was my greatest earthly support and as I wrote “precious beyond compare.” I still feel that way about my wife of 27 years as the trials have made our marriage stronger and more precious.

Richard Sibbes, a Puritan once wrote in a book called the Bruised Reed, (in the year 1630) “After conversion we need bruising so that reeds may know themselves to be reeds, and not oaks.” Karla and I have experienced this bruising in a way that we will never be able to forget.

As I read from my posting on this day I confidently wrote “I can honestly say to you all that the LORD is still my strength and my song.” I believed it then and I believe it now as I type these words today, five years later. However, this does not mean that my faith did not experience any bumps in the road.

On March 2-3rd, 2009 the Central District of the Evangelical Free Church was having their annual meeting in Des Moines, Ia. Normally I would have attended. I have many friends in the E. Free Church. One good friend of mine took it upon himself to find a quote from a regular Patros Logos article that I had written earlier for the home-school newsletter in our state, (2000-present). He brought it to this conference,  had it put on an 18 by 23 inch poster, which he had laminated…upon which three dozen people expressed their well wishes for us.

The words of mine that were on this placard were as follows: “…God is in control. Regardless of the tribulations and trials we may undergo, all of these tribulations and trials are under the hand of an Almighty God, who is not only all-powerful, but He is also good and loving in all of His ways toward us. Mike Evans, from Brothers Be Empowered By Providence

This friend sent it to me in a round cardboard tube and I had it put up in the room for me to look at. I think it arrived somewhere between March 8-10th.  It was on the wall at the end of my bed. I had previously believed these words and taught this theological truth for many years. Now I found myself coming face to face with whether I actually believed them or not. When the rubber met the road, and I had nothing left in the tank, so to speak, did I really believe that God was in control? Did I really believe that He had a hand in this trial? Did I really believe that God was good and loving toward me in these days?

I lay awake at night staring at these words I had written by my own hand, asking myself these questions. I was uneasy. I was offended. My own words made me queasy. In fact I remember asking Karla to put something over this poster to hide the words…for a day or two. It is a difficult thing to explain a feeling of doubt. But that’s what it was. No doubt about it. It was a doubt based not upon my prior experience or belief, but based entirely upon my present circumstances. I knew better than to let any present circumstance dictate prior beliefs, but it was a struggle. I kept looking at these words, particularly at night when doubts do their dabbling. Wrestling.

I had always told the people I have shepherded over the years the importance of having their doctrine and theology (beliefs about God and His ways) in place before the difficult things came their way. In fact I had even told them that I would not be standing at their bedside after a tragic event quoting Romans 8:28 “And we know that for those who love God all things work together for good, for those who are called according to his purpose.” On the contrary it has always been my intention to weep with those who wept, not give them a double wound.

Here I was, weak and helpless, brain surgery that had left me paralyzed on the entire right side of my body and unable to speak in the early days…only to be followed by sleepless night upon sleepless night in the ICU, only to be followed by a blood infection, blood clots, and finally emergency open heart surgery. So here more than three weeks from the original brain surgery and I can only move my toe and my thumb a very little bit.

This is when I actually began to think of just exactly what the absolute sovereignty of God entails. And this is what I have come to believe. The absolute sovereignty of God is either the most hellish and damnable lie in the universe or the only true source of comfort in any and every trial. The line between these two statements is separated by a razor blade’s width and yet which direction one falls determines everything about how we view God and ourselves. Everything.

I have come to realize that there is no comfort at all in a middle of the road position between these two statements. If there is anything at all that happens in this universe apart from the eternal perspective of One who sees the beginning from the end and takes every possible contingency into account in His providential ordering of everything, in love, then there must be some events that are outside of His governance. And if there are any events that are outside of His governance then I reject the proposition outright as that of an impotent god. An impotent god is no god in my estimation, but rather a god of our own making. God’s got guts. He has a very strong stomach indeed. And yet He is also able to sympathize with us and enter with us in our weaknesses, trials and sufferings.

I realize that this is a wholly inadequate explanation of why evil and suffering exist from the human vantage point (theodicy). It is not my intention to give simplistic answers to complex and unanswerable questions. What had happened to me was not good. God worked good from the depths of our trial, just as He had promised.

But in non-moral things there are ways of acknowledging the coinciding of God’s absolute sovereignty and human responsibility. For example, what is the relationship between what I have said regarding the absolute sovereignty of God and prayer?

I believe with all of my heart that prayer makes a difference in what God does or does not do. I believe that I am alive today because of the prayers of tens of thousands of people throughout the world that were storming the throne of God on my behalf on the day I coded. The blog had 5,790 hits on that one day alone.

