Forward Progress

"The name of the Lord is a strong tower; the righteous run to it and are safe." Proverbs 18:10

A friend (who recently walked through cancer with her dad) shared this verse with me and it has repeatedly encouraged me over the last week as Dad has been in the hospital. How thankful we are that Jesus is our STRONG TOWER and in Him we are SAFE!

Thursday and Friday were days of amazing progress for Dad! I (Jennifer) only had to be away from the hospital for a few hours to find everything different when I returned - one by one reduction of the medicines being given through IV, removal of the epidural, eating solid foods once again, getting up and out of the bed, walking in the hall, and so much more. Of course, there have also been a few bumps in the road (such as the pathology report and anticipating chemotherapy and radiation) but still there is no doubt that God has been and will continue to show Himself faithful in Dad's healing. He is our STRONG TOWER!

One little bump that we have been waiting to get over is Dad's lack of voice. Since his surgery he has only been able to speak a little above a whisper. First, we thought it was from the breathing tube used during surgery (a normal occurance). But yesterday, the surgeon, Dr. Lackner, said that he believes one of Dad's vocal cords is paralyzed. The removal of the lymph nodes during surgery was in very close proximity to the vocal cords and resulted in one of them being "caught in the crossfire." This means that the Ear, Nose and Throat doctors will need to see him, and then they will do a procedure that will help to correct the problem. We are hopeful that Dad will be able to have this done on Monday. Even though it is another hurdle to cross, I think Dad is just thankful to know that something can be done to help him get his voice back. Please pray that Dad can get in the schedule on Monday and that the procedure will be successful. Thank you!

We had a good night at the hospital Friday night; there were many fewer interruptions in our sleep because Dad is doing so well and there is less the nurses need to do for him. This morning, Mom reported that Dad's x-ray is once again clear and the right lung looks great! Also this morning, he was up and out in the hallway for another walk; here is a picture.



I didn't catch him with the best expression on his face (he really was happier than he looks in the picture!), but at least you can see that he is making forward progress! He will be moving to a regular room as soon as one becomes available; hopefully sometime today.

Thank you so much for continuing to pray for Dad as well as for the rest of us. Dad told me this morning that he is amazed at all of the people who are praying and who have sent cards and visited him. The Lord is using you; you are a blessing to us!

Vocal Chords

The surgeon stopped into see Dad yesterday and thought everything looked great. He is hoping to get him moved to a regular room today and maybe discharged Tuesday or Wednesday. The one issue Dad has is his voice. He has not be able to talk since the surgery. We thought it was from the intubation during the surgery. Dr. Lackner said his one vocal chord on the left was injured during the surgery. The nerve was probably damaged when they removed the lung and there was no way to avoid this. Dr. Lackner had told us of this possibly happening when we met with him before surgery, but I had since forgotten about it.

The doctor is going to have ENT come and look at Dad today or tomorrow and maybe perform a procedure on Monday. Dad talks in a whisper because the left chord is not working. The doctor would inject collagen into the chord to get it fatter so it touches the working chord (or something like that). If he doesn't like the results, he can have a bigger procedure after chemo/radiation that includes attaching a different nerve to the "broken" chord.

We have goals of walking, eating, etc. over the next few days to build up his strength and endurance. He is doing very well. He is in a good mood and motivated to get up and around. Thanks for your prayers! Blessings!

Diet Coke and Hamburger

Dad enjoying his lunch of hamburger and Diet Coke!  Today has been a good day!

Yesterday

I meant to blog last night but the day got away from me. Dad had a great day yesterday. He got up and walked 3 times and is ready for more today. He has only insulin on his pole and we will get rid of that today. He didn't have any appetite so he was drinking lots of Ensure to get his nutrition. This morning he ate eggs and bacon for breakfast . . . and coffee, of course. He says that things don't "taste", but he didn't enjoy the Ensure so we are going to eat for "survival" not taste today! ; )

One of the PA's was just here and said we may be moving back to a regular floor today. That is one step away from home!! Yeehaw!

Praying for another good day today. Thanks!

Physical and Emotional

Physically Dad is doing awesome. He only has 2 bags hanging from I.V. pole. He is up more and moving around - slowly but moving is moving! He is eating pretty well, his oxygen is good and his heart is staying in a nice rhythm. Emotionally, he is up and down.

