Category Archives: Medical Nitty Gritty

(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 #2

Mike and Karla

As many of you know five years ago at this exact time our family was enduring the greatest trial of our collective lives. The idea came to me yesterday to write of the memories and experiences that I had during those days over these next 6 plus weeks (corresponding to the number of days we spent in Rochester) in real time plus five years.

Karla suggested that I write blog posts that correspond to these days as well. I thought that was a splendid idea and so over these next weeks I plan to write regularly on the blog. I plan to use some of the text from these real time updates 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, if you are interested. This self challenge, call it a gimmick if you will, provides me with great motivation to write as I relive each of the days anyway. I have asked Karla to write some of these posts because it was her attention to the details that allows me to…well, get it right.

February 15, 2014 (2009 Sunday)

I remember this day because of all the chaos I created in the Intensive Care Unit by simply uttering three words. Karla tells it like this in her first posting on that day:

“We did have a bit of excitement this morning. Mike indicated that his chest was hurting, which was immediately followed by a pulse of 160 for a few seconds. That brings everyone running in the ICU. He then said, “My heart hurts.” He did not mean his physical heart, but rather his heart is heavy with all we are going through. I told him to quit being poetic, and never say that your heart hurts in the ICU unless it is physical! Needless to say, he had an EKG anyway and some follow-up. I am assuming tonight that we will hear it was just one of those blips in the process. He is talking more, but still quite worn out. You might be amazed at the number of medications he has been on. He has steroids to reduce the swelling, insulin because the steroids affect blood sugar (although he’s off this now), something to keep the blood pressure low, iv’s, antibiotics, and morphine when he needs it for pain. Whew!””
Karla was correct on both counts. First, I should have stopped trying to be poetic. I should have been more careful in choosing my words…but those were the words that I was feeling at the time, and so those were the words I used. And second, she was correct that I was simply feeling overwhelmed at the sheer weight of this trial and the toll it had taken, was then taking, and would in the future take on our family. Moreover I knew there was still plenty that could go wrong. Yet this was my golden opportunity to put the theology (study of God) which I had preached all these years into practice in a major way.
Since I was still having trouble with word finding I didn’t have the ability to communicate what I had really intended by those words. Oops. My bad. Funny bad, but my bad nonetheless. I had also not slept well at all the previous night with all the IV’s and monitors making all kinds of noises. Regardless, my heart was genuinely aching over these things to the point that my pulse jumped to 160 for a few moments. Such was the genuine ache of my heart from the costly seat of my humble and helpless position.
Dean Osborne from the church was also there and took those three words “my heart hurts” in what would turn out to be eerily prophetic as you will come to see in just eleven more days.
He wrote, “Last week wore many of us out both physically and emotionally, plus the little excitement this morning when Pastor said his heart hurt which had the medical staff rushing around and just about put me over the edge. I feared Pastor had thrown a clot or had a major bleed. After the dust settled I’m not sure Karla was as excited as she was last night about Pastor being able to talk, but that’s just an observation on my part.

This morning we brought church to Pastor Mike. Scripture reading from Psalm 95, followed by a few comments and prayer. I thought about singing, but Pastor’s had enough trauma for the week. At 1 A.M. this morning I woke and began to reflect on the week and was reminded of Psalm 139: 13-14 “For you formed my inward parts: you knitted me together in my mother’s womb. I praise you, for I am fearfully and wonderfully made. Wonderful are your works: my soul knows it very well.”

