Saturday, January 31, 2009

Waiting patiently / Patient waiting

I am sitting here with mom, dad, and the doctor who performed the original colonoscopy. If there is any redemption to be found in this entire situation, it is in the friendship that I see forming between dad and this kind doctor who has sincerely walked beside him every step of the way. As men of integrity, they have both faced a personal crisis and are emerging with their character in tact, fortified, and deepened. It's beautiful to watch.

The best news of the day has been that of dad's pain level. In a very routine manner, the nurse came in and asked dad to assign a number to his pain. His response? A two!! The nurse's response spoke for us all. She whipped her head around and exclaimed, "Really? That is awesome!" Later she admitted that she felt a little weepy at the news. The nurses here have been so sensitive and caring. The entire 8th floor has been cheering for dad since his first day here. Nurses really are a special crew. Also, dad felt hungry for his meal tonight and ate all but 8 or 9 peas. He even enjoyed a few bites of carrot cake!

Things are moving in the right direction. We are all thrilled. There hasn't been much talk of dad's official discharge date, but if today is any indication, it's right around the corner.

At the moment, dad is looking up jokes and quotes on his iPod. That's more like it!

Here's one: "On the other hand...you have different fingers."

Friday, January 30, 2009

The difference a day makes

I am staying at LaWonna's house tonight with her kids while she went in to stay with dad overnight. Mom was sent home to sleep in her own bed for the night. This picture was sent to me from a friend who was in to visit dad earlier in the evening (thanks, Bethany!). This is his first real dinner in 10 days.

Love you so much dad!

Day 10

A doctor from the surgical group was in to see dad this morning. He pulled up a chair at the foot of dad's bed and basically resigned to waiting things out another day. Dad gets the feeling that all involved were hoping that he would be going home today. Another doctor from the same group later admitted that his pain level and progress so far has been greater and slower than they had originally anticipated. We all agree that we would rather see him here getting the care he requires than at home and in need of care that would not be immediately accessible.

His blood work looks good today. The JP drain was removed this morning, which leaves the PICC line as the only remaining tube in dad's body. His diet has been advance to soft solids at whatever level he feels he can tolerate. He has been cleared for showers and is encouraged to get up and out of bed several times per day.

As a transitional measure moving forward, an internist of dad's request will be brought into the mix of doctors to assist in his long term recovery plan. Yesterday, dad had asked who exactly was directing all of this activity, to which the answer was, "well, no one really." The internist will provide a broader perspective on how to best address dad's needs from now through complete recovery.

Dad is only now beginning to comprehend the magnitude of what his body has been through. He is seeing that the days ahead will need to be traversed one at a time, and with great patience and care for himself.

Continue to keep him in your prayers as his body fights infection and pain. Pray for wisdom and understanding on behalf of the doctors involved. Pray for mom as she makes this transition alongside of dad. They both express their overwhelming gratitude for all of the support you all have expressed during this time.

So for now, we wait one more day. Dad is better today than yesterday (in some areas) and drastically better than he was one week ago. Time moves steadily forward, and so do we.

To close, dad has made jokes about people wishing him a speedy recovery. He just hopes that he doesn't wreck getting there. :)

Peace and love to you...

Thursday, January 29, 2009

What group are you with again?

We have lost count of how many doctors are overseeing dad's recovery. Mom has tried her best to keep track of them all, but it may be an unattainable goal. Each doctor has their unique opinion of how dad is progressing. I will tell you what they think and, like us, you can decide for yourself. If you have any brilliant epiphanies, let us know. :)

The infectious disease doctor has noted 3 types of bacteria and has prescribed a different antibiotic for each. He thinks that dad's pain is from infection in the belly that seems to be coming along nicely in accordance with the antibiotic treatment. He also noted that dad's incision is healing well and open wound care won't be necessary.

The surgeon group believes that dad is on the right track in all areas. They believe that his pain is originating in his incision, which they feel is healing nicely. Just in case, an x-ray was ordered this morning to get a look at what is happening inside of his body. The results aren't in yet. Also, to assist in making dad a little more comfortable, the doctor from this group ordered Ativan. This is the same medication that sent dad into an 8 hour hallucination just 3 nights ago. An alert on dad's chart stopped this medication from actually being administered. Whew!