The pathology report yesterday was a big downer. We are so focused on getting through this surgery that we kind of "forgot" about the cancer. The surgeon had thought the stage was more like a 1 or 2. Having the pathology report say a "3a" was tough. However, the more I thought about it, I am seeing the Lord's favor in the midst of it. If the surgeon had realized how big the tumor was or how close to the heart, he may have wanted chemo first or he may have said he wouldn't be able to operate. We want to be thankful not worried!

After the pathology report, everything else seemed to be "clouded". A lung xray came back and was "worse" than the day before. A nurse coordinator came in and explained about going home and how some of that would work. Mom and Dad took that information the wrong way and it depressed them.

In reality, the lung xray was pretty much the same as it had been and actually showed improvement today. The nurse coordinator was just trying to convey that he was here to help them get whatever they needed when the time came for them to go home.

The "dark cloud" had settled in for the day and was making everything harder. Our goal for today is to be positive and motivated. Please pray for Dad's emotional health as well as his physical. Please pray for Mom to trust in the Lord and not get fearful or anxious. We are giving Mom a little break today - she may be spending the night plus she just needs to get out of the hospital periodically.

We are just trying to take one day at a time, trusting that the Lord is holding this all in the palm of His hand.

"Show love to the Lord your God by walking in his ways and holding tightly to him." Deut. 11:27b (emphasis mine)

Take Away

I just signed in to write a post and noticed that Don had already done it and took my "topic"! ; ) The surgeon resident came in this morning and started to "take things away" - the morphine drip (which Dad wasn't using anyway!), his catheter, etc. He is also talking about the I.V. nutrition but that hasn't happened yet. It is nice to see the amount of bags on the pole decreasing!

The other piece of information that we received today is the pathology report. It shows that the cancer was a stage 3A. We don't understand all of it yet and will need to ask more questions, but we do know that there will definitely be follow-up chemo and radiation for Dad once he is healed from the surgery. The doses they talked about prior to surgery were very "doable" and we kind of expected this especially since the tumor was larger and more involved than expected.

We are just going to take one day at a time . . . so today we are rejoicing that he is doing better and that they are "taking things away"! We are focusing on his pain control, getting him to eat food and helping him to move more.

"Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own." Matthew 6:34

Less stuff

I (Don) just stopped by to see Jim & Rhonda after my lunch break. The first thing I noticed was less stuff! Less tubes, less medicine. He walked a little with more confidence than Monday (the last time I walked with him). His voice is getting stronger. A long way to go, but looking better over the last 24 hours. Yeah!

New Room

Dad's new room was not available until midnight. We had him all ready to go and then tried to sleep while we waited. Once they moved him up, they got him settled pretty quickly. It helped that they moved him in his bed and let him continue to use the same bed. He shares his new room with another gentleman. This is going to be a little tough for my dad. Please pray for grace.

He is now supposed to only need his pap machine at night. He wore it from 10 pm until about 4:30 am this morning. They wanted him to try for 6 am so he did really well. The machine loosens up some of the mucus. Once they take it off, they want him to cough and get the mucus out. It is a lot of work but he really wants to get away from the pap machine if he can.

He is doing well. Here is the mailing address with his new room number.

James Kooiman
Patient Mail
Hospital Room 8833-1
PO Box 6159
Omaha, NE 68106-0159

He received a huge stack of cards yesterday that put a smile on his face. Thanks!

Mom will be here at about 7 am. Please pray for her day! Thanks!

Moving On Up!

Today is moving day. Dad will be moving to an "intermediate" care room today. It is a step down from ICU. He is now off of the pap machine during the day which he is very excited about. They also removed his epidural. He has improved so much from even yesterday.

He has had several visitors today and lots of cards! We will repost the hospital address once we have the new room number. Thank you for all of the attention and encouragement! Blessings.

A Peaceful Night

"...He grants sleep to those He loves." Psalm 127:2

Thank you for your prayers for a more peaceful evening and night. Once again the Lord has looked upon us with favor and granted us a restful night (as restful as can be expected in a hospital!). I (Jennifer) had the privilege of staying with Dad overnight and am happy to report that all is well on this watch. I am hopeful that Mom also had a peaceful night of sleep at Lori's house!

Also, I am the bearer of good news. Dad had a chest x-ray taken Monday evening and it shows that his lung is clear and looks great! Any mucus that he needs to cough up is actually in the back of his throat; there is nothing in the lung that should not be there. Praise God for that! Also, the nurse said that his lung capacity numbers are amazing. He has better numbers with just one lung than some people have with two. Once again we see the Lord's favor over Dad. And perhaps his gift of gab has helped to keep his lung in good working order. (Did I say long winded?! Maybe just chatty!)