But I also believe that God ordained those prayers be made on my behalf. Every single one of them. We are responsible to pray and God is responsible to work His sovereign will (prompting people to pray). Both occurred on that day and every day. Praise be to God!

I had written the words in front of me on the laminated poster during a time of relative ease and comfort. Now they both offended and comforted me simultaneously. I am glad to have had that experience of doubt and wondering if I really did believe it all.

I remember hearing John Piper say in a sermon once how followers of Jesus could rest safely inside the impenetrable walls of Romans 8:28, where nothing could touch them. That was what I was experiencing even in these very real doubts that came on the heels of the most traumatic month of my life. I never want to experience that again…both the trauma and the doubting. But then God doesn’t consult us regarding His plans.

Nothing did ultimately touch me. My faith in God and His plans and purposes in all things are stronger than ever. My understanding of God’s ways, however, continue to be a conundrum in my mind. But then God does not ask me how He should work, does He. Nope, “Our God is in the heavens; he does all that He pleases” (Psalm 115:3). From our earth bound perspective God’s ways often if not always seem to be manifestly inefficient. But then again God sees the big picture from the tallest mountain, with nothing but loving purposes in mind.

(Karla’s) Real Time Reflections from Five Years Ago (#9)

Mike and Karla

February 26, 2014 (2009)

This is the ninth in a series of blog postings we are doing in real time plus five years post brain surgery. (click on the colored link to see a summary post Five Year Anniversary ).  Portions of these recollections will be included in the book I am currently in the process of writing. This is the day the music almost died.

(Karla writing)

Here are the posts from this day, five years ago.  If you take the time to read them, please notice how matter of fact and void of emotion they are.

Back to Surgery

Just a brief update.  Mike was up at 6 this morning and had a brief seizure.  This was followed by a longer seizure.  They gave as much ativan as they could and moved him back up to neuro ICU.  Somewhere in that process they discovered that his blood pressure was low and the heart was not working right.  The ultrasound showed blood clots in two parts of his heart and something else in a third.  They think that the filter may have broken loose and that is the unknown item.

I am posting this at about 11 a.m. on February 26th, and they have just taken him into surgery.  If it all goes routinely, it will be 4-6 hours long.  They will remove the clots, the other thing, and fix what they think is a hole in his heart, if need be.  The doctors use words like unstable, critical, and high risk.  Not good.  Our optimistic Dr. Fogleson said that this is an extremely serious situation.

We know that God has this entire situation in His control.  We ask that you would lift Mike and the surgeons up to our God, the father of our Lord Jesus Christ.

Out of Surgery

These next posts will probably be brief and to the point.  You might wonder why I even bother.  One reason is that we have such a great number of people following this, and then praying.  The other reason is that now I just have to wait.  I might as well let others know what’s going on here.  The surgery went very well.  They were able to do everything they wanted to do.  They removed one very large clot and several smaller ones.  The filter is in place, so they do not know where the clots came from.  He had very low blood pressure for four hours, so there are concerns regarding the kidneys from that.

There is also now an issue with the head wound.  It looks infected today for the first time.  The neurosurgeons will aspirate it and may end up going in again and clean it out.  That may happen as soon as the cardiac people allow it.  Dr. Meyer is dumbfounded by all this and said that he has never seen anything like it.  He also commended the cardiac surgeon’s quick work, saying that if it had not been so fast Mike would be dead by now. On the positive side, the swelling in the brain is almost gone and all the blood from the AVM surgery is gone, which explains the great progress he was making in rehab.

He will be on the ventilator for about the next 24 hours.  After that they will wake him up and see how his neurological functioning is.  Between now and then we can just wait and pray.

As I read what I wrote five years ago, my words do not even come close to conveying what I was going through.  If brain surgery day was hard, and blood infection day harder, heart surgery day was off the charts hard and almost unbearable.  One of the things that I repeatedly told myself during this whole ordeal was that there were so many more people who had it worse.  So many more wives and children suffering more than we were.  So many more people in worse condition than Mike was.  Especially at Mayo. On this day, I truly felt that I had it about as bad as anyone in the world at that moment in time.  I didn’t stay in that thought long, but for awhile I was there.

I never really relayed all the events of that day.  Before I go into it all, as you read this, please don’t judge me.  You never know how you will react in a situation until you are in it.  As I have looked back over the past few years, there are some things that I have felt extremely bad, even guilty, about.  I shouldn’t have.  I didn’t do anything wrong.  In retrospect it just looks like rather bizarre behavior to me.