The gastro group is pleased with dad's progress, but they express some concern with the bloating of the belly. They aren't real clear as to why dad's pain is getting worse, not better. This group was most excited about the return of his bowel function.

The nutritional group was responsible for the PICC line. We haven't really heard from them since.

I reviewed dad's list of meds this morning and have some questions about potential interactions that may be contributing to his pain level. Hmmm. What group handles that? I guess I will start with the nurse and see what happens.

Dad is more alert today and looks more like himself out of his eyes. Pain is a major issue. He just can't seem to get the relief he is looking for. Pray for relief for him in this area. It's his biggest struggle and will play a role in determining when he can go home.

When I figure out exactly how he is doing, I will let you know. Being a patient advocate requires spreadsheets and charts. We may need a full time assistant by the weekend. We are now accepting applications.

:)

Wednesday, January 28, 2009

How's the family?

I have heard this question asked directly and indirectly through your comments so I thought I should respond.

To start, today marks the 35th birthday of Angela Joy Beiler. Happy birthday, Angie! We miss you here but know you are loving us from heaven!

Mom is a trooper. She has spent every night but one at dad's side in the hospital. The thought of not being there with him isn't really an option for her. As long as she feels that she can rest well, she seems to be doing fine. After bringing blankets and pillows from home and a few personal items, she settled into a quasi routine at LGH. Life stopped for all of us, but especially for her. When I spoke with her today, she commented that she felt very peaceful. The love that her and dad have is a testament to the power of love and commitment. Love you mom!

Russ (LaWonna's husband) went ahead with a trip that was scheduled before all of this happened. He left on Friday and returned to us on Monday. He felt reluctant to go in light of dad's situation, but LaWonna encouraged him to go and be with his brother. Upon his return, we learned that he was ill the entire time and is even now sick and in bed. He needs some of your prayers, too. LaWonna has been juggling the responsibilities of being a mother and the desire she has to be with dad. Mia,2, Ryan, 4, and Trinity, 8 certainly keep her busy. With some help from a few sitters, she has been able to spend time with dad during the day. She stays in touch by phone, otherwise. We all just miss being together.

I need to give a shout out to my boy, Cristian, who has been so understanding, tender, and flexible during the last week. After the first night of seeing Pop Pop in the hospital, he told me that if he could takes his place in there, he would. That's my boy.

On January 5, we, as a family, decided to join together as the leadership team of The JoAnn Group, dad's latest endeavor. We met several times at the end of 2008 and felt ourselves coming together in a new and unexpected way. The JoAnn Group is now officially a family business. On the Sunday before dad's routine colonoscopy, a sprinkler head in the Family Center froze and burst, flooding the 2nd floor and part of the 1st floor. I remember thinking to myself that day that something was not agreeing with our new found unity as a family. The damage was minor and only provided an opportunity for us to work together. Then Wednesday came. And again, it has afforded us yet another opportunity to come together as a family. The whispers and workings throughout the last few months have been profound. A shift has occurred and it is right on time.

Now as I sit here sniffling and sneezing, I find myself smiling and shaking my head at the whole string of events. I shared with some friends earlier today that the work we are doing, the work that dad began, must be pretty important given all the attempts to thwart our enthusiasm. Honestly, it just challenges me to do more.

The first 28 days of 2009 have been a reality check for all of us, but the energy it has brought to our family is the blessing that continues to unfold.

More will be revealed...

Are we there yet?

Yesterday was an exhilarating day with good news on several fronts. Dad's bowels are back in action. His blood work is near perfect. His diet has been advanced to include foods with the protein his body needs to regain strength. The culture from his incision showed almost no bacteria. The antibiotics will continue to be monitored for effectiveness and his incision is so much improved already. We are experiencing the benefits of prayer and the gift of God's hand in the unseen places on dad's behalf.