Dad is continuing with two hours on the pap machine and then two hours with just the nasal tube. Over the night, his oxygen flow on the nasal tube was first reduced to 4 liters and then the next time reduced to three liters. In both cases, he was able to keep his oxygen saturation number up in the 90's where they want it to be. That is positive progress toward breathing all on his own!

Thank you for walking through this experience with us. Your prayers make all the difference!

Baby Steps

"On Him we have set our hope that He will continue to deliver us, as you help us by your prayers. Then many will give thanks on our behalf for the gracious favor granted us in answer to the prayers of many." 2 Corinthians 1:10b-11 (emphasis mine)

Mom was doing her Bible Study last night and discovered this verse. We thought that it so fit the verse from the other day that we wanted to share it with you. We are so being helped by your prayers and the Lord is definitely granting us His "favor" in response. Thank you.

Dad has had a great afternoon. After his exercise with the PT this morning, he took a huge long nap. He was okayed for a "clear liquid" tray which consisted of green jello, cranberry juice, ice tea, grape popsicle and chicken broth. He ate every morsel! We told him that it was a "baby step" to a hamburger. Well it is actually a step to "soft foods" - the hamburger will come later. He has been approved for a diet coke which will make him VERY happy.

He is now 2 hours on the pap machine and 2 hours off. He loves the off time. He is much more alert and talkative. His voice is still really hoarse but it is getting better. His hemoglobin is a little low (7.4) so they are giving him a unit of blood so it doesn't go below 7. They have changed his dilaudid to morphine to see if it reacts with his body better. His comment to that was, "you get addicted to that" and has not used it since they changed it. So far, he seems to be ok with the pain.

Dad has been having rough evenings. Don calls this "sundowning". Apparently, patients get agitated, confused and a little sicker once the sun goes down. Please pray that Dad has a better evening tonight than the previous ones. Thank you.

Crabby is Good!

When Don and I got to the hospital today, Dad was crabby! (Mom was too, but she doesn't show it as much!) They had been messing with him and moving him and checking him etc. etc. Then the PT lady came in - oooooh, he was a little testy! But we know that means he is feeling better!

The PT person had him up and walking. She encouraged him to walk to the door and look out at the "world" a little bit. It was so good for him. Then she had him sit in the recliner instead of the bed. I told him that he needed "to get his stink off". It worked - he was tired but it was a "good" tired from the exercise. He was much more agreeable and even laughed at one of the doctors.

He always seems so pensive. We can't tell if it is just the medicine or if he is really thinking about stuff. I asked him if he was worried about anything. He paused for a long time and then said, "I didn't think it would zap me so much." He had no idea how big this surgery was. I told him that his ignorance was probably a good thing. He couldn't remember what day it was today and that really bothered him. He doesn't like to be confused. He also doesn't like change. Hmmmm. . . his world is all about confusion and change right now! Please pray for peace amongst the chaos. I am praying for a deep contentment from the Lord that overrides the circumstances. Thanks for caring and praying!

In His Arms

Praise the Lord; praise God our Savior!
For each day he carries us in His arms. Psalm 68:19

This awesome verse was in my daily reading today. He is so good!

Dad's heart went into afib again last night. They gave him some different medicine and it finally did return to its normal rhythm. When they did the surgery, the tumor was very close to the heart so they had to mess with the sack around the heart. It is now inflamed. I have not heard the lab numbers today to see if it is any worse. It was not something that they were terribly worried about but just watching. Please pray for that to all settle down.

They did reduce his oxygen intake to 30% this morning because his blood gasses are much better now. I think he will be doing 2 hours on the pap and 2 hours with just the nasal tube. That will be better. He is not really liking the mask.

Dad is having hallucinations from his pain medicine. It is a narcotic (in the morphin family - dilaudid) so we are not surprised by this but he does not like it. Please pray that these would either stop or that there would be a different option for his pain. Yesterday, he saw a spider run across the TV. He describes it as "creepy"!

I am off to relieve Mom - please continue to pray for rest for her. She is going on a few hours of sleep at night and maybe a nap of 2 or so hours during the day. She needs more rest but doesn't want to leave Dad. Please pray for strength and endurance and rest! Blessings!

Sitting Up

I snuck a quick picture while Dad has his oxygen mask off and was sitting up.  He was asking for diet coke and joking with the nurse.  Nice glimpses of a "healthy" Dad!  He has had a great afternoon.  No big changes to report but wanted to share the picture!