For 44 years, Pastor Mike’s brain has managed to navigate around his AVM, which turned out to be the size of a peach. Pastor Mike excelled at sports in High School and College in addition to his sharp mind. His brain’s ability to literally rewire the neurological pathways all took place without his knowledge or help. We are truly “fearfully and wonderfully made.”
Saturday night is also when the tick tock sound began in my head. At first I thought it was literally a clock or a metronome making the sound as the rhythm was about one time per second. I asked Karla if she could hear it and she said that she could not. Over the next days and weeks, even into June (remember now this is the middle of February) this sound would continue intermittently. No one could tell me why I was hearing these tick tock sounds until a follow up visit in June when Dr. Meyer explained that it was just the titanium plates settling into their place. Ok. Whatever. At first the sounds were continuous day and night. Over time they lessened in intensity and could even go away by the position I laid in my bed. However, the thought did occur to me that if I had to live with this tick-tock sound long term it would drive me certifiably mad. I could not imagine life like this. It also made me think with genuine empathy of those who are forced to live with relentless annoyances and continuous pain.
By this time I was also beginning to be very hungry and thirsty. After all, I hadn’t eaten a real meal now since Wednesday evening and it was now Saturday evening…but broth was a possibility for tomorrow (Monday) if I could pass the swallow test. Keep in mind that my body was half out. So right down the center of my body was the dividing line between function and non function. Therefore half of my esophagus and throat muscles were not working. The docs were concerned that the liquids might go right to my lungs and cause me to aspirate…so they gave me little pink sponges with a few drops of water every hour. Even though I was well hydrated because of the IV fluids I was so very thirsty!
Karla posted again on that Sunday which I thought should be included just to show how much bigger things are than what we can even imagine at any given time.
Karla wrote: “ I have been hanging out in the Mary Brigh 8D Family Waiting room, I have observed and met many families. These people are very kind and interested in what is going on with each other. I have had an opportunity to talk with several families about health crises they are facing.
I met one family whose son came home from high school on Wednesday to find his mother on the floor. She had a brain hemorrhage and was basically in the same condition as Mike was following surgery. Her husband and children shared the same frustration as I did with the lack of communication. They were excited to hear that Mike was talking, as he knows what it is like to not be able to communicate. I will be able to follow their journey as they have started a Caring Bridge site.
Another woman is here from Montana with her son who suffers from uncontrolled seizures. He currently has a grid on his brain to determine exactly where the seizures are coming from. They will then take out the part of his brain that is the problem. I told his mom today that people in my family have had seizures for the past 30 years and this was the first time I had ever prayed for someone to have a seizure. He had one this morning.
It has been good to be able to pray for others when I wake up in the night. Every family here is in a crisis situation, and some are trusting in God and others aren’t. You can certainly see the difference. I hope to be able to pass along a word of hope as I talk to these people. Our situation has certainly given me greater compassion for other people.”

Yep I agree honey…and empathy.

Mike

Anticipating a Great Birthday Present!

The greatest birthday present in recent memory, other than another year, is surely one that I will receive on the 19th of September, 2011,   when I will have the three pins holding my right ring finger together surgically removed…the pins not the finger.

I hope the bones in the finger will stay where they are supposed to stay once the pins are removed.  It has been vastly inconvenient to have to do everything with one hand only for 53 days…including the typing of this post…though I am left handed… a small blessing.  I broke it on July 29th while tubing on a lake with our friends, the Ropps near Kalamazoo, Michigan…500 miles from home on the second day of our vacation, on the last run of the day…again vastly inconvenient.

After going to the E.R. the doctor there said it would need surgery within two weeks…so they put the first cast on and sent me on my merry way armed with percoset…a dear friend in those early days…but with our vacation plans still intact…which was good for the rest of the family, but torture for me as we then spent seven days at Maranatha, a Christian conference center in Muskegon on the eastern shore of Lake Michigan.

To be on Lake Michigan but not be allowed to swim because of the cast…well I think it gives me some appreciation for what it must be like to be a Cubs fan….of course I’m not sure that even then one could truly understand the disappointment…unless they were in fact a Cubs fan.

The only two lessons I learned from this episode were 1. I was unsuccessful in doing a barrel roll on a tube..this time.  Some might argue that I need to come to grips with my increasing limitations…that I’m not as young as I once was etc. etc.  I refuse to entertain any such notions on this my 47th birthday.  2.  I am brave in some things.  I had the guts to set the finger myself, by yanking on it as it only bent at an awkward angle and then going to the hospital where they were duly impressed, in fact offering that if my day job didn’t work out they might have a place for me in trauma medicine.  I chuckled. Karla was not amused.