The only news we hope to hear is that dad is going home. There hasn't been any talk of it yet, but we are hopeful. Along with continued monitoring of the infection, pain, food intake, and high blood pressure are the factors that will determine the timing of his release. Prayer has been a powerful force this past week, so I ask that we continue to pray for these issues to stabilize and continue to improve. Perhaps I shouldn't be so timid in my request. My cousin commented yesterday that God really showed us up by producing a "pooh" when we were only asking for a fart. :) Just something to consider...

I am home sick today but was able to talk with dad on the phone this morning. He sounded groggy, but good. After running me through the standard updates he said, "I just feel so blessed." Who says that after 7 nightmarish days in the hospital? Wow. While we are gathering around trying to be a blessing to him, he is really just blessing us more. The genuineness of his character continues to amaze me.

Thank you for caring for dad during his time of need. It means so much to him and all of us.

On behalf of the family,

Joy LaVale

Tuesday, January 27, 2009

When God "Moves"

I am so happy to report that dad, by faith, sat himself upon "the throne" of grace, and let's just say, God moved and so did he! I have never been happier about a bowel movement in my life. This is really good news. He laughed and thanked "Jesus, and God, and everybody else!"

His pain continues to be a challenge, but the nurses here are working with him to get a more comfortable routine in place. His spirits are up today. The nurses are all falling in love with him just as so many of us have over the years. God is so good.

I will report more later. For now, we celebrate this progress!

Peace and love...

Let's do this again...

Please join in a group prayer today at 9:00 AM EST for the inner workings of dad's bowels. The outside of his belly is improving, but the inside progression remains a mystery. The only way of knowing that the bowel is healing on the inside is by evidence of movement. Yes, we are back to farts. As of yesterday, dad has gurgles in his belly, but we need some evidence of healing and movement.

Thank you God for your faithfulness to Jonas. Thank you for hearing the prayers from yesterday and granting him rest. Today we come to you with another need and we place it confidently in your hands. Only you know what is happening on the inside of his body. Only you can command a bowel to move. We ask, in Jesus' name, that your healing power would work through Jonas' digestive system and breath life into all the necessary parts and functions. Touch his body now. Heal the places that we cannot see. Touch him now and restore the complete function of his bowel. In Jesus' name...

Monday, January 26, 2009

A gurgle, a giggle, and maybe a ginger ale

Today seems like a turning point in some way. The last 24 hours have been intense and we are all feeling a little more at peace for the moment. The nurse noted a gurgle in dad's belly this morning which indicates that some function may be resuming. In response to this discovery, dad is allowed a small diet of clear liquids that can include ginger ale. Dad loves ginger ale! The list of broths sounds boring, but dad said that when he drinks water, he prays and asks the Lord to make it taste like steak. :) I was reading the blog comments to dad this morning and we came across Rodney's comment about stopping by to "pull his finger" to assist in moving some gas. Dad responded with a sort of groggy, rolling laugh that was so lovely for all of us to hear. He is more himself today than he's been this entire time. A pile of cards have shown up through the mail and he loves to hear them read to him. He smiles at the thought of the friends that are supporting him right now.

The PICC line seems like a good alternative and we are glad that we waited until dad was in a more comfortable position to go through with the procedure. This line will remain in place for up to 8 weeks, or for the duration of his ongoing antibiotic treatment.

I am convinced that the intensity of your prayers have made this day feel like a turning point. I can't explain exactly what the relief is that we are experiencing, but it feels good.

More will be revealed...

Prayer Works

Mom reported to me this morning that the last time she looked at the clock before falling asleep, it was 10:30. Her and dad both rested well until about 3 AM. Thank you for joining us in battle on dad's behalf. God is good. He hears the cries of His people.

Dad is getting the PICC line now. The nurse is briefing us on the risks and benefits. The bottom line is this...Dad needs nutrition for strength.

A doctor was in this morning and accidentally poked a hole in dad's incision. Understandably, this was painful for him, but it turned out to be a blessing. The oozing that resulted actually relieved some of the pressure dad was feeling in his abdomen. Imagine that.

If you can, join us in praying together again this morning at 10:30 EST on dad's behalf. Strength, healing, and peace...in Jesus' name.

I will post an update later in the day.

