The service is set for 6:30 PM on Monday at New Life Presbyterian Church in Dresher (2015 Limekiln Pike). There will be some dinner-ish and desserty food at the reception, so plan accordingly.
Several folks have asked about donations in Dad's honor. In lieu of flowers, contributions may be made to the Deacons' Fund at New Life Glenside (467 N Easton Rd, Glenside, PA, 19038).
For those who are traveling by air and need the information for the "bereavement fare," things are being handled by Joe Schlupp at the Baron Rowland Funeral Home in Abington, phone 215.887.7375.
Feel free to contact me with any other questions about travel or logistics. My number is 773.682.8725.
Thursday, April 30, 2009
Funeral Plans for Dad
Our just-about-final plan at this point is for the family to bury Dad on Sunday, and then to hold a memorial service on Monday evening (May 4th), open to all who would like to attend. It will be held at New Life Dresher, which is at Limekiln and Susquehanna. Details and directions will be posted/linked here. The exact time is still TBD, but will be decided today.
Wednesday, April 29, 2009
After the many family and friends had gradually and reluctantly left Dad's side last night, Nana, Dad's mom, was one of the last to leave. After a long day of expecting that the end could come at any moment, we were all starting to wonder if Dad might be sticking around with us for a while longer. Nana had been sitting in a chair by Dad's side, holding his hand, never moving for the entire day. At about ten o'clock she was waiting to board the elevator to go home with Sandy and Joe to get a few hours sleep. I said to her, "I'll see you tomorrow, we may have him for another day." She looked at me and said "No. I don't want him to be here tomorrow, it's too much. I told him my last good bye. It's time for him to go home."
In the end it was Cara, Katherine, Mom and I settling in for the night with Dad. The three of us kids had been making calls and plans and arrangements, and we came in to the room to find Mom in her pajamas lying next to Dad in the bed, talking to him. She said that this was her last chance to feel him next to her, "in this body that I have loved." Of course she was sort of squinched in between him and the railing, so we eased him over and made room for her. It was like he was home in bed with her, in the bed where he jokingly pointed and told Cara last week "Right there. I'm dying right there, next to your mother." We were talking about Dad, and the day, and the way things were, while Katherine got comfy and squeaked around in her sleeping bag on the air mattress, and Cara got ready for bed. Mom was describing something a friend had been thinking about, how in heaven there will be no more faith, because we'll have "sight," and no more need for hope, because we'll have the Object of our longing. How the one that will finally "remain," of that trinity of spiritual gifts, will be love.
For a while I had been thinking about the meaning behind Dad's many exhalations and vocalizations, as we listened for days to his murmurs and groans, and later to his labored breathing, as he tried to speak, or else to express something deeper than speech. I remembered Romans 8, and the idea of "groaning" there. Like all creation groans to be set free from "bondage to decay," like a mother groans in childbirth--the pain that is necessary, always, to give birth to great joy--like we groan for "the redemption of our bodies," and even the Spirit of God himself intercedes for us with "groans that words cannot express." Amazing that groans can be more expressive than words, and that words can fail to articulate the longing that a groan embodies. Groans "too deep for words." I think it was these deep longings that Dad's groans expressed--the longing to remain with his wife and his children and mother, along with the longing to be finished, home, to be free of his ruined body--the longing to be done with suffering and to see it turned to joy--the deep longing for resurrection and to see the face of his Savior.
We talked about all of this, and then started talking and laughing quietly about Dad, while still shedding tears, like we had done many times over the past few days with Sandy, Christine and Daisy--and with Julie over the phone as she drove the 1800 miles to get here. We were talking about who he was, what was so wonderful about him and why we liked him, and the things people had said about him that day, the hymns we'd sung--"When peace like a river," "My Jesus, I love thee," "My hope is built on nothing less," "On Jordan's Stormy Banks," "In Christ alone my hope is found." We were marveling at Dad's ability to cut to the heart of the matter, how he was capable of seeing the truth so clearly in situations where others got hung up on details and overwrought scenarios and pride and politics. How Dad was actually apolitical, because when he was most himself he had no agenda other than the truth, and the unity of the body of believers, and the good of his friends. He was so able to minister to others because he was all but free of self-regard and self-importance. There was no pretense whatsoever about him: he never pretended to be something more or less than who he was, never fawned and never patronized, and this made everyone he knew feel safe and loved around him, like they could relax and be themselves too. That was the environment in which real discipleship and communion could happen.
So we all unwound a bit after the big groups and the intensity of the day, and I think Dad sensed that, and as we relaxed he relaxed too. I was saying to Mom that Dad seemed to be lingering on even though we had started to pray that God would take him once Julie, Rob and the kids had arrived and spent time with him--but that it was nice. We were just spending time together and reflecting, and a burden was beginning to be lifted. At that point we said to each other that as long as Dad wanted to linger, to tarry with us there on the shore, we would linger with him, because we were still reluctant to let him go, even though we were praying for an end for him. Cara was saying what would turn out to be a last, tearful good bye, and she was by the bed sharing some time with him and Mom. Katherine was remembering the waterskiing incident of many years ago when she (claims she) almost drowned, and how Dad jumped in to save her, but right after that, being Dad, told her to get right back up on those skis. We were talking too about how the next moment for Dad, the next time he opened his eyes, all the pain would be finished, and he would be with Jesus, "face to face."