A Milestone

Dad has asked for the remote control. We knew that once he asked for the TV to be on, we would have hit a milestone! He is now working on how to manage the clicker - good distraction for him!

His kidneys are working better. He is now supposed to be 3 hours on the pap machine and one hour off. He is going to get a PICC line so they can start putting some nutrition into him. All good news. They think he may be in ICU one more day for sure.

I wanted to take a picture of him sitting up in bed, but he didn't really like that idea. I may sneak one later when he is sleeping. He looks so much better. We are very thankful!

A New Day

I just talked to Mom; Dad is doing well this morning. She did have some excitement at around midnight. Dad's heart went into afib. The surgeon had told us that this was a possibility and it was likely to happen on Saturday. I love it that he called that!
Anyway, they were able to get it under control with medicine.

Mom was able to get some rest but she sounds very tired. Our family is going to have some worship/devotion time this morning and then Don is going to take me and get her. We want to be there when the surgeon does rounds at about 9:30ish. Please continue to pray for Mom. She needs some rest today.

And please continue to pray for Dad. I will do another post once I am there and know more. I am praying that the Lord returns blessings to all of you, over and beyond anything you can imagine, for the prayer coverage that you are providing for Dad. We strongly believe in the power of prayer and a faithful God who listens. Thank you!

Favor received!

The Lord is so faithful! The day is coming to an end and Dad is still in the ICU but we have seen lots of improvement today.

I think I wrote earlier that we were hoping he would urinate more to help the potassium level as well as the fluid on the lung. For those of you that are medical people, he urinated over a liter of fluid in 8 hours. They are confident that his potassium is lower and won't even check it again until morning.

They took another chest xray this afternoon and it showed marked improvement in his lung. It showed a definite decrease in the fluid (decreased right basilar opacity - Don is here with me now!)

He is now getting 50% oxygen which is down from the 65% from this morning. His heart rate has now returned to a more "normal" level.

Mom is really excited that he is using his hands more and he is doing great with his coughs. His color is better and he seems to be much more relaxed. We are really encouraged. There has been a little bit of talk of moving him back to a regular room tomorrow but we will wait and see.

Thank you so much for your prayers. Mom will stay here tonight. She is really tired but wants Jen and I to be with our families tonight. Please pray that she gets some sleep. We will get her out of here as soon as we can tomorrow morning! Blessings!

Favor

I was reading my daily Bible reading during my "shift" in Dad's room a little bit ago. We are on Psalm 67 today. This is the verse that caught my attention:

"May God be merciful and bless us,
May his face smile with favor on us." Psalm 67:1

As I am sitting here amongst the beeps and breathing machine noises, I am asking the Lord to be merciful to us. I am asking for His blessing on my dad, the doctors and the nurses. But I am pleading for the Lord to "smile with favor on us."

Dad is stable. He has some fluid on his lung and a high level of potassium. They gave him some lasik to get him to urinate more which will help both of those problems. He seems to be doing better with pain unless they move or shift him (which they do alot on this floor). He is also breathing well on some "pap" machine thingy (obviously Don is not here with me!).

I am so thankful that he is not getting worse but, please Lord, "smile with favor on us" and let us see some improvement soon. Thanks for caring and praying and sending us your encouraging words.

Bump in the Road

Dad had a rough night so early this mornning they transferred him to the ICU. He is needing more oxygen and a little bit closer care. They are concerned about his kidneys working but everything seems to be stabilizing. They are also concerned about fluid on his lung. Thanks for praying. We will post again when we know more.

Slowly But Surely

Dad had a good day.  We saw marked improvement by the end of the day.  He ate well and continued to exercise his right lung.  He uses the pillow he is holding to help him cough. Mom thought he was cute holding his heart pillow while he slept!

They removed his chest drain tube today.  It was nice to have one gone but I think they added a couple other things.  It is amazing how many things they can put into him at one time.  He gets tired of the poking and moving and prodding but if he is complaining, we know he is feeling better. 

He is doing a good job of managing his pain.  They set him up with a morphin button and he still has an epidural.  If he feels pain, he pushes one of the two buttons to feed himself more medicine.  He has put himself on pretty tight restrictions (tighter than the doctor even).  They are watching his kidneys and his diabetes and his oxygen levels and on and on.  It gets a little bit overwhelming but so far, so good.

Mom will stay with him tonight and then Jen will be back in the morning.  I will take the afternoon shift again because we want to have one of us with him at all times.  We are praying for continued improvements.  One step at a time; one day at a time.  We so appreciate your encouraging words and prayers.  Blessings.   

