Wednesday, October 31, 2007

The good, the bad, the funny...and the serious

It was a very eventful day at the hospital.

The best news: Nathan is off the respirator! After more than two weeks on the respirator and two days of having his arms restrained to prevent him from yanking the tube out of his mouth, Nathan now wears just an oxygen mask over his nose and mouth. He doesn't like that mask (and is restrained to keep him from removing it), but now that he's rid of that respirator tube, he can talk. That is a very specific answer to the prayers of many (most notably, Hannah; she prayed the numbers on his respirator down, by stages, each day!).

Not good news: The intensive-care doctor who told us early on that his teeth are intact was mistaken (and very apologetic; it seems she was misinformed and none of us have been able to see his mouth with the respirator in place). The facial surgeon explained that Nathan's teeth and jaw were badly damaged in the accident. His chin has already been reconstructed, but it will be six months before he is ready for the oral surgery to restore his teeth. That is some very sobering news.

Good news: One of Nathan's close friends from Faith Academy, Josie Cederholm, now at home in Sweden, today arrived to visit. As with Hannah and me, Nathan is thrilled to see such a good friend when he is lucid, but he is still struggling with the effects of the gradually-reduced sedation. Please continue to pray that the Lord will give him sweet sleep (Psalm 127:2) and quiet his mind and heart when he is awake.

On a funny note: I hope it is not out-of-place to quote Nathan by way of giving you a feel for where he's at in terms of grasping, and not grasping, some very daunting realities. Nathan's first words to Hannah (well-muffled by the oxygen mask that covers his mouth): "Why are my hands tied?" He went on to announce, "I'm fine!" and tried to yank the mask off. He followed that up with, " I wanna get up!" When Hannah explained "No, you can't get up yet," Nathan indignantly asked, "Why not?!!!" (He can't see his legs.)

Seriously, we are very concerned that when Nathan becomes aware of the extent of his injuries (e.g., his shattered legs and teeth, and a jaw that may have to be "wired" shut for two weeks, if not operated on), he will be dismayed (to say the least). It is not too early to begin praying for Nathan's HEART--that the Lord will give him extraordinary COURAGE. Joshua 1:9 and Isaiah 41:10 come to mind: "...Be strong and courageous! Do not be afraid or discouraged. For the Lord your God is with you;" "Don't be afraid, for I am with you. Do not be dismayed, for I am your God. I will strengthen you. I will help you. I will uphold you with my victorious right hand."

Tuesday, October 30, 2007

"He gives sleep to His loved ones"

Tonight's good news: Nathan's brain has improved to the point that he is being weaned from the sedation medication he has received for more than two weeks.

Not-so-good news: That weaning process is difficult. After some encouragingly lucid moments this afternoon, Nathan was hallucinating this evening. Sometimes pleasant hallucinations; more often, upsetting hallucinations. Our attempts to assure him that he's not in danger seemed to be futile. Please pray that the Lord would allow him to sleep as his body adjusts to being free of the chemicals he has become accustomed to. Psalm 127:2 says God gives sleep to his loved ones. Join us in asking Him to do that for Nathan.

It was hard to see Nathan suffering from those hallucinations, but Lamentations 3:31-33 says "...the Lord shows compassion according to the greatness of his unfailing love. For he does not enjoy hurting people or causing them sorrow." We can look forward to tomorrow's new mercies.

Monday, October 29, 2007

Credit where credit is due (our "utang na loob")

The (third) surgery on Nathan's right leg took place this afternoon. We got to see Nathan about 90 minutes after he returned to the surgical intensive care unit. He opened his eyes as soon as he heard our voices. His eyes appeared to be more focused than we had seen so far, and Hannah excitedly told him to squeeze her hand if he recognized us, which he immediately did. That was encouraging, of course. :) Then he dropped off to sleep again, while we waited to talk with a surgeon.

The surgeon said it will be about three weeks before Nathan can put any weight on that right leg. His left leg is in worse shape (from the ankle, to the leg bones, to the knee). It is not yet ready for further surgery. Hopefully, it will improve within a few days to allow for further surgery. The surgeon emphasized, however, that Nathan's legs are not the key issue; Nathan's head (I gather the surgeon meant Nathan's brain) recovery is the key issue, and that the legs are very secondary. That kinda put things in perspective; but clearly, Nathan's head is better (his mind clearer) each day.