And moments later when the end came it was very swift and almost miraculously peaceful. Shortly before midnight there was a pause in Dad's breathing, and then he started breathing again, smaller and smaller, with spaces in between, but quieter and quieter. It felt different, and we knew he was very close. We called Kate over from her bed where she had been lying as we chatted, and we all held on to Dad as he breathed his last breaths and the pulse in his neck slowed and then stilled. It was perhaps 45 seconds from when we first noticed the change in his breathing. Immediately after, it was like a huge burden had been lifted off of all of us, and it was eerily quiet. Dad's breathing had created a rhythm of life, however fragile and tenuous, in the room, but that breathing was also the voice of pain, and it was the groanings of a longing deeper than words. So to hear it stilled was both a relief from suffering and a symbol of loss, but the silence signified joy for Dad--to die is gain--and the fulfillment of his deepest, life's desire.
Thank you, thank you, thank you to everyone reading this for all the love you've shown Dad and us over the past decades, months and days. We are so grateful to be in the midst of such an amazing community. More from us later, as there is much to do. We will be posting more info here about funeral arrangements and the memorial service this weekend. Peace.
In the end it was Cara, Katherine, Mom and I settling in for the night with Dad. The three of us kids had been making calls and plans and arrangements, and we came in to the room to find Mom in her pajamas lying next to Dad in the bed, talking to him. She said that this was her last chance to feel him next to her, "in this body that I have loved." Of course she was sort of squinched in between him and the railing, so we eased him over and made room for her. It was like he was home in bed with her, in the bed where he jokingly pointed and told Cara last week "Right there. I'm dying right there, next to your mother." We were talking about Dad, and the day, and the way things were, while Katherine got comfy and squeaked around in her sleeping bag on the air mattress, and Cara got ready for bed. Mom was describing something a friend had been thinking about, how in heaven there will be no more faith, because we'll have "sight," and no more need for hope, because we'll have the Object of our longing. How the one that will finally "remain," of that trinity of spiritual gifts, will be love.
For a while I had been thinking about the meaning behind Dad's many exhalations and vocalizations, as we listened for days to his murmurs and groans, and later to his labored breathing, as he tried to speak, or else to express something deeper than speech. I remembered Romans 8, and the idea of "groaning" there. Like all creation groans to be set free from "bondage to decay," like a mother groans in childbirth--the pain that is necessary, always, to give birth to great joy--like we groan for "the redemption of our bodies," and even the Spirit of God himself intercedes for us with "groans that words cannot express." Amazing that groans can be more expressive than words, and that words can fail to articulate the longing that a groan embodies. Groans "too deep for words." I think it was these deep longings that Dad's groans expressed--the longing to remain with his wife and his children and mother, along with the longing to be finished, home, to be free of his ruined body--the longing to be done with suffering and to see it turned to joy--the deep longing for resurrection and to see the face of his Savior.
We talked about all of this, and then started talking and laughing quietly about Dad, while still shedding tears, like we had done many times over the past few days with Sandy, Christine and Daisy--and with Julie over the phone as she drove the 1800 miles to get here. We were talking about who he was, what was so wonderful about him and why we liked him, and the things people had said about him that day, the hymns we'd sung--"When peace like a river," "My Jesus, I love thee," "My hope is built on nothing less," "On Jordan's Stormy Banks," "In Christ alone my hope is found." We were marveling at Dad's ability to cut to the heart of the matter, how he was capable of seeing the truth so clearly in situations where others got hung up on details and overwrought scenarios and pride and politics. How Dad was actually apolitical, because when he was most himself he had no agenda other than the truth, and the unity of the body of believers, and the good of his friends. He was so able to minister to others because he was all but free of self-regard and self-importance. There was no pretense whatsoever about him: he never pretended to be something more or less than who he was, never fawned and never patronized, and this made everyone he knew feel safe and loved around him, like they could relax and be themselves too. That was the environment in which real discipleship and communion could happen.
So we all unwound a bit after the big groups and the intensity of the day, and I think Dad sensed that, and as we relaxed he relaxed too. I was saying to Mom that Dad seemed to be lingering on even though we had started to pray that God would take him once Julie, Rob and the kids had arrived and spent time with him--but that it was nice. We were just spending time together and reflecting, and a burden was beginning to be lifted. At that point we said to each other that as long as Dad wanted to linger, to tarry with us there on the shore, we would linger with him, because we were still reluctant to let him go, even though we were praying for an end for him. Cara was saying what would turn out to be a last, tearful good bye, and she was by the bed sharing some time with him and Mom. Katherine was remembering the waterskiing incident of many years ago when she (claims she) almost drowned, and how Dad jumped in to save her, but right after that, being Dad, told her to get right back up on those skis. We were talking too about how the next moment for Dad, the next time he opened his eyes, all the pain would be finished, and he would be with Jesus, "face to face."