Sunday, January 25, 2009

Praying together

Nights are turning out to be the most restless part of dad's time in the hospital.  Tonight at 10:30 PM EST and again tomorrow morning at 10:30 AM EST, please pray with us.

Lord, we love you.  We thank you for giving us this day.  We thank you for Jonas and the example you have given us through him.  He is yours.  We trust you completely.  We pray for peace over him now as he battles this infection.  Give him rest now.  Enable his body and mind to relax.  Settle your presence on him, around him, in him.  Bless him with the peace that only you can provide in the midst of this storm.  You are a good God.  We are fearfully and wonderfully made.  Let your spirit give Jonas the rest he needs to recover.  Calm every fiber of his being now. Cradle this strong and loving man in your arms and give him peace.  In Jesus' name...

Psalm 4:8  I will lie down and sleep in peace, for you alone, O Lord, make me dwell in safety.


24 hour window

The doctors are very interested in the next 24 hours of dad's progress. This time span will determine the effectiveness of the current antibiotic regimen and the urgency of finding other ways to provide nutrients to dad's body. He is finally resting some today, but the lack of food is becoming a concern. Earlier, we declined the PICC IV, at least for now. I felt very strongly that dad needed some time to rest before he went through another procedure, no matter how minor or routine. We will make a decision about this tomorrow. The doctor agreed that this was fine.

In the meantime, pray specifically for the necessary advancement in these coming 24 hours. He needs deep rest, noted intestinal activity (farts, bluntly), and expressed interest in food - in that order, preferably.

He seems a bit more coherent than last night, which is a huge relief. He continues to be VERY uncomfortable and unable to find a suitable position to settle into deep sleep.

Thank you all for your prayers. There are literally hundreds of people praying for dad right now and we get comfort and strength from simply knowing that. God is here. He is working on our behalf. He is working in the ways we can't see or imagine.

"Talk" with you all tomorrow.

What day is it?

I am here again with dad today. LaWonna is on her way in. Mom stayed at the hospital last night and didn't sleep a wink. Apparently, dad didn't either. It seems that the combination of pain meds, antibiotics, sleep deprivation, and the general physical stress that dad is experiencing is resulting in a sort of delirium. This was the most difficult part for mom during the night. He makes sense only in short bursts and is compelled to get out of bed without warning.

Mom was ordered (by us), to go home and sleep for awhile in her own bed. It's hard for her to leave, but I reminded her that we need her to take care of herself, too. Aunt Vern came to drive her home and assist with whatever need may arise. Thanks Aunt Vern for being such a good friend to mom!

The doctors seem positive about the progression of dad's antibiotic treatment. Several more staples were removed from the incision site to allow for draining if necessary. The incision is just a smidgen less irritated today than yesterday. A smidgen? We'll take it! They are planning on inserting a pick (spelling?) line later this afternoon as a more permanent solution to the IV. It's a sterile procedure that lasts about 30 minutes. A line is inserted in a vein in the arm and taken to a main artery of the heart. It sounds a bit scary, but the nurse assured us that it is a somewhat standard procedure. Admittedly, we are leary of anything "standard" or "routine."

At the moment, dad is "resting" in the chair "watching" Fox News. As I am here today, I am praying peace and rest over him. He really is exhausted and could use some uninterrupted rest.

Peace and rest...

Saturday, January 24, 2009

Day 4...Again

The infectuous disease specialist was just here. It appears that dad has cellulitis and another infection that originates within his abdomen. This is not the news we were hoping for and are feeling a bit deflated. Heavy antibiotics will be given beginning immediately and could last as long as 6 - 8 weeks. As of now, this prolongs his stay in the hospital.

Honestly, this is hard stuff. Your prayers are appreciated...and necessary.

Peace and love,

Joy LaVale
(on behalf of the Beiler family)

Day 4

Good morning. I just asked dad if he would like to communicate a message to everyone reading the blog. He simply wants to say thanks for the prayers.

Yesterday was an eventful day. A "bath", a trip for an x-ray, and two short walks to the hallway and back...all went well. The x-ray showed only a small area of "crackles" in his left lung that has been determined as normal for post-op at this stage.