Talking with the doctor about bones reminded me of our conversation with a doctor several days ago...which conversation, in turn, reminded me of my reading in Psalm 139:13-15. The doctor explained that the trauma surgeons' job is to make sure that broken bones are properly aligned. Once the bones are aligned, she said, the pieces grow together on their own. Well, thought I, I don't know that that's all there is to it. Psalm 139:13-15 says that God Himself "knits" us or "weaves" us together in our mother's womb. So I want to give credit where credit is due. While we have Nathan's surgeons to thank for carefully and expertly aligning the shattered bones of his legs, is it not Nathan's Creator who is "knitting" or "weaving" those pieces back together? I figure we owe both Nathan's surgeons and Nathan's Creator an enormous debt of gratitude ("utang na loob" in Tagalog). The surgeons do the alignment and our Creator and Great Physician does the healing! :)

Sunday, October 28, 2007

Grateful for His mercy; in need of new mercies

Nathan's condition is encouraging and distressing at the same time (if that is possible!). It is encouraging to see him making generally steady progress. It is distressing that the process is so slow and that he has so far to go.

He has already undergone three operations--the first the night of the accident (to stabilize both his legs and his face) and two since (one on his legs and the other on the bones of his face). Two or three more operations will be required. He is scheduled for his fourth operation mid-day tomorrow: the second operation on his right leg. He will have more surgery on his left leg and ankle at some future date. More surgery on his jaw may or may not be required. He is still on a respirator and he has to have his arms restrained much of the time to prevent him from yanking the tube from his mouth.

He cannot, of course, talk with that respirator tube in place, but he responds to our singing to him, or assuring him of God's care, or reading him letters from friends and family, in one of three ways: (1) tears fall from his eyes; or (2) he grimaces (I figured out that he's trying to weep aloud, but cannot, due to the tube in his mouth); or (3) his respiration monitor alarm goes off, indicating that he is not taking a breath (because he is weeping). So we do some singing and reading him letters, but we don't "overdo it." Please pray that Nathan will soon be able to get along without that respirator.

God has shown great mercy to Nathan and to us in a vast host of ways. (Just one example for now: The nurse on duty tonight is so kind to Nathan and to us.) I will try to blog further on God's mercies while Nathan is in surgery tomorrow. But we continue to feel the need of his "new-every-day" mercies.

"I will never forget this awful time, as I grieve over Nathan's losses and his suffering. Yet I still dare to hope when I remember this: The unfailing love of the Lord never ends. By His mercies Nathan has been kept from complete destruction. Great is His faithfulness; his mercies begin afresh each day. I say to myself: We can count on God not to abandon His children. Therefore I will hope in Him!" (adapted from Lamentations 3:20-24, New Living Translation)

Saturday, October 27, 2007

Thinking about respirator tubes, and prayer

Two new developments at the hospital: First of all, Nathan was responsive, not only in the evening (as he has been the last couple days), but also in the early afternoon. He continues to move his arms and hands, squeezing our hands, frowning, and perhaps even trying to smile. That is encouraging. The other new development: they have had to restrain Nathan's arms to keep him from yanking the respirator tube out of his mouth. The fact that he is alert enough to try to get rid of that tube is good news. But sadly, the tube is a necessary annoyance until his breathing is stronger. Nathan initiates virtually every breath on his own now, but he needs the respirator to deepen his breathing in order to get enough oxygen.

One frustrating side effect of having that tube in place: Nathan cannot talk to us. I was reminded of Psalm 27:8: "My heart has heard you say, 'Come and talk with me.' And my heart responds, 'Lord, I am coming.'" (New Living Translation)

One of the joys of relationship is hearing the voice of our loved ones. That that respirator tube prevents Nathan from talking to us is distressing to him and to us. We are looking forward to getting rid of that miserable tube! It is sad, and hard, to relate to a loved one who doesn't talk.

I'm not entirely sure why God so rarely speaks audibly (except that it invariably scares the hearers spitless!). But our Father's invitation (or plea) in Psalm 27:8 makes it clear that hearing from us is important to him. He knows full well what's going on, and what's on our minds and hearts. But He wants to hear us talk to him. Reason enough to pray.

Friday, October 26, 2007

Courage to keep on

Today's scenario at the hospital resembled yesterday's in many respects. Two encouraging developments on the medical front: Nathan's inter-cranial pressure monitor was removed today (because pressure on the brain is no longer a problem), and he has begun trying to breathe on his own. He still needs the respirator to supplement his own breathing, but he initiates each and every breath on his own.

Just like yesterday, he became responsive at seven p.m., moving his arms and squeezing our hands. It is wonderful to have him conscious of our presence, but it is awful to see him having to endure the suffering associated with having his airways suctioned and having cold packs around his body (to reduce his temperature). I wiped one after another tear from Nathan's eyes and cheeks as he seemed to be trying to speak. (Of course, he cannot speak with the respirator tube in his mouth.)