And moments later when the end came it was very swift and almost miraculously peaceful. Shortly before midnight there was a pause in Dad's breathing, and then he started breathing again, smaller and smaller, with spaces in between, but quieter and quieter. It felt different, and we knew he was very close. We called Kate over from her bed where she had been lying as we chatted, and we all held on to Dad as he breathed his last breaths and the pulse in his neck slowed and then stilled. It was perhaps 45 seconds from when we first noticed the change in his breathing. Immediately after, it was like a huge burden had been lifted off of all of us, and it was eerily quiet. Dad's breathing had created a rhythm of life, however fragile and tenuous, in the room, but that breathing was also the voice of pain, and it was the groanings of a longing deeper than words. So to hear it stilled was both a relief from suffering and a symbol of loss, but the silence signified joy for Dad--to die is gain--and the fulfillment of his deepest, life's desire.
Thank you, thank you, thank you to everyone reading this for all the love you've shown Dad and us over the past decades, months and days. We are so grateful to be in the midst of such an amazing community. More from us later, as there is much to do. We will be posting more info here about funeral arrangements and the memorial service this weekend. Peace.
A friend's perspective
Andrew asked me to share my perspective on Roger's last day here on earth. Here are a few of my thoughts:
I will never forget yesterday. For 10 hours I hung out in Roger's room as we walked my dear brother most of the last mile in his six year fight with the Unwanted Visitor that ended my wife Nancy's life last year.
It was agonizing. Once more I heard the labored, crackling noises that a person utters in their last hours of breathing. I remembered our nine month battle with cancer. I remembered the many miles we have walked with Roger and Karen since they welcomed us home from Ireland in 1992. I ached for the hours of grieving Karen was to face. And once more my soul raged against the insult of death.
It was glorious. I saw the fruit of this humble, loving man as friends, relatives and even a former student from Africa came to say farewell. The day was thus filled with stories, songs, scriptures and sobs. Roger was dying surrounded by those he had loved and served. God led me to share many scriptures during that watch, including passages from Psalm 48 and 142 that had been impressed upon me during the passing of others whom I deeply loved. Such a departure affirms the truth of the gospel. It also contrasted vividly with the other death occurring on the ward yesterday. We were walking Roger toward the Light, the other family was shrouded in dark gloom.
I left the hospice at 9:30. Karen wanted quiet time with her best friend by then. That was only fitting. So, I left her there with Roger and three of the kids. Yet, I am thankful that he let me help Roger take the final steps. You see, when Jesus came for Roger just a couple of hours later, a friend and I were praying for the race to end.
Again, that was fitting, we can walk one another to the Door, but in the end HE opens it for the fortunate one who is taken Home. Well done, good and faithful servant. You ran a good race. As my daughter KJ said, "he is with my mommy." --and many others who loved him. Most importantly Roger sees the face of the One who loved him best of all. Roger, thanks for helping blaze the trail for us to follow in His good time.
Dan Macha
Neighbor, Fellow New Life Elder, and Brother in Christ
Tuesday, April 28, 2009
Tuesday Afternoon
Last night Sandy and Cara stayed with Mom and Dad in the room. It was a long night as they slept fitfully and listened to Dad's breathing change to a rattling sound. Since then his breathing has become more labored, and the rattling sound fills the room. It is hard to watch him as his body slowly shuts down, to remember the man he once was and to see him lying in bed, so near to death. Andrew, Daisy, Katherine, and Nana joined them at various points through the morning. It has been a long day with many visitors (Ellie, Ed, Aunt Florence, Sue, Glen, Bill, the Hollands, the Julianis, Karen Keller, Marlene Hammerschmidt, Terry Traylor, Jim Spaulding, Joe, Diane and Chuck Marsh). Dan Macha has been here through the day, faithfully praying and encouraging Dad in "finishing the race". Nana has been sitting by Dad's side holding his hand, quietly letting him know that she is there. We are singing hymns and other songs, reading scripture and telling Dad that we are there for him. There have been many moments of tears, but also moments of praise as we recall God's promises, and are reminded of the hope of heaven.
The facilities here are really quite nice, and it enables us to step out of the room and gather on the couches in the family room to decompress, and then step back in to be with Dad again. We have just received dinner, and are looking forward to a warm meal after a day of eating snack foods- it is such a blessing.
We will keep you updated if his status changes.
We don't know when the end will come, but we are so encouraged by your comments, and the prayers we know you are praying.
The facilities here are really quite nice, and it enables us to step out of the room and gather on the couches in the family room to decompress, and then step back in to be with Dad again. We have just received dinner, and are looking forward to a warm meal after a day of eating snack foods- it is such a blessing.