I stayed here with dad overnight so mom could sleep in a normal bed, uninterrupted for the night. Like dad, I slept in spurts. All things considered, he is fairly low maintenance. For those of you who know him well enough this comes as no surprise. He is a pleasure to be around even now.

The doctor was in this morning and expressed some concern about redness around the incision. New antibiotics have been ordered to cover a broader scope of bacteria. Dad admitted that this news made him a bit uneasy and agreed that a prayer request was in order. His epidural was also removed this morning and they have switched him over to pain pills, with a continued option for IV meds if needed. He expressed some additional concern about the possibility of the pills upsetting his stomach. The thought of heaving or stressing his belly in any way makes him nervous. After seeing the incision for myself, I share his anxiety in this!

Please pray that he would be comfortable today and able to handle the progression of meds with ease. Pray that the right antibiotics would be administered and that God would intervene on any infection that may be developing. Even now it is obvious that his body is not liking the pills or the antibiotics. Cold sweats, stomach discomfort, and a slight panic are occurring. Pray...

He enjoys hearing your comments and believes in the power of your prayers. Keep them coming. We still have a few hurdles to overcome in the next few days.

Peace and love,

Joy LaVale

Friday, January 23, 2009

Baby Steps

Dad had a rough night last night. Pain and a sort of panic interrupted his rest. He currently has a slight fever and the nurse has noted a slight crackling in his left lung. The staff here is attentive and well informed and we feel that he is in good hands.

The doctor was just here and removed the covering from dad's incision. As dad likes to say, there is a 12 to 14-inch "zipper" running straight down the center of his belly. I admit, seeing the incision was alarming. Yet another reality check as his condition emerges daily.

He is attempting his first "walk" now. If he gets out of the room he will be doing more than expected.

Please continue to pray for strength and peace for him. Pray against fever, infection, blood clots, and pneumonia. These are the greatest threats to his recovery at this time. He remains feisty as usual, but he is certainly in an obvious struggle.

Peace and love to you all.

Joy LaVale
(on behalf of the Beiler family)

P.S. In the process of writing this post, with three people in assistance, he walked to the door of his room and back to his chair. We are thrilled at this progress and he is saying that he would like to try that again after a quick nap. Thanks to Josh and Nikki for assisting dad on his first walk and for the prayers!

Thursday, January 22, 2009

When moving 12 inches requires a nap to recoop...

Mom reported that dad rested well through the night. All through the night she was singing an old Bible School song..."in my heart there rings a melody, rings a melody, rings a melody of love." This brought her comfort as she reflected on all of the love that is surrounding her and dad at this time.

It's 1:45 PM and the nurses are here to make some adjustments to dad's epidural. The anesthesiologist opted for this in hopes of reducing the amount of pain meds dad would need. Turns out, they are increasing the epidural dose to compensate for the amount dad was needing intravenously because his pain is not very "manageable", as they say. With much discomfort, grunting, groaning, and assistance, he was moved to a chair and has been sitting there for the past 2 hours. He said he's ready for bed now and that he needs a nap. Just now he started to lean forward in the chair and we all panicked and asked him what he thought he was doing. He said, "I'm leaning forward, what's it look like!" Then he made some jokes with the breathing apparatus that he is required to use every hour to maintain healthy lung capacity. He admits that he feels "pretty wobbly" and that he is seeing about 1 1/2 of each person in the room. It must seem pretty crowded in here to him. :)

He is so worried about all the tubes and wires getting tangled that he just now instructed the nurse about how he needed to turn so he wasn't laying on everything. Getting back into bed from a chair that is sitting less than 12 inches from the bed is quite an undertaking. Grunting along, he made it. He then corrected the nurse again and reattached the bed controls to the side of the bed. It appears that his engineerability is not effected by heavy narcotics.

It's difficult to watch dad struggle. He has always been so strong, healthy, and independent. I know in my head that he will get better, but my heart (and I speak for everyone) breaks to see him hurting.

Visitors have been slim and that has been good for now. We anticipate more as the weekend approaches and are taking things a moment at a time.

We sense your prayers. The grace that is here is peaceful and still. We trust God to work his good and perfect will in all of this.