The passages of Scripture that seem to best describe God's agenda for Nathan, and for his family, at this juncture:
"Wait patiently for the Lord; be brave and courageous; yes, wait patiently for the Lord.... The Lord gives his people strength; the Lord blesses them with peace.... So be strong and take courage, all you who put your hope in the Lord!" (Psalms 27:14; 29:11; 31:24, New Living Translation)

Please continue to pray God's mercy on Nathan. It is imperative that his wounds and his lungs not become seriously infected, and he needs a lot of strength, both physical and emotional, to keep on keeping on.

Thursday, October 25, 2007

Surprised by joy!

When we got to the hospital after Nathan's surgery, the doctor looked serious. They had not, he explained, been able to finish the surgery on Nathan's face. They'd finished the eye sockets and cheekbones, but after almost four hours of surgery, they decided they'd have to leave the jaw for next week. That was disappointing. I'd been looking forward to Nathan's waking up after more than ten days of sedation, but the doctor told us they wouldn't be waking him only to anesthesize him again sometime soon . But we comforted ourselves with the thought that progress is being made. (The doctor added that the biggest threats to further progress at this point are infections in Nathan's wounds or in his lungs.)

And then... just before visiting hours ended, I suggested to Hannah that I sing Nathan the song that had become a bedtime tradition with Stacey ("Jesus Loves Me"). Hannah seemed to think it was a bit corny, but she joined me in song. Imagine my surprise (almost shock!) when I saw and felt Nathan's hand move in mine. I told Hannah as much, and she told me I must have been imagining things. I began wondering aloud whether I was, in fact, imagining things, when I saw a teardrop course down his cheek. Again, Hannah was doubtful. "It'd just the ointment on his eyes," she said. But then Hannah herself was dumbfounded to feel his other hand squeeze hers. The two of us were so excited we could hardly contain ourselves. I told Hannah that it must have been our singing that was the "secret" to Nathan's responsiveness; so Hannah suggested that we sing "Amazing Grace." As we did so, Nathan began moving one of his legs, both arms, his head and face, and even wiggling his shoulders and chest. I suppose he might have spoken had he not had the respirator tube taped in his mouth!

It was almost as exciting (and almost as unnerving) as watching someone in a morgue become responsive! (The doctor had explicitly told us that we should not expect that Nathan would "come to" by opening his eyes and saying, "Hi, Mom and Dad," but I must admit that that is precisely what I was expecting. So to have his motionless figure, with eyes still shut, suddenly begin moving was the most wonderful shock of my life.)

What a wonderful reenactment of the Luke 7:11-17 story that has meant so much to Hannah from the very day we got the phone call about Nathan's accident:
"...Jesus went with his disciples to the village of Nain, with a great crowd following him. A funeral procession was coming out as he approached the village gate. The boy who had died was the only son of a widow... When the Lord saw her, his heart overflowed with compassion... Then he walked over to the coffin... 'Young man,' he said, 'get up.' Then the dead boy sat up and began to talk to those around him! And Jesus gave him back to his mother." That last phrase has been precious to Hannah from the very hour we got the phone call from Austria. The Luke account concludes by saying that the crowd were awestruck. "We have seen the hand of God at work today," they said. And "the report of what Jesus had done that day spread all over Judea and even out across its borders."

The report of what God has done for Nathan and for Hannah and me and our family will likewise spread from one end of the globe to the other. We have praying friends on virtually every continent! THANK YOU for praying...and for continuing to pray. Please pray that our Great Physician will prevent infections in Nathan's wounds or in his lungs. (The sooner he gets off that respirator the better; it tends to cause infections in the lungs. And he has a rash, on and off, that the doctors attribute to his being allergic to some of the antibiotics they have given him to deal with the threat of worsening infections.)

We are thrilled at what God has been doing for Nathan and for us! And we are grateful to you ongoing pray-ers!

"...My heart is filled with joy; I burst out in songs of thanksgiving!" (Psalm 28:7)

Wednesday, October 24, 2007

Gott sei Dank!

Yesterday was a difficult day at the hospital for Hannah and me. Unpleasant surprises (e.g., the trauma surgeon's saying that he proposed to start with surgery on Nathan's broken ankles (we knew his legs are broken, but no one had told us his ankles are broken!). Disconcerting changes in plans (e.g., because there is some infection in Nathan's legs, they will be leaving the external "scaffolding" in place for 5-6 weeks). At one point, the surgeon said that he didn't propose to do surgery today at all. That was discouraging.