We feel that the end is near, but that Dad is holding on, waiting for Julie to arrive. She has been driving since Saturday from Texas with her family of 8. They are due to arrive anytime now.
We will keep you updated if his status changes.
Monday, April 27, 2009
I just wanted to say thanks to Becky Wilson for her encouraging comment last night about Dad's likely ability to hear us and to sense our presence, even when he is unable to speak or even to respond clearly. We had a powerful confirmation of this this morning when, after we had heard the bad news, Dad had a period of about two hours of relative alertness and responsiveness. It started about when Dr. Stadtmauer came in and was able to rouse Dad right away by saying once, directly, "Roger." The other three of us were completely surprised, because the doctor yesterday was unable to get Dad to come around, even by speaking much louder and applying several firm pats and shakes to Dad's body. But right away Dad opened his eyes and looked directly and for about a minute at Dr. Stadtmauer, squeezed his hand, and murmured, as if to acknowledge and thank him for everything they've shared over the past 6 years.
Shortly after Dr. Stadtmauer said good-bye to Dad, Dad was looking at us in a way he hadn't in days--his eyes still foggy and not quite focused, yet actually seeing--looking at us--and his murmurs and groans were expressive, and not merely the monotone, seemingly unconscious sounds of pain, discomfort or confusion that we'd become accustomed to hearing from him. We raised the bed to a sitting position, and Christine and I were able to talk to him on our own, and he was reaching out to us, and hearing and watching us, and murmuring in response. It was difficult to see him trying to talk and incapable of finding speech, but at the same time we were talking to him, telling him we loved him and knew that he loved us, and that we knew what he wanted to say--and hoping that we did. And Mom came around the bed, and he perked up still more, and tried feebly to reach out, so she hugged him and I put his reaching arm around her and held it there. And he tried to speak, and she kissed him, and held his head, and prayed with him and cried and told her she loved him, and that it would all be alright, that Jesus was near, and he was crying too, crying sounds but no tears. It was all a terrible, beautiful moment of shared pain, and love, and mutual comfort.
Shortly after Dr. Stadtmauer said good-bye to Dad, Dad was looking at us in a way he hadn't in days--his eyes still foggy and not quite focused, yet actually seeing--looking at us--and his murmurs and groans were expressive, and not merely the monotone, seemingly unconscious sounds of pain, discomfort or confusion that we'd become accustomed to hearing from him. We raised the bed to a sitting position, and Christine and I were able to talk to him on our own, and he was reaching out to us, and hearing and watching us, and murmuring in response. It was difficult to see him trying to talk and incapable of finding speech, but at the same time we were talking to him, telling him we loved him and knew that he loved us, and that we knew what he wanted to say--and hoping that we did. And Mom came around the bed, and he perked up still more, and tried feebly to reach out, so she hugged him and I put his reaching arm around her and held it there. And he tried to speak, and she kissed him, and held his head, and prayed with him and cried and told her she loved him, and that it would all be alright, that Jesus was near, and he was crying too, crying sounds but no tears. It was all a terrible, beautiful moment of shared pain, and love, and mutual comfort.
The decision was made, this morning, after consulting with Dr. Stadtmauer and our attending physician, to move Dad into hospice care. Though the CTscan of Dad's head came in negative last night, and Dad was looking livelier this morning, it quickly became clear that in fact Dad's condition had only deteriorated further.
The new attending, Dr. Nair, took the situation in hand immediately on seeing Dad and looking at his charts. She examined him carefully and explained his status to us, frankly and clearly, including many details that the doctors over the weekend had neglected to share with us. The long and short of it was that, while Dad's brain did appear to be clear of any bleeding or tumors, an older MRI indicated that there was cancerous growth within the actual bones of his skull. In addition, he has apparently been in acute renal failure, and his liver also is failing, in both cases due to the plasmacytoma discovered last week. In short, the doctor said, Dad's body is in a self-induced coma, and is essentially in the process of shutting itself down. The cancer, Stadtmauer said, is now moving throughout his body, and its effects are at this point non-reversible, including its effects on his mental state.
We questioned him carefully on what measures might be available to Dad now, and he said that the few things they could do could not save Dad, and would be so invasive and cause so much discomfort and additional suffering--with only a slim chance of success--that he could not really recommend them. We had to agree, especially given that these procedures, even if they "worked," could offer no promise of any real increase in his quality of life for however much longer he might survive. Add to that the fact that Dad, in his living will and in conversation with Mom and us kids, had indicated that he did not want his life prolonged merely for prolongation's sake, i.e. with no real hope of recovery. Dr. Stadtmauer said that what Dad is going through now is the "natural" way the body brings things to a close in this situation. In the end, we felt that the decision to move Dad to hospice and halt any further medical interventions in the course of the myeloma was the merciful and loving choice, and the choice Dad himself would make.