Some background on the events of that day. Mike had wanted me to go home to see the kids the night before because a storm was coming.  I had told him that I would not go home until he could push the button himself to call the nurse.  When you are in rehab, nurses try not to bug you all night long.  Once you are in bed for the night, they do not come in again until 7 in the morning unless you call.  Up to this point, Mike had not been able to push the button.  So when he woke up during the night and asked me to call the nurse because he wanted something for his back pain, I not so nicely said, “If you want me to go home tomorrow, push the button.”  He did, and took a single Tylenol for the back pain.  Yes, a storm was coming for sure!

My initial post said that Mike was up at 6 and had a brief seizure.  It seemed like an eternally long seizure, not brief.  And I don’t really know that it was short.  I know that they gave him 4 doses of ativan, which was all they could give him, so it was probably really quite long and he was basically just knocked out afterward.  Oh, and his heart quit beating and he wasn’t breathing.  I don’t really know if that in and of itself would stop a seizure, but I would think so.  After imploring the nurse to move more quickly, asking whether or not he was breathing, and the crash team coming in after she had called a code, I left.

At this point you may have a few questions.  I know what they are because several people asked me these questions.  “Why did you leave?  How long did they work on Mike before his heart started beating and he could breathe again?  What exactly did they do to him?”

This is where you need to not judge.  I know people who stay in the room when this sort of thing happens.  I know people who do not leave the side of the person who is in the hospital.  I am not that person.  I figured that the ten or so people who were in the room trying to figure out what was going on did not need a hyperventilating wife around.  Hyperventilating wives is not a normal occurrence in the rehab unit.  So once again I had no place to go.  Since every spare person was in my husband’s room, they sent me to the nurses’ break room to calm down.  I eventually came out.

I also have no idea how long they worked on Mike.  I do know that they did CPR and broke ribs in the process.  A couple years after the whole ordeal, we finally asked for more details.  Specifically, the doctors all kept saying, “Well they had to use pressors on you, which is very serious.”  We had no clue what these were.  After the fact we learned that pressors were used to keep Mike’s blood pressure up.  Due to the clots that were in his heart and lungs, he hardly had a blood pressure.  We now know that most doctors would use a couple pressors, and if that didn’t work, the person died.  The critical care doctor working on Mike used 5.  Five is an unheard of number of pressors to use.  Every doctor we saw for several days commented on what amazing work this critical care doctor did.  I don’t even know his name.  He had a South African accent, but I only met him once.  So all I really know is what they did worked, and they quickly moved him back to the neuro ICU to figure out what was going on.

In the midst of all this, I was trying to get ahold of someone to come stay with me.  The friend from Iowa who was there was getting ready and didn’t hear her phone ring.  I finally got ahold of Connie Krueger, who I was staying with, to see if she would come up.  She called Denae Harder, a college acquaintance who became a good friend, and they both came to the hospital, even as the snow was bearing down and Denae’s kids were home from school because of the storm.  I also had the pastor who our Iowa friend was staying with show up, as well as my pastor from my childhood who now lives in Rochester.  So we had small army to gather to hold me up through all this and to pray for my dear husband.

I also made several other phone calls.  To my parents, who said they would leave immediately.  My sister took the older boys in to Des Moines and they came up too.  The husband of the friend who was already up there with me came up, as well as my father-in-law and friends from church.  All in a terrible blizzard.  I was very grateful they all arrived safely!  I also called several friends who told me afterwards that I sounded like I was in shock.  I am sure that I was.  I don’t know how else you get through something like that.  I will say that my calls left many of them very concerned.  One friend who is a doctor could hardly make it through the day, crying out of concern for us.  Our pastor friends talked to doctors in their churches and were told that Mike would likely die.  One friend told me that she was rehearsing in her head what she would say to me when she saw me at Mike’s funeral.  Do those words hit you anywhere close to how they hit me?  Mike’s funeral. I have tears running down my cheeks now.

After I made these phone calls, I went back in to talk to the doctors.  They were all visibly shaken, which is not normal for these doctors even in bad situations.  They still did not know what was going on, and would let me know when they did.  By this time Denae and Connie had arrived and were listening with me.  Always good to have extra ears!  I was also very shaky and weak feeling.  So any guesses as to what I did next?  Again, don’t judge.  Yep, I went to the cafeteria and had breakfast.

My husband is literally dying, and I went to eat.  Who does this?  I can’t remember if someone suggested this to me, but that’s what I did.  And this is what I have felt guilty about for 5 years.  Why would I leave my dying husband for food?  Granted, it took care of the shakiness, but someone could have gotten me food.  I vaguely remember saying that I would go get it myself, but it still seems bizarre to me.  I attribute it to being in shock, and having reached the threshold of intensity that I could handle. So Denae and I went and had breakfast.  We weren’t gone long, and it was enough of a break for me to catch my breath for the next round of stress.