Our worst scare came when the ICU staff said an opthamologist had been called in to look at Nathan's eyes. They had told us his eyes were fine, so we were fearful that things had changed for the worse.

By the time we left in the evening, we were worn out, but things were looking up. The opthamologist finally showed up, and explained that their calling him was a good sign. Nathan's brain condition had improved to the point that they could dilate his pupils to examine his retinas. Dilating his pupils was something they hadn't dare do before (they had been watching his pupils to alert them to sudden brain problems). And the surgeon decided he'd go ahead with the leg/ankle surgery today after all.

And today was a great day. Nathan tolerated the the 6-7 hour surgery well and he looks better than ever. They got him all cleaned him up and styled his hair to match the photos Hannah had taped up beside his bed! :) Said the nurse, "He's a nice boy." (Since she's never seen him conscious, I assume she means he's a nice-looking boy.) And the ICU doctor explained that the external "scaffolding" on Nathan's legs is the best, and least painful, approach to effecting the healing badly-shattered leg bones. So far, so good.

Nathan heads back to surgery at 7:30 am tomorrow for the bones of his face (his jaw, cheekbones, and the back of his eye sockets). After that, they'll begin gradually waking him up. (He'll have one more operation next week on the ankle that the surgeon did not do today, as it was somewhat swollen.)

Nathan has a long road ahead, but we are making progress, and Hannah and I are happy and grateful...to the doctors and nurses, to you pray-ers, and to God Himself. Gott sei Dank! Thank God!

Tuesday, October 23, 2007

Update on Nathan

Unless Nathan's situation deteriorates overnight, they will operate on Nathan's ankles and legs tomorrow.

They do not, however, propose to replace the stainless steel "scaffolding" (external stabilizers) protruding from both legs with rods hidden inside the legs. Some degree of infection in the legs makes it inadvisable to insert the rods, so Nathan will have that external "scaffolding" in place for the next five or six weeks. I think that is likely to be one of a host of disconcerting developments for Nathan over the next few weeks, so prayers for his emotional recovery will be in order once he is slowly awakened (after the proposed surgery on his face on Thursday).

Persisting in prayer

Hannah and I were reminded Sunday evening about the need for persistence in prayer from two memorable stories: the Exodus 17 story about Aaron and Hur holding Moses' weary arms aloft in order to secure the victory over the Amalekites, and the Luke 18 story about the widow who received what she asked for (even from a no-good judge!) because she simply would not give up asking.

Thank you,
friends, for persisting in prayer, as you are able.

Medical update

As you know, Nathan has been unconscious and dependent on a ventilator for more than a week. They yesterday began reducing his sedation to see if he can begin to breathe on his own. If he does so, and if there is no increase in inter-cranial pressure, and if there is no fever, even with reduced sedation, they will proceed with surgery on his legs on Thursday and do at least one operation on his skull on Monday. (Two operations on his skull may be necessary.)

If they are not able to proceed with the leg surgery on Thursday, Nathan will probably need two operations on his legs: one to remove the stainless steel "scaffolding" currently in place, and then a second operation (to insert the rods) after he heals from the first operation. They would prefer, of course, to do both leg procedures at once (i.e., remove the "scaffolding" and insert the rods at the same time). So please pray that Nathan begins to breathe on his own right away, and that there is no increase in inter-cranial pressure from now on. Please pray also that he does not begin running a fever.

"Swooping" to Nathan's rescue

Family friend and long-time missionary to Africa Dave Hall put us onto a passage of Scripture that has been an encouragement to Hannah and me: Deuteronomy 33:26-27a. In the New Living Translation, it reads: "There is no one like the God of Israel. He rides across the heavens to help you, across the skies in majestic splendor. The eternal God is your refuge, and his everlasting arms are under you..."

What a wonderful reminder of the sort of God we have as Father! There is no one like Him! He is like a powerful "super-hero" soaring through the skies and, to use Hannah's word, "swooping" down to help us, his strong arms upholding us. The super-heroes of the movies that have been popular recently cannot compare to Him when it comes to power to save, nor can they compare to Him when it comes to a passion to come to the rescue of the helpless. That is just what we need...and that is who He is.