Christine had spent the night with Dad, and Mom and I arrived this morning at around 7:30; by about 9:30 the call had been made. Katherine, Daisy, Sandy and Cara have joined us here, along with Dappie (Mom's Dad), Uncle Chuck (Mom's brother), Aunt Diane and Colton. Dad's brother Bill is arriving from France in about an hour, and Nana, Uncle Wayne and Aunt Sue (Dad's bro and sis) will be coming in this evening. Marc Davis came to encourage and pray with Dad this morning, and stayed with Dad while Christine, Mom and I grabbed some lunch and spoke with the folks from hospice. John Yenchko and Mom and Dad's friend John Freeman also came to pray with Dad and say good-bye to him.
Dad will be transferred to Penn's brand new Rittenhouse hospice unit this evening. He will have a large private room, one of just 12 in the facility, which has large common areas, a kitchen and a dining room where the family can gather and be near him during this time. Please pray for Dad, for courage and confidence, and peace and relief from any suffering, that the Lord would make his presence felt to him. Pray for us as we seek to love and bless him in these final moments--however long they may turn out to be.
The new attending, Dr. Nair, took the situation in hand immediately on seeing Dad and looking at his charts. She examined him carefully and explained his status to us, frankly and clearly, including many details that the doctors over the weekend had neglected to share with us. The long and short of it was that, while Dad's brain did appear to be clear of any bleeding or tumors, an older MRI indicated that there was cancerous growth within the actual bones of his skull. In addition, he has apparently been in acute renal failure, and his liver also is failing, in both cases due to the plasmacytoma discovered last week. In short, the doctor said, Dad's body is in a self-induced coma, and is essentially in the process of shutting itself down. The cancer, Stadtmauer said, is now moving throughout his body, and its effects are at this point non-reversible, including its effects on his mental state.
We questioned him carefully on what measures might be available to Dad now, and he said that the few things they could do could not save Dad, and would be so invasive and cause so much discomfort and additional suffering--with only a slim chance of success--that he could not really recommend them. We had to agree, especially given that these procedures, even if they "worked," could offer no promise of any real increase in his quality of life for however much longer he might survive. Add to that the fact that Dad, in his living will and in conversation with Mom and us kids, had indicated that he did not want his life prolonged merely for prolongation's sake, i.e. with no real hope of recovery. Dr. Stadtmauer said that what Dad is going through now is the "natural" way the body brings things to a close in this situation. In the end, we felt that the decision to move Dad to hospice and halt any further medical interventions in the course of the myeloma was the merciful and loving choice, and the choice Dad himself would make.
Christine had spent the night with Dad, and Mom and I arrived this morning at around 7:30; by about 9:30 the call had been made. Katherine, Daisy, Sandy and Cara have joined us here, along with Dappie (Mom's Dad), Uncle Chuck (Mom's brother), Aunt Diane and Colton. Dad's brother Bill is arriving from France in about an hour, and Nana, Uncle Wayne and Aunt Sue (Dad's bro and sis) will be coming in this evening. Marc Davis came to encourage and pray with Dad this morning, and stayed with Dad while Christine, Mom and I grabbed some lunch and spoke with the folks from hospice. John Yenchko and Mom and Dad's friend John Freeman also came to pray with Dad and say good-bye to him.
Dad will be transferred to Penn's brand new Rittenhouse hospice unit this evening. He will have a large private room, one of just 12 in the facility, which has large common areas, a kitchen and a dining room where the family can gather and be near him during this time. Please pray for Dad, for courage and confidence, and peace and relief from any suffering, that the Lord would make his presence felt to him. Pray for us as we seek to love and bless him in these final moments--however long they may turn out to be.
Sunday, April 26, 2009
Sunday Afternoon
Dad's condition remains serious and the exact causes of his symptoms uncertain. He has now been basically unconscious for about 24 hours; he has moments where he opens his eyes, but rarely with anything like "seeing" going on; he has been reduced mostly to non-verbal vocalizations, and when he did speak to Mom last night it was nothing coherent. This morning he was aware enough to respond "hospital" and "HUP" when the doctor asked him where he was, but he then went on to answer "hospital" to all her other questions. Over the past four or five days there has been a gradual, but, when seen altogether, dramatic decline in Dad's overall mental and physical state.
The doctor and his team came by this afternoon, and Mom and I got a chance to hear his assessment and ask direct questions. He was unable to rouse Dad at all, and thought that his sluggishness might be caused by the medication, specifically the Oxycontin and the Ativan, so he prescribed Narcan, which would reverse the narcotic effects of these drugs. He said it may also be caused by blood viscosity, itself a result of calcium being shed from the bones into the bloodstream, as well as the increased protein numbers, both the result of myeloma activity. On the other hand, other tests seem to point away from significantly increased blood viscosity, and the specific lab result for that won't be available for a while. It's also possible that there's some bleeding in Dad's brain resulting from the lowered blood counts, but again, the doctors say that the platelets are not all that low--though he's just received a transfusion to replenish them--suggesting that the root cause is still likeliest to be plasmacytoma--myeloma tumors--in the brain or upper spinal column. The doctors are contemplating a spinal tap to analyze his spinal fluid for signs of the myeloma, but in the meantime expect that the CTscan will show any hemorrhaging or cancerous growth.