And it began again immediately.  Upon getting back, I found out that the doctors thought surgery was the best option.  There were two surgeons in the country who do the surgery Mike needed, and one of them “just happened” to be at Mayo.  He also “just happened” to be the surgeon on call that day.  And “just happened” to be between surgeries so he could operate on Mike.  Dr. Meyer came in with a surgical fellow that I could barely understand who explained what they planned to do.  He explained the risks involved, that if Mike survived the surgery, which was a big if, he could end up permanently paralyzed on the right side as he currently was, completely paralyzed, or even in a vegetative state.  They did not know how long he had been without oxygen or if the surgery would be successful.  They did know that his kidneys had shut down, which is the first in the order of organs that shut down when there is a lack of oxygen to the body. They needed my permission to do the surgery.  I asked Dr. Meyer what he thought and he said that Mike was young and they should do everything possible.  I then signed the long form without reading a word of it, something I never do.

After they left, I broke down.  I explained to my friends that before the brain surgery, Mike and I had talked about what I was supposed to do in a situation like this.  Well let me tell you, there is no such thing as “A situation like this.”  It is not a black and white issue, which is how I like issues to be.  Mike had told me that if a situation arose that would leave him in a vegetative state, I was not to pursue medical treatment.  I wondered out loud if that is what I had just done.  The pastor, who was the friend of a friend, Randy Charlton, gave excellent counsel.  He told me that Mike had never envisioned this situation and could not have known what he was asking of me.  He told me that Mike’s days were in God’s hands, which is exactly what Mike and I believe, and that it was up to God to take care of it.  If this was the day when Mike’s number of days were complete, God would take care of it.  So I was at peace with the decision that I had just made.  I then asked if I could have a minute with Mike before they took him to surgery.  They said to make it quick.

So I went in and laid hands on my husband and asked God to heal him.  And if he was not to be healed, please take him quickly and painlessly.  And then I left Mike in God’s hands, which is where he was whether I verbalized it or not.  I was very thankful for the small army that sat with me throughout the day and the group that arrived that night.

As you know, since Mike is still alive, the surgery was successful.  Mike is not upset with me for my bizarre behavior, and didn’t even know about till last week.  Once he was settled in his room by late afternoon, I was hungry again, so my parents took us to the Canadian Honker for supper.  Yes, once again, I know where I ate.  My parents, Luke and Benj, my sister Betsy and brother-in-law Brandon, and a friend from Iowa.  We had a brief respite from the stress and then back to the hospital we went.  I will say that it was hard to leave Mike there that night.  He was on a ventilator and looked like he was not alive.  There were two nurses monitoring him all night.  And my parents had gotten a couple hotel rooms across the street from the hospital, so I would be close.  I was able to sleep and be back there first thing the next morning.

I am worn out after writing this.  We have said it before, but it all feels so real to us still.  I remember things as I see them, so I can still see all these events unfolding in my mind.  The pain is different now, because of all we have been through since, but I understand it more.  It has shaped me and is a part of my life.  And now I can cry and move on.  Today Mike and I went out for lunch to celebrate five years of life that looked like it wasn’t going to be.  One of our kids asked why they didn’t get to celebrate too.  So we said we’ll do that this weekend.  I am so thankful that God miraculously spared Mike’s life and that we are where we are today!  I love you, honey!

Mike’s take on that day: An amazing mercy from God and an amazing wife! I love you too honey!

Real Time Reflections from Five Years Ago #8

DSC_1160If you have been following these postings for the last couple of weeks you will know that this is the 8th in a series of postings Karla and I are doing in real time plus five years to the day of my having brain surgery (Five Year Anniversary)  to remove a large  AVM [arteriovenous malformation] from the left frontal lobe of my brain.

Today’s posting includes the events of Feb. 24th and the 25th, 2009. I have included nearly all of the text from Karla’s postings from those two days.  It was God’s mercy and intricate orchestration of all the upcoming events that are the reasons I am still alive today.

Five years ago today was my first blog entry following the brain surgery and blood infection. As you can see this post included 104 words that took me one hour to dictate with Karla patiently bearing with me. Karla tells me it is ok to let you all in on the truth that those who knew Karla (including me) at this time would not have characterized Karla as a patient person. I really do love my wife!

Mike Speaks: Finally! (February 24, 2009)

Where does one even begin to tell the tale?  Let me start by thanking all of you for your tremendous support, encouragement, prayers and blog comments.  Of course, I am only beginning to read those.  My brain is still somewhat foggy.  After expecting to spend 2 nights in ICU, to have spent 11 sleepless nights there is beyond comprehension.  I am grateful to finally have the surgery and blood infection behind me and be heading off to rehab sometime today.  By the way, it took an hour to dictate this with Karla typing, just so you know how far I still have to go.