I was, this past Sunday, surprised and delighted to discover the same "swooping" "super-hero" theme in Psalm 18. David composed that psalm on the day the Lord rescued him from his enemies. Sunday was that sort of great day for us. Nathan's CT scan revealed no new problems. I adapted the New Living Translation of Psalm 18 to celebrate Nathan's good day. Nathan is by no means out of the woods yet, but Sunday's CT scan was cause for rejoicing and we invite you to join us in a celebratory psalm:

"We love you, Lord, you are our strength. You are our fortress and our savior; you are the rock in whom we find protection. Your are our shield, our strength, our stronghold....

Nathan's death stared us in the face... but in our distress we cried out to you, we prayed to you for help. And you heard us; our cry reached your ears....

You opened the heavens and came down... You flew, soaring on the wings of the wind....

You reached down from heaven and rescued Nathan; you drew him out of deep waters.

The Lord lives! Blessed be our rock! May the God of our salvation be exalted!"

Psalm 18:1-2, 5-6, 9-10, 16, 46

Thank you, friends, for calling on the Lord to save Nathan. He has been doing just that, and we want to honor Nathan's savior from death...

But Nathan is far from "out of the woods." So please join us in continuing to pray Psalm 6:2-4 and 9 for him:

"Have compassion on Nathan, Lord, for he is weak. Heal him, Lord; his body is in agony.... Return, O Lord, and rescue him. Save him because of your unfailing love.

We know you have heard our plea, that you will answer our prayer."

Saturday, October 20, 2007

Gruss Gott!

A friend has, for months, been urging me to write a blog, but only now am I inclined to do so, as there may be those who would like emailed updates on Nathan's condition without having to wade through my thoughts and feelings as I write. So I will try to keep my emailed updates to-the-point and reserve my "musing" for this blog.

Yesterday was a difficult day. Our hopes had been climbing higher and higher the last couple days, only to have Nathan take a (life-threatening) turn for the worse yesterday morning. The ICU doctor who had been so cheery, even bubbly, a couple of days earlier seemed somber as she told us that the inter-cranial pressure on his brain had suddenly soared. They had to grab a bag to ventilate him (hyperventilate him) to bring the pressure down as they ran through the halls to the CT scan in an attempt to discover the cause. To no avail. No inter-cranial bleeding showed up on the scan; so they have no idea what caused the inter-cranial pressure to spike. They know he needs rest more than ever, so they have deepened the level of his sedation. And explained to us that the prognosis is uncertain with trauma to the brain. They emphasized that the outcome of brain injuries is less predictable than the outcome of injuries to other parts of the body.

When evening visiting hours ended, the doctor told us that we should go home. Like Nathan, he said, we need our rest. But I told Hannah over dinner that Nathan's setback had "taken the wind out of my sails" and wondered if I would have as much trouble sleeping as I have the last few nights. To my surprise, God graciously gave me a good night's rest. When I did wake up in the wee hours of the morning, I happened to read Psalm 3:5 and Psalm 4:8: "I lay down and slept. I woke up in safety, for the Lord was watching over me....I will lie down in peace and sleep, for you alone, O Lord, will keep me safe." And I managed to go back to sleep and get a couple more hours' rest.

And I was encouraged this morning to read Lamentations 3:20-33. My paraphrase, based on the New Living Translation: "I will never forget this awful time, as I grieve over Nathan's loss. (Every day I get a kick out of the quaintness of Salzburg and hate to think that Nathan will miss it all. Right now as I type this, great big fluffy snowflakes are falling; and Nathan is missing it.) Yet I still dare to hope when I remember this: The unfailing love of the Lord never ends! By the Lord's mercies Nathan has been kept from complete destruction. (Imagine! Nathan's eyes and his teeth emerging unscathed when the bones under his eyes and his jaw were broken! And virtually no injuries to his internal organs!) Great is the Lord's faithfulness; his mercies begin afresh each day. I say to myself, 'We are God's children. So we can count on him to be there for us!' The Lord is wonderfully good to those who wait for him and seek him. So it is good to wait quietly for salvation from the Lord..... The Lord does not abandon anyone forever. Though he brings grief, he also shows compassion according to the greatness of his unfailing love; he does not enjoy hurting people or causing them sorrow."

To my amazement, Austrians customarily greet one another, not by saying "Guten tag," but by saying "Gruss Gott" ("greet God" or "salute God"). People on the street are routinely urging one another to acknowledge God! What an appropriate way to honor Nathan's savior from death! (The police accident investigator yesterday showed us how the huge van that struck Nathan was damaged. The heavy side mirror was completely sheared off by the force of hitting Nathan's head, and the wheelwell and mudflap were splashed with blood from Nathan's legs.) It is a miracle that Nathan survived at all. Gruss Gott!