One last thing,..yesterday morning, before receiving the call from mom, I was sitting at my table reading and came across I Timothy 3: 1-4, 7. Oddly, I grabbed a note card and wrote it down. When I returned home from the hospital last night, I picked it up and it took my breath away. I had no idea what it would mean to all of us at the end of yesterday's events.

"Here is a trustworthy saying: If anyone sets his heart on being an overseer, he desires a noble task. Now the overseer must be above reproach, the husband of but one wife, temperate, self-controlled, respectable, hospitable, able to teach, not given to drunkenness, not violent but gentle, not quarrelsome, not a lover of money. He must manage his own family well and see that his children obey him with proper respect. He must also have a good reputation with outsiders, so that he will not fall into disgrace and into the devil's trap."

Dad is the "real thing." Even in his darkest hours, these qualities light his way.

Please continue to pray for strength and protection against complications.

Peace and love from all of us...

Wednesday, January 21, 2009

Reality Check - January 21, 2009




Dad was scheduled for a routine colonoscopy at 7:00 this morning. So routine in fact, he drove himself to the appointment with plans to have mom pick him up after the procedure. At 8:00, the doctor called mom and delivered the news that none of us could have anticipated. During the procedure, the scope became caught, ripping a 3-inch tear in the wall of dad's bowel. The doctor admitted to mom at that time that this was a serious emergency and that dad would be transported to Lancaster General Hospital (LGH) for immediate surgery.

LaWonna and I arrived at LGH at 9:00, with Russ and mom following shortly after. We were escorted into the OR pre-prep area and arrived even before dad. He was coming by ambulance from Brownstown where the original procedure was being done. When dad arrived, he was visibly uncomfortable, but coherent. At this point, we had little information and were somewhat in shock. Already Uncle Merrill, Aunt Vern, Uncle Jake, Uncle Dale, and Aunt Fi had arrived in typical Smucker fashion.

The surgery to repair the perforation began at 10:45 and ended at around 12:30. These hours were long and anxious, but having the support of friends and family was a huge blessing. Finally, we were called in for a consultation with the surgeon. He explained that instead of simply stitching the tear, he decided to remove a four-inch portion of the colon and reattach the unaffected ends. He explained that dad was in the perfect scenario for such a horrible scenario. Because of his preparation for the colonoscopy, his bowels were clear and the likelihood of infectious material escaping was greatly reduced.

Since the moment he arrived at LGH, dad has been cracking jokes between moans and wooziness. Some of our favorites:




  • Prior to surgery, he overheard the nurse briefing us on the crowded conditions in the recovery room and she reassured us that she would let us see him as soon as possible after the surgery. His response? "Just tell them to put me in the garage."


  • When the anesthesiologist asked for his age, he replied, "Old enough to know better." To which the doctor looked at me and asked, "No really. How old is he?"


  • The nurse asked me to get the okay from dad to allow for a blood transfusion in case of an emergency, to which dad replied, "Just make sure it's red."


  • Another nurse was commenting on the many colored arm bands that dad had acquired. All dad wanted to know was, "Are they purdy (pretty)?"


As a family, we joked that this experience will at least give dad some new material. All of our lives have been sprinkled with little one liners straight from the brain of Jonas Beiler. Jokes aside, it is difficult to see him in this condition. It's just hard to process.



The doctor from the originating colonoscopy is here with us now. He insisted on coming here and briefing us directly on what happened earlier this morning. His honesty and the immediacy of his contact with us is comforting. In his 29 years of performing colonoscopies, this is only the second incident of this nature that has occured, and never this severe.



For at least the next week, dad will be residing in the "penthouse" at LGH. After that, the recovery process is anticipated to be two months or more. We will be here with him all the way. He has never abandoned us. In this small way, we have a chance to pay him back.



Please pray that his body would be strong and ready to fight any potential complications. The next seven days are considered the most critical.



On behalf of all of us,



Joy LaVale





P.S. As I am posting this, Trinity and Russ are at dad's bedside singing Johnny Cash's Folsom Prison Blues. I am amazed at his demeanor after such a physically taxing day. God's grace is more than sufficient.