Karla’s post from February 24th:

Another Rough Evening  

Just when I think we’ve turned the corner, something else happens.  During physical therapy, Mike started to feel funny, then proceeded to have a seizure.  He was standing at the time, and thankfully the therapists told him to sit down just before the seizure started.  He rested for awhile, and then sat up to eat.  After eating, he wanted to sit in a chair for awhile.  Shortly after he sat up, he had another seizure.  They gave him a shot of ativan, so he slept for quite awhile.  They do not have any reason yet, but it may be the new antibiotic he started this morning.

I usually do not read all that drug information they give, but happened to this morning.  One of the possible, but unlikely, side effects is seizures.  This medication may have lowered his seizure threshold even to allow seizures.  I told the attending, who then told our one of our usual doctors.  He came in and told him that the attending had thought of this.  I told him it was actually me, which got a laugh out of everyone.  He is now back on the previous antibiotic.

They have also started him on a second anti-seizure medication.  Hopefully these two changes will take care of the problem.

 His day is scheduled to start at 7:30.  He is very much looking forward to getting dressed in real clothes!

Mike was initially in a room with another man, as there are no private rooms available.  He had a terrible cough and had the t.v. on all the time and Mike was not able to concentrate on what the various therapies.  We were able to get a different room that currently does not have anyone else in it.  It is to be filled last, but he could end up with a roommate.  I told someone today that we needed to pray for all those people who could possibly end up in here, that their progress would be so good that they would not need rehab!…Off to sleep in the lovely foldout chair they brought me!  This will be a new experience.  You’ll be hearing from me tomorrow.

 Finally! A Decent Night’s Sleep (February 25th)

After all that went on last night, Mike was finally able to get a good night’s sleep.  He went to sleep shortly after 10 and didn’t wake up till it was medicine time.  It looks like we have a reasonable idea as to why the seizures occurred yesterday.  Mike’s dilantin levels were very low, probably due to the antibiotics affecting it somehow.  They have put him on a different medication for seizures and a very high dose of dilantin today.  He has had occupational therapy and is at physical therapy right now, and everything appears to be going well.

 Dr. Meyer was in this morning and was very encouraging.  He said that he goes longer between visits at this point so that he can see improvement, and he definitely did this morning.  This was in spite of Mike having seizures last night, followed by lots of medication.  He was also pleased to see the movement in his arm and leg.  Dr. Meyer is now making comments about ending up with excellent function in both limbs, which is really a strong word from him.  He also said that hopefully Mike will be able to be entirely off seizure medication after a year or so.  Mike was also happy about that. A friend of ours posted the following verse on the blog, and this is what was going through my mind last night.

 James 1:2-6 2 Count it all joy, my brothers, when you meet trials of various kinds, 3 for you know that the testing of your faith produces steadfastness. 4 And let steadfastness have its full effect, that you may be perfect and complete, lacking in nothing. 5 If any of you lacks wisdom, let him ask God, who gives generously to all without reproach, and it will be given him. 6 But let him ask in faith,

That’s at least part of what this whole ordeal is about, perfecting our faith.  And hopefully the faith of our children and other family members and friends and who knows who else.  So we’ll just keep trying to count it all joy!

Mike’s take on those two days, Feb. 24-25th, 2009:

I remember that it felt very good to finally be in the rehabilitation unit after enduring setbacks and discouragement. I felt weak going into rehabilitation after fighting off the blood infection. I also remember my roommate who had a terrible cough and Karla advocating for me with the nurses that I needed to be able to focus and rest well, none of which would have been possible in that room. She was able to secure another double room just down the hall that was empty. Keep in mind now that if there had been another person needing to enter rehab that day or the next Karla would not have been allowed to stay in the room with me overnight…for the next two nights, which is a crucial component to God’s micro-managing of this entire ordeal. As you will see in tomorrow’s post by Karla the 25th is the last memory I have for a few days. In the rehab units patients are not hooked up to any monitors.

I remember having the two seizures on the 24th of February. I remember thinking to myself “I’m not supposed to have these anymore! That’s what the surgery was for!” I remember going “out” for both of them.  The kind of seizures I had were like an out of body experience. I realized what was occurring but was not fully aware and completely unable to stop. It is the most helpless feeling in the world, next to nurses trying to murder me when I was on the psychotic drug to lower my blood pressure and sleepless nights in the ICU. This led to a phenomenon called ICU psychosis. I think of myself as a fairly stable person psychologically speaking. I assure you that this is a very real phenomenon. I experienced it with great intensity…as real as anything I have ever experienced, or seen, or tasted, or known.