Two Years Ago Today (on Feb. 12th 2009) I Had Brain Surgery

Click here and go to slide number 8 if you want to see a cool ultrasound picture of the blood clot in my heart and the PowerPoint Presentation for Grand Rounds

Ultrasound video of the blood clot in my heart!

This was my bogus AVM...all AVM's are bogus.
Evans Family in August 2010

It’s difficult to comprehend that two full years have elapsed since my brain was taken out of my skull and replaced with a new and better one.  Actually that didn’t happen at all.  What did happen was that two years ago today I underwent a seven hour surgery to remove an arteriovenous malformation (AVM).  An AVM is a confused blob of intertwined arteries and veins as the very name suggests.

Mine was huge by AVM standards…nearly the size of a peach.  I figure it took up about one-sixth of the total mass of my brain.  The surgeon didn’t remove any actual brain mass.  It was never there to begin with!  (: You figure out what that means.

Dr. Frederic Meyer, from Mayo Clinic in Rochester MN, performed the surgery using a state of the art million dollar microscope strapped onto his head.  And thus began the great adventure.  See the summary of Mike’s brain problem if you are interested in reading more about this 46 day stay at Mayo, the loss of speech and movement on my right side, the blood infection, the blood clot(s) in my heart and lungs, the emergency open heart surgery after I coded two weeks after the brain surgery, and the long, slow recovery, and the tick-tock…metronome  sound in my brain that no one else could hear that hounded me day and night for a time.  Yes, it is grand to be alive!  By all conventional wisdom I should not still be alive on this earth.  I am a blessed man!

The Evans family sitting on an old fence just before it broke

It doesn’t seem like two years ago…It’s all still very fresh…painfully fresh.  I wrote one year ago that I had hoped by this time I would be able to go an entire day without thinking about the trauma of those days.  I still wake up at night and my mind often goes right back there.   I arose at 4:30 a.m. this morning with my mind racing….that’s why I came downstairs to write the bulk of this posting.

A whole day?  Nope.  Mission failed.  Not even close.  I can’t manage to go even a single hour without being taken back in my mind to those harrowing days.  They are tattooed on my soul with indelible ink.  The tattoo is fading a bit but I suspect it will always be there.

Some seem surprised that it has been two whole years since the surgery.  Me too sometimes, but other times I feel like I’m Bill Murray in the movie Groundhog Day.  I don’t remember how it ends.  Does anyone out there remember?

I’m all but certain how mine will end.  According to Revelation Ch. 21 it will end ultimately in the New Heaven and New Earth with the glory of God being the all-sufficient light as followers of Jesus live forever in the proximate presence of a God whose imminence, rather than being terrifying, will be all-comforting.   There will be no more tears or sadness or mourning or death or AVMs or cancer or….you name it…anything that has to do with this fallen world will be forever done away with.

Karla has been amazing through this whole ordeal and is worthy, I think, of a medal of honor!  Thank you  to my children, the Crossroad Church Family who cared for my family in many ways, Dean and Kathleen, Ray and Connie, Pastor Rehfeldt, Dick and Marilyn, Kathy, Steve and Denae, and the three Randys each of whom were angels  (if  angels are “ministering spirits sent to serve for the sake of those who are to inherit salvation”  as Hebrews 1:14 says), Kara and Eddie, Betsy and Brandon, Katie, Justin and Kayla, Justin and Cheryl, John, Holly and Taylor, Shirley, Steve and Marla, Tim, Bev and Jeff and Dad, Sister Cashel, Rebecca, Sarah, Stefano, and the rest of the truly amazing staff in the rehabilitation unit at Saint Mary Hospital, Connie, Dave, Dale, the Earlham Community, and all the Drs. and surgeons along the way to whom, in a sense…a very real sense, I owe my very life.

Below are some pictures that are vivid reminders of what a close brush with death I experienced just two years ago.   If you are having a bad day these pics should provide a cause for pause….and then praise to a God who still works wonders!

Thrilled to be alive,

Mike Evans

Blood clots from the left lung
Blood clot from my heart...no wonder it stopped! (numbers are centimeters not inches...but still)
Blood clot being pulled from my heart...I didn't take this pic. in case you were wondering