As it turns out, the Narcan didn't enable Dad to be much more responsive--he woke up, but was mostly just agitated, without very much ability to interact intelligibly. This seems to suggest that his problem is, as the doctor said, "organic" rather than narcotic. We should know more after the scan results are analyzed.
Sandy, Christine and Erin were in this morning, and Daisy, Ed, Cara and Katherine will be arriving soon via train. Erin and I are supposed to fly out in the morning, but we will still keep all of you updated. Thank you as always for your prayers and many kind calls, emails, comments and other gestures of sympathy and solidarity. Please continue to pray for all of the same things--insight and imagination for the doctors, stamina, encouragement and faith for Mom and Dad, and, still, for some measure of healing for Dad. Pray that he would not be in distress, physical or emotional, and that he would be able to have some mental clarity, some ability to interact with Mom and the rest of us, that he would know that we are with him in this, and that he is loved.
The doctor and his team came by this afternoon, and Mom and I got a chance to hear his assessment and ask direct questions. He was unable to rouse Dad at all, and thought that his sluggishness might be caused by the medication, specifically the Oxycontin and the Ativan, so he prescribed Narcan, which would reverse the narcotic effects of these drugs. He said it may also be caused by blood viscosity, itself a result of calcium being shed from the bones into the bloodstream, as well as the increased protein numbers, both the result of myeloma activity. On the other hand, other tests seem to point away from significantly increased blood viscosity, and the specific lab result for that won't be available for a while. It's also possible that there's some bleeding in Dad's brain resulting from the lowered blood counts, but again, the doctors say that the platelets are not all that low--though he's just received a transfusion to replenish them--suggesting that the root cause is still likeliest to be plasmacytoma--myeloma tumors--in the brain or upper spinal column. The doctors are contemplating a spinal tap to analyze his spinal fluid for signs of the myeloma, but in the meantime expect that the CTscan will show any hemorrhaging or cancerous growth.
As it turns out, the Narcan didn't enable Dad to be much more responsive--he woke up, but was mostly just agitated, without very much ability to interact intelligibly. This seems to suggest that his problem is, as the doctor said, "organic" rather than narcotic. We should know more after the scan results are analyzed.
Sandy, Christine and Erin were in this morning, and Daisy, Ed, Cara and Katherine will be arriving soon via train. Erin and I are supposed to fly out in the morning, but we will still keep all of you updated. Thank you as always for your prayers and many kind calls, emails, comments and other gestures of sympathy and solidarity. Please continue to pray for all of the same things--insight and imagination for the doctors, stamina, encouragement and faith for Mom and Dad, and, still, for some measure of healing for Dad. Pray that he would not be in distress, physical or emotional, and that he would be able to have some mental clarity, some ability to interact with Mom and the rest of us, that he would know that we are with him in this, and that he is loved.
Saturday, April 25, 2009
Newer News
The attending doctor from oncology has come by to see Dad, and he believes that Dad's symptoms are a result of the increased activity of the myeloma, and probably not specifically linked to any tumor growth farther up his spine. His protein levels have risen further, and because he hasn't been drinking fluids, his blood is actually thicker, making the effective level of proteins in his blood still higher, only aggravating his symptoms. The hope is that as they rehydrate him via IV, his sluggishness and discomfort will abate somewhat. In the meantime, they have begun administering a new round of steroids to reduce the tumor growth that is presumably behind all of this.
Thankfully, Dad has been transferred to a private room. The doctors no longer think that an MRI is necessary, but the ear, nose and throat specialist is checking him out now.
More soon. Please continue to pray for Dad's strength and spirits, as this is discouraging news for a very tired man. We'll keep you updated.
Thankfully, Dad has been transferred to a private room. The doctors no longer think that an MRI is necessary, but the ear, nose and throat specialist is checking him out now.
More soon. Please continue to pray for Dad's strength and spirits, as this is discouraging news for a very tired man. We'll keep you updated.
Saturday Morning
They were able to fit Dad in for a CT scan last night, and it didn't show anything out of the ordinary, but the MRI, scheduled for today, should tell them more. They also expect a specialist to come look at his throat. Mom ended up coming home at about 1:30 last night because Dad was placed in a very small double room and there was no way she could sleep there. She's back at the hospital now; the rest of us will be visiting later in the day.
Friday, April 24, 2009
E and I are just back from Penn. After a long sit in the ER waiting room, we were finally seen by an ER physician, who ordered some tests and conferred with the folks in oncology. They took blood for labs and tested Dad's coordination. They hope to get Dad in for an MRI tomorrow, to look for signs of the myeloma further up his spine and in his brain. For the past couple of days Dad has been exhibiting symptoms suggesting that the myeloma is advancing--extreme fatigue, disorientation, slurred speech, and trembling hands, as well as lack of appetite, gagging and difficulty swallowing.