I make this disclaimer about the state of my mental health so that when I share this next memory you will not dismiss me as an outright lunatic. You see, Feb. 24th is also the day I began to experience an overwhelming sense of impending doom. I’m not sure if this began before or after the seizures but I can tell you it was real. I just knew that something awful was going to occur but I didn’t know exactly what or when. I don’t think I shared this with Karla but it was there. And it wouldn’t leave me. I have never experienced this before or since but it was there and rightly so as we will see what happens early tomorrow morning.  My last memory was on the night of the 25th complaining about a pain in my back. The nurse asked if I would like two Tylenol. Karla encouraged me to take two. I said one would be fine. The source of the pain, in retrospect, was not something that could have been helped even by taking two Tylenol.

Karla will be writing the bulk of these next “real time” postings and updates.

Real Time Reflections from Five Years Ago #7

This is the 7th in a series of blog postings from five years ago when our family was going through the massive trial of brain surgery to remove an AVM from my left frontal lobe. Forty six days we spent in Rochester, MN at St. Marys Hospital.  During those traumatic days Karla kept the world updated via these daily blog posts.  Now I give my perspective on those dark days back in February 2009.

Petra in Jordan

I am currently in the process of writing a book about our experiences from exactly five years ago to the day. We are writing in real time plus five years. As you can see these memories are still very fresh in our minds. If you are interested in reading each of these Real Time Reflections from Five Years Ago you can do so by just scrolling through on the home page of my blog.

Sunday Feb. 22, 2009.  Karla wrote:

“I thought I’d better put the date in the tag line, because these days are all starting to run together for us.  Mike will not be at all impressed with what I call each post, but he’s the creative one, not me.

It has been a very busy morning!   When I walked in at 7:45, Mike informed me that as usual, he had not slept.  However, his night nurse had spent time working with him and discovered that when his right leg is bent, he is able to have good resistance against a hand on his foot.

During breakfast, the infectious disease doctor showed up.  I get the feeling that they are very bothered by not knowing where exactly this infection entered Mike’s body.  His temperature is down and he’s improving, which is the important part from the surgeons’ perspective.

We started to watch a John Piper sermon on the computer, only to be interrupted by physical therapy (PT).  Mike never turns down therapy, so we put the sermon on hold!  He is actually starting to get some slight movement in both his hand and leg.  I want to emphasize that this is slight and is not an indication of what the final outcome will be.  We were both very happy about it though!

Immediately after PT left, they started getting Mike ready to transfer him to the regular neuro floor.  This makes both of us a little nervous, but the nurses have been made aware of the problems last time we were here and I feel good that it won’t happen again.

Dr. Fogleson stopped in after the transfer to let us know that the latest round of blood cultures did not grow the bacteria after 48 hours.  This means Mike can get the permanent IV in and not have to get new ones every 3 days.  That will be a relief!  They will also be able to do blood draws out of this line, so the end of being poked is in sight.

The doctor also said that the bacteria is responding to this antibiotic, so unless something changes, we will stick with this. The plan now is to keep Mike on this for 2 weeks and then stop and see what happens. That part is a bit worrisome to Mike. The worst case scenario is that the infection returns. If that happens, they will assume it is in the brain and reopen the site and clean it out. Both surgeons feel quite confident that they won’t have to do this, but it is a possibility. I am thankful that we have chosen to have rehab at Mayo so that the doctors can follow him. Please be praying that the antibiotics will work and that will be the end of the infection…

The song that has been going through my head today is, “You (God) are always good and loving, merciful in all your dealings.”  I have been trying to focus on how God has been good and loving and merciful through this trial.  We’ve probably said these things before, but they bear repeating.

We found the AVM after a seizure, not a hemorrhage that could have led to Mike’s death.  We live close to Mayo Clinic, which is one of the few places in the country that it could have been treated.  We switched insurance last March.  Our previous insurance would not have covered treatment at Mayo Clinic.  Our insurance will cover rehab here as well, for more days than most insurance companies will.  We have many friends and family members who have helped us and walked through the whole ordeal with us.  Mike is in great shape physically, which will make rehab go much better.  Our kids have held up amazingly well, even with Mom and Dad gone for two weeks now, and more time to come.

As you can see, God has been good and loving and merciful to us.  I wait to see what more He does!

On February 23rd Karla wrote:

“We had a friend stay at the hospital last night so that I could go home and sleep.  I arrived this morning to find out Mike is headed for minor surgery today. Yesterday Mike was having severe pain in his right calf.  A priority ultrasound was ordered at 5 p.m.  Unfortunately, emergencies have higher priority, so he did not get in until 10 p.m.  They found a blood clot behind his right knee.  Since he has just had brain surgery, they do not want to use blood thinners.