Thankful

Jen and Mom stayed with Dad overnight last night. We didn't feel peace about leaving him by himself. He had been having trouble with his oxygen saturation number (I think that is right?) so the alarms kept going off. However, they eventually changed the oxygen flow and put a mask on him so the night turned out better than expected.

I went home to make sure the six grandchildren were doing ok. They have been "living" together since Wed. night at our house which they are absolutely loving!

This morning Dad was doing much better so I made sure the kids had some breakfast and decided to take a walk around our circle. I don't think that I have ever thanked the Lord for my lungs in the past. All of this stuff going on with Dad has given me a new realization of how thankful I am, how amazing lungs are and how wonderful the Lord has made our bodies.

As I try to get Dad to breath and eat and talk a little bit, I am so thankful for his life, his impact on my life and the impact he is having and will continue to have on my children. Thank you Lord for Your grace and mercy.

We will continue to keep you posted!

Very Long Day

We spoke with the surgeon just a few minutes ago. He did confirm that he took the entire left lung. He said that the tumor was a little larger than he had expected (as compared to the CT scan) and was extending into the surrounding lung tissue. Because of this, the surgeon had to resect the blood vessels further back toward the heart. As a result, the bottom lobe of the lung could not be safely spared. Our number one priority today was for all of the cancer to be removed, even if that resulted in a more extensive surgery. The breathing tube has been removed and Jim is resting, recovering from the sedation. As of right now, he is in the process of being moved from recovery into his hospital room.

It has been a very long day. Thank you for all of your thoughts, your prayers, your notes, messages, food, etc, etc, etc. We appreciate it all very much. We would also appreciate continued prayers for a quick uncomplicated recovery and negative margins on the pathology report.

Cards can be mailed to the hospital at the following address:
James Kooiman
Patient Mail Hospital room #7837
PO BOX 6159
Omaha, NE 68106-0159

Finally Done

We are waiting for the surgeon to come out and talk to us, but we have talked to the plastic surgeon who was a part of the surgery. She has told us that everything went well but they had to take the entire left lung. We had been praying that it would only be the upper lobe but the goal was to get all of the cancer. We are thankful that the surgery went well.

They have moved Dad to recovery for observation and then they will be moving him to a room. Thank you for praying.

Quick Update

We just received a quick update from the nurse. The surgery started at 1:40 pm and all is going well. We don't know how much longer it will take but will let you know if we hear anything else. We are very thankful that it is going well. Thank you for your prayers.

Here We Go!

They put him in a dress and a fun hat then they took him through the secret doors!  He was feeling really good but asking for a brownie!  I am hoping that he forgets who took the picture of him in his hat! 

Surgery could be 2 to 4 hours.  We will have period updates as we wait.  Thank you for your prayers! 

Slight Delay

Dad has been "bumped" by 2 emergency procedures.  They said that it could be a couple hours before they get started.  He is all dressed and ready to go so I guess it is up to Pastor Dave to keep him occupied!  He is whining about his lack of coffee this morning so we are praying it goes quickly! ; )

Lung Cancer

The night we returned from Guatemala, my dad told us that they had found a mass in his lung. Since that night, we have been on this journey of doctor appointments, scans, stress tests etc. etc. Dad is the one getting poked and scanned and checked but we have all been on this emotional rollercoaster. The whole journey has been fast and overwhelming.

The mass is in Dad's upper left lobe near his brochial tube. He had coughed up some blood and was experiencing shortness of breath. These events triggered an x-ray, CAT scan and eventually a biopsy. The biopsy told us almost immediately that it was cancer. It is a non-small cell squamous cell carcinoma (for those of you that need to know!). The pulmonary specialist sent us on for a PET Scan and a meeting with an oncologist. Our prayer was that the tumor would be operable since this type of cancer is not as responsive to chemo or radiation.

Our prayers were answered and we were sent on to a surgeon. We met with him last Friday and the surgery is scheduled for this Thursday at 9 am. Our prayer is that all of the cancer will be contained in the upper left lobe so that they can remove just that part of the lung. If the tumor encroaches into the lower lobe or into the blood vessels or the brochial tube, there is a chance that the whole left lung will need to be removed. And then it gets more complicated.

We are trusting the Lord for a uneventful, smooth surgery on Thursday. We know that He holds all of this in the palm of His hand.

"But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me." 2 Corinthians 12:9

If you think of us, we would so appreciate your prayers. My dad's first name is Jim. We will try to update as this journey continues especially on Thursday. Thank you!