When we left Dad was about to be placed in a room, though not in the oncology ward as we had hoped. Please pray that he will be transferred there, where "his" doctors and nurses are, as soon as possible, and that he would get a room where Mom can stay with him comfortably. She is spending the night with him tonight...accommodations dubious. Pray for her as well, as she assumes the bulk of the burden of caring for Dad and sees to it that he gets the treatment he needs and that he doesn't get lost in the swamp of red tape that is the hospital system.
The kids are having breakfast together tomorrow, and may all go see him later in the day. Pray that we would have wisdom and sensitivity as we try to minister to both of our parents, and that we would find a way to bless and encourage them as we remember these past 25 years together.
When we left Dad was about to be placed in a room, though not in the oncology ward as we had hoped. Please pray that he will be transferred there, where "his" doctors and nurses are, as soon as possible, and that he would get a room where Mom can stay with him comfortably. She is spending the night with him tonight...accommodations dubious. Pray for her as well, as she assumes the bulk of the burden of caring for Dad and sees to it that he gets the treatment he needs and that he doesn't get lost in the swamp of red tape that is the hospital system.
The kids are having breakfast together tomorrow, and may all go see him later in the day. Pray that we would have wisdom and sensitivity as we try to minister to both of our parents, and that we would find a way to bless and encourage them as we remember these past 25 years together.
Down to HUP again
My dad is currently in the ER at HUP, waiting to get admitted. Early this afternoon my dad was having difficulty swallowing, and he started to choke and gag. In addition, he was experiencing some slight tremors. After my mom spoke with the nurse practitioner, it was decided that my dad needed to come to the ER at HUP to get admitted so that they can figure out what is causing this choking and gagging. The nurse practitioner told my mom that it is possible that the cancer is now affecting my dad's spine or spinal fluid, and nervous system. To determine if and what is affecting my dad's spine, they need to do an MRI and some other tests. The nurse practioner told my mom that this is not uncommon and that if the tests confirm that the cancer is affecting my dad's spine, they are able to treat the spot on the spine directly with chemo. In addition to the choking, gagging, and tremors, my dad has had some periods of disorientation as well.
Please pray that my dad would get admitted to a room soon, and that the doctors would be able to run these tests and be able to determine, with real clarity, what is causing the choking and gagging for my dad, and, how to to treat it. Please also pray for stamina and strength for my dad as he undergoes these various tests, and for faith for him and my mom, and our entire family, as we walk through this valley.
We also received the news on the biopsy of my dad's liver today. The results came back positive for cancer in my dad's liver. While this is hard news to hear, we are thankful that the test results are clear and we can go in a new direction to fight this cancer. Hopefully, my dad will qualify for a clinical trial of a new chemo, since the chemo he is on is no longer working against the cancer.
More later, as we receive news. Thanks for praying!
Please pray that my dad would get admitted to a room soon, and that the doctors would be able to run these tests and be able to determine, with real clarity, what is causing the choking and gagging for my dad, and, how to to treat it. Please also pray for stamina and strength for my dad as he undergoes these various tests, and for faith for him and my mom, and our entire family, as we walk through this valley.
We also received the news on the biopsy of my dad's liver today. The results came back positive for cancer in my dad's liver. While this is hard news to hear, we are thankful that the test results are clear and we can go in a new direction to fight this cancer. Hopefully, my dad will qualify for a clinical trial of a new chemo, since the chemo he is on is no longer working against the cancer.
More later, as we receive news. Thanks for praying!
Thursday, April 23, 2009
Still waiting...
...for biopsy results. Today Dad went to the hospital to get his blood checked, and again his levels were high enough that he didn't need a transfusion, so that is something to be thankful for.
Dad continues to be very weak and deeply fatigued. Please pray that he would be able to eat and sleep, and that he would have energy to spend time with the family this weekend. Christine, Erin and I are in town to visit (Katherine and Rusty come Saturday), and we'll be celebrating Mom and Dad's 25th anniversary.
Dad continues to be very weak and deeply fatigued. Please pray that he would be able to eat and sleep, and that he would have energy to spend time with the family this weekend. Christine, Erin and I are in town to visit (Katherine and Rusty come Saturday), and we'll be celebrating Mom and Dad's 25th anniversary.
Wednesday, April 15, 2009
Wednesday April 15
Today Dad got a transfusion because his red blood count went below a certain level. Also, the doctor feels that his fatigue, fever, and weakness are being caused by the cancer since his protein levels have risen. This means that the current chemo is no longer working. He will have a biopsy of his liver either tomorrow or Friday to determine the nature of the questionable spots. Mom is staying in the room on a cot and going back to the house when she can, to do laundry, shop for supplies and bring in the mail.