The vascular guy was just in.  He described the filter that they will put into the vein at the top of his leg.  This will trap any clots that might form and prevent them from progressing to the lungs.  If clots are trapped, there may be some discomfort, but a major problem will have been prevented.

Mike told me to be sure I don’t make a big deal out of this.  Quite honestly, this feels like a finger stick or something equally insignificant compared to what we’ve gone through.

We had a good conversation with the vascular doctor.  He said that he felt so sorry that we had to go through this.  One day all is well, then there’s a seizure and the roller coaster starts.  He asked why God would give a preaching pastor something that takes his speech away.  Mike said that others have worse problems than us and then gave the answer he always does and we know to be true, “Because this is how God can be most glorified.”  He then quoted, “God works all things together for good for those who love Him and are called according to His purposes.”  We also think the speech will be all the way back, so that is not even worrying us a bit.”

Later that same day she wrote in part:

“The procedure to insert the filter in the vein went well. Mike went down for the procedure at 10:45, and was back in the room at 12:15.  He had to lay flat, again, until 2.  Then he ate lunch and started back in on the therapy.  No rest for him today!  He went from occupational to speech to physical therapy.

Therapy has been going very well.  The physical therapist he saw today may be the one he has in rehab.  She was very encouraging and optimistic.  I think that is a requirement for the job.  It has been quite amazing to see him get some movement in his hand and arm. We are anxious to get into rehab tomorrow!  Since insurance limits the days, I am assuming we will have a schedule by Wednesday.  I am planning to go home this weekend and really looking forward to spending some time with our kids!”

Mike’s take on those two days:

After enduring another largely sleepless night in the neuro ICU I was weary yet also somewhat encouraged by finding out during the sleepless night that I was able to have some resistance with my leg. Let me tell you something. To go from nothing to something  is massive! Most of us imagine in our minds things like God creating something (the world and everything in it from no-thing) but to see or feel this occur in real time is remarkable indeed.

The doctors’ concern regarding the blood infection continued to mess with my psychological state of mind.  When Karla writes about the possibility of it being in my brain, and having to reopen the site and says “that part is a bit worrisome to Mike” let me tell you it was much much more than just a bit worrisome.  The way things had gone thus far I had no doubt about the infection returning and having to reopen my skull and clean it out.  The doctors discussed this possibility in my presence and it made me sick to my stomach.

When Karla writes “I am thankful that we have chosen to have rehab at Mayo so that the doctors can follow him. Please be praying that the antibiotics will work and that will be the end of the infection…” I heartily concur! If we had chosen to rehab in Des Moines I would be dead, due to what would follow in a few days. I am so glad that we chose to stay in Rochester to do the rehab and have the original doctors stay with us through the end.

I can also see Dr. McBane, the vascular doctor very clearly, as though he were standing here right at this moment asking, with tears in his eyes why God would give a preaching pastor something that takes his speech away.  I managed to tell the doctor that others have worse problems than us…and then I said more. “I have no idea really other than because this is how God can be most glorified.”  I then quoted Romans 8:28 “God works all things together for good for those who love Him and are called according to His purposes.”  As a Christian himself this brief exchange set Dr. McBane off on a quest to understand more fully the relationship between suffering and the sovereignty of God.

Real Time Reflections from Five Years Ago #6

Evans_0009boostFive years ago at this exact time our family was enduring the greatest trial of our collective lives. The idea came to me on the day after the  Five Year Anniversary of brain surgery (Feb. 12, 2009) to chronicle the events of those days in real time plus five years.

Karla and I will both write over these next 7 plus weeks (corresponding to the number of days we spent in Rochester) in real time plus five years. Five years out things are still very fresh as you will see.

I plan to use some of the text from these real time reflections in the book I am currently writing. This does not mean that I will necessarily be blogging every day but I will be writing every day and I will pass some of that along to all of you.

In those early days after brain surgery and the massive complications that would follow, it was Karla’s daily blog postings that enables me to now tell the story. However, during the days that I was conscious the memories are still vivid.

Real Time Reflections from Five Years Ago #6 Feb. 20-21

On February 20, 2009 Karla wrote:

When I talked to my sister last night, she said the tagline for yesterday’s post (It’s a New Day) was deceptive. She expected an encouraging report and felt duped.  She thought something like Here We Go Again would have been better.  She’s right.  Today is looking up, so we’ll try this tagline again!

It is almost 10 a.m., and so far today we’ve seen the primary doctor, an infectious disease doctor, a doctor from speech pathology to do a long assessment, the head of speech pathology, and the occupational therapist, who also happens to be a Luther grad.  The physical therapist got sent away because someone else beat him here.  Mike also ate breakfast in there somewhere.  Whew!

Mike’s fever went down overnight after he was put on the cooling blanket.  However, it does continue to fluctuate.  We have been told this will probably continue for awhile.  We will not know what the specific bacteria is that is causing the infection for a couple of days.  They also do not know where it came from, which appears to be a bigger issue than I initially thought.

The speech people were encouraging from my perspective, but not Mike’s.  He wants things to go really quickly and they aren’t.  His speech fluctuates with the fever, so at times it is better than others.

We have not been told when we will leave ICU, but I am guessing not until at least tomorrow.  It’s kind of hard to hear everyone else around here talking about leave after a day or two, when we have been here 10 out of the last 11 days.  That’s just me feeling sorry for myself.  I think Mike and I were both overly optimistic in our expectations.  We had hoped to be going home yesterday.

On another note, Gabbie vomited last night at about 4:30 a.m., all over my parent’s new carpet, new bed, and new bedding.  Ugh!  So, my mom had to take the day off to take care of her.  Please pray that none of the other kids get sick.  I feel terrible that my mom is having to deal with this.

Karla’s second posting for the day was as follows:

This will be quick, because snow is coming and I am heading back to the house where I am staying.

The doctor was just in and Mike said, “Greetings, Dr. Folgerstrom.”  That would be great, except his last name is Fogleson!  This guy has a sense of humor and got a kick out of it.

Mike has been much more alert and talking a lot more this afternoon.  His temperature is below 100 now, which is good.  All the fluid that was around the incision wound following has gone away, so they are pretty sure the infection is not from the surgery.

Several people have asked what the name of the bacteria is.  It is not one that is often seen and I couldn’t possibly remember it.  I will ask the doctor to write down the name tomorrow.

Mike had a great physical therapy session today.  They had him sitting up and writing and then standing, assisted, next to the bed.  Apparently the gludious maximus muscle is starting to work, which is a very good thing.

I had better get going.  I plan on getting a good night’s sleep tonight.  Dr. Fogleson said as he left that he is on call all weekend and that he hopes for some good cases this weekend.  He left and returned an few seconds later and said, “That means I want to help people.”  We knew that.  He had a long day of surgery.  That wanting to help people is why we are here!

On February 21, Karla wrote:

I finally made it to the hospital at 10 this morning.  I managed 9 hours of sleep!  Mike had told me to take the day off, but I declined.  I woke up to a blanket of snow, but the roads weren’t too bad.

Mike is doing fine this morning.  There is really not much new happening.  His temperature is not normal yet, so I am hoping that they keep him in the ICU until that is under control.  We found out yesterday that he can move directly from ICU to rehab, so that is what I am hoping for.

Right now Mike is quite bored.  The therapy people will hopefully be in today, but it is not a sure thing on Saturday.  Therapy takes a lot of time and wears him out.  Maybe he’ll be up to reading some blog comments today!

My sister came down for the day and we are going to look for clothes to wear in rehab.  He brought mostly jeans and pullover shirts, which is not the right clothing for rehab.  So, it will be interesting to see what we come up with.

Dean, from our church, is heading home today.  He asked Mike if he there was any message to relay to the church.  Mike said, “Tell them God’s word is true.  All of it.”  That’s a good word for the day.

Mike’s take on those two days:

These two days stand out in my mind because of the come and go nature of the fever from the blood infection I was fighting at the time. Just when I thought I had it licked it the fever would return. Those were three dark days indeed. Karla never wrote down the long name of the bacteria that was determined to have been in my bloodstream, but it was consistent with what would be found in the colon. This was the first time that I heard of the possibility of reopening the incision in my skull and cleaning out the site. That freaked me out big time. Even the possibility that they might have to reopen the site, and remove the pieces of my skull once again was almost too much for me to fathom. It was on my mind constantly.

At the time I had not noticed that my ability to talk would come and go in direct proportion to my fever. High fever little speech. Lower fever much more talkative. It was also very discouraging to realize that we had originally been told we would probably be going home by this time, when I wasn’t even out of the neurological ICU yet!

I also remember greeting Dr. Fogelson that morning by mispronouncing his name. This was just one of the many problems I had with word finding in those early days after the surgery. It came out funny but I had not even intended to be funny…for once. It was extremely frustrating to me. Plus, I was in no joking mood with the possibility out there of opening my skull once again and treating the infection directly. But this fear was nothing compared to what I should have feared in retrospect as we will see just five days from now on February 26th, 2009 when my life nearly came to an end.