Please continue to uphold both Mom and Dad in your prayers.
newsblip
The news as of yesterday afternoon was that Dr. Stadtmauer wanted the radiologist at Penn to look more closely at Dad's MRI results before scheduling any biopsy.
Tuesday, April 14, 2009
Down to HUP
Just wanted to dash off an update this AM. Mom and Dad were transferred down to the hospital at Penn last night via ambulance. The decision was made to postpone any biopsy until Dr. Stadtmauer and his team had a look at all the test results and could compare them to past tests. Mom was hoping to be able to spend the night there with Dad to be able to be there to talk with the doctors first thing in the morning. Dad is extremely fatigued and seems to have just a raft of aches, pains, symptoms and side effects. Please pray for relief and healing for him, and for strength and courage for both of them. They have had some visitors, which has been a blessing, and Nana (Dad's mom) has been faithfully visiting during this and Dad's other hospitalizations. Today is Mom's birthday, by the way. Please continue to pray for insight for the doctors. More later.
Monday, April 13, 2009
Easter
Dad spent the weekend at Abington hospital, where the doctors have been trying to figure out the source and type of this latest infection. There's been a lot of testing and waiting for results. Still no word on Dad's protein levels from a couple of weeks ago; he's had blood transfusions as well as blood taken to do cultures to identify the nature of the infection. MRI, X-ray, ultrasound, PETscan. The doctors are still uncertain of what has been causing the fevers, sweats and fatigue, as well as the acute pain in his jaw and ear.
The most urgent issue at this point is the discovery via MRI of some lesions on Dad's liver and kidneys. There is a biopsy scheduled for 4 PM today. Mom says that there were some lesions in the area previously, and she has urged the doctors at Abington to get in touch with Stadtmauer down at Penn. She asks that we pray for this situation, that the chemo would continue to work, that advance of the myeloma would be stopped, and that these lesions, whatever they are, would be healed. She also asks that we pray that the communication between the doctors at Abington and those at Penn would be productive and unhampered by ego, and that their diagnosis and prescriptions would be accurate and effective.
The most urgent issue at this point is the discovery via MRI of some lesions on Dad's liver and kidneys. There is a biopsy scheduled for 4 PM today. Mom says that there were some lesions in the area previously, and she has urged the doctors at Abington to get in touch with Stadtmauer down at Penn. She asks that we pray for this situation, that the chemo would continue to work, that advance of the myeloma would be stopped, and that these lesions, whatever they are, would be healed. She also asks that we pray that the communication between the doctors at Abington and those at Penn would be productive and unhampered by ego, and that their diagnosis and prescriptions would be accurate and effective.
Friday, April 10, 2009
A New Round
This is just a quick update before I head off to the hospital. Roger was hospitalized Thursday afternoon for what may be another infection. Please pray for the doctors as they work to determine the cause and find an effective treatment for whatever is going on. We'll send updates as they come. (There's still no report from the lab on Roger's protein level from the April 1st appointment.) Thanks so much for your prayers.
Wednesday, April 8, 2009
Waiting for the results
On April first Roger and I headed down to HUP for Roger's regularly scheduled monthly appointment with Dr. Stadtmauer. The antibiotic Roger had taken for the blood infection he caught two weeks prior had apparently worked, and he gave Roger a clean bill of health in that regard. Dr. Stadtmauer said he was "guardedly optimistic" about the efficacy of the new chemo regimen Roger has been on, but we would need to await the new protein level readings before he could be sure.
Well, as of this date, April eighth, the labs have still not sent their results to HUP, so we all continue to be in the dark as to what those levels are. The nurse practitioner who works with Dr. Stadtmauer has promised to call me as soon as they come in, and when I get the news I will be sure to post it.
This past week I landed a nasty four-day cold--but, thank the Lord, Roger amazingly did NOT catch it. However, yesterday Roger did spend the day at Abington Hospital getting transfused with two pints of blood. Not the best way to start a new April.
But as always we are encouraged when we see the little crocuses and daffodils with their cheery faces telling us Spring is really here. And this week, Holy Week, points our hearts to the true and eternal Spring, a new birth and new life through the death and resurrection of our Lord Jesus Christ. Thanks be to God for His inestimable gift! He is our source of hope in every circumstance.
Well, as of this date, April eighth, the labs have still not sent their results to HUP, so we all continue to be in the dark as to what those levels are. The nurse practitioner who works with Dr. Stadtmauer has promised to call me as soon as they come in, and when I get the news I will be sure to post it.
This past week I landed a nasty four-day cold--but, thank the Lord, Roger amazingly did NOT catch it. However, yesterday Roger did spend the day at Abington Hospital getting transfused with two pints of blood. Not the best way to start a new April.
But as always we are encouraged when we see the little crocuses and daffodils with their cheery faces telling us Spring is really here. And this week, Holy Week, points our hearts to the true and eternal Spring, a new birth and new life through the death and resurrection of our Lord Jesus Christ. Thanks be to God for His inestimable gift! He is our source of hope in every circumstance.
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