May Your New Year be Boring!

I'm celebrating the New Year with a sigh of relief. I am SO happy to see the backside of 2011 going out the door. To briefly review the debacle that was 2011:

• I started the year with mono and a fibromyalgia flare.
• I ended May with a  nasty car accident; I had a head injury and a broken collarbone.
• John's cancer was found in June; he had lots of hospitalizations and chemotherapy.

On the good side:

• We're both alive (which we have no business being), to the consternation of our doctors.
• John has kept his job and our health insurance.
• I've come out of retirement, and have a job that I love.
• We've added a new member to the family: Jethro the dog.

To sum up:

• As a dear friend once said, normal moved and left no forwarding address.
• We haven't been bored.
• It could have been worse.
• I don't want to take one of those tests that tells how stressful your year was.

So I wish you all the best thing I can think of - a very, very boring 2012!

About that cow . . .

I've been transplanted. I grew up in Atlanta, and somehow landed in small-town Indiana. Very small. Smaller than my high school. I love it here and have asked my husband to promise me we'll never again live in a town big enough to have stoplights. But there were some adjustments. For one thing, I'd always had anonymity, so for 2 years I had nightmares about going to the post office naked. But about the cow . . .

We live on the edge of town - which means almost in the center of it - with an Amish farm to the east and an English (i.e., non-Amish) farm to the south. There are lots of horses, some hens and pigs, and cows. Occasionally you see a cow wandering around in the street somewhere. When I was a child, I do not remember ever looking out the window of my father's highrise office building and seeing, way down there, a Holstein wandering down Peachtree Street. So this was new to me. But it could startle even the natives. Finally, about that cow . . .

Early one Sunday morning Mertice woke up across the street from us, got her cup of coffee, and opened the front door. Looking out, she was eye-to-eye with a cow. It was standing on her front porch, calmly looking at her through the storm door. Mertice yelled for DeWayne that there was a cow on the porch. DeWayne, understandably, thought this was an exageration of some sort. Coming to see for himself, he discovered the literal truth - there was a cow on the porch. DeWayne never gets excited about anything, certainly not livestock. He calmly got a rope out of the garage, looped in around the Holstein's neck, looked at its brand, and walked it back home.

There's no particular moral to this story, except maybe that you should keep a length of rope in your garage. But the incident stands out in my mind as one of those times I was startled into asking myself, "Where am I, and how on earth did I get here?" Besides moving me to admiration of DeWayne's calm competence, the morning is symbolic of my time here. Some day when I'm in a nursing home with the last staged of dememtia, I'll be muttering about that cow.

John and His Drugs (by John)

Folks:

It occurred to me this morning that I need to update people on what's going on with me, especially since it's been an adventurous past few days.

I went in last Wednesday for my normal chemotherapy, and blood work discovered that my potassium was quite low. I wound up staying at the hospital for about 9 hours while some IV potassium ran in.

But Dr. Suh (my oncologist) also showed us a CT scan of my chest which showed a 1.1 cm. x 1.2 cm. nodule in my lower left pleura. Without doing a biopsy, we don't know for sure what that nodule is, but she had to go on the assumption that it was cancerous, even though I am doing much, much better than I was before chemotherapy. Dr. Suh decided to switch one of my chemo drugs from Alimta to Taxol. Taxol has a different mechanism of action on cancer cells than Alimta, and she thought that the difference would be something to try. So Friday last I got my first infusion with the Taxol. Turns out that the emulsifier for the Taxol causes an allergic reaction in about 30% of people, and I was one of them. So I got to spend the rest of the day stoned on Benadryl, and slept real well Friday night.

The upside of the Taxol is that I don't have the crushing fatigue that I did on Alimta. I bounced back pretty quickly, and was able to go to church on Sunday, something I would not have been able to do on the Alimta. There is some joint pain associated with the Taxol, but it's nothing I can't live with.

That's it for now. Thanks again for your prayers and thoughts.

John

John Has PET Scan - Jethro Wonders Why He was Left Out

Folks:

I had that PET scan on Wednesday. The results were, well, rather neutral. The lesion in my left lung has decreased in size, but there it still evidence of cancer in my left ribs, and right hip. Also, there is a lesion (1 cm. by 1 cm.) on my left pleura, which my oncologist, Dr. Suh, is trying to decide what to make of. She is consulting with the Goshen Hospital radiologists, and her former colleagues at the University of Houston (where she did her fellowship) to get some answers, and possibly some new direction for my chemotherapy.

Joan also has an interesting thought about all this. I had X-rays of the chest done in February before surgery on my throat, and there was no evidence of anything growing in my lungs. Yet by April, I was definitely symptomatic for cancer. This says that the cancer was pretty fast-growing. Since there was a six-week gap between the diagnosis of my cancer and the beginning of my chemotherapy, who knows how much the cancer had grown? In other words, the cancer my be responding well to the chemotherapy, and what we are seeing on the PET scan on Wednesday is actually a great improvement over what was really there in August. We'll never know, because the gap between my PET scan in July and the start of treatment in August was too great.

One last thing: as Joan puts it, Dr. Suh is confused by the PET scan, but happy with the organism! The organism is, of course, me, and she (and Joan) are happy with the progress I have made in getting back to work, getting some strength back, and overall improving every week. It seems that no matter what the PET scan shows, I am getting better. And that's great news.

Thanks for your prayers and concerns. I just wanted to give you all and update.

John

John Goes to Work (by John)

Folks:

Just wanted to let you know that I was blessed to get to another milestone in my recovery from CHF and cancer: I went back to work at Panera yesterday! I did well, even though due to a few call-offs and something the AM needed to do, I wound up staying 2 and 1/2 hours extra (total of 7.5 instead of 5). It went well, though I was tired when I got home last night.

I am only working 3 days per week, and about 15-16 hours total per week until I get my stamina back, But getting to work at all was a first big step, and I am looking forward to what will happen as my strength at work grows.

The next big event will be October 12th, which is when I will be receiving a Positron Emission Test to check what the chemotherapy has done for me (or, conversely, not done). I will let everyone know the results soon after I do.

Thanks for your continued prayers and support.

John

John Speaks for Himself (by John)

Hello, all:

This is John. Just a brief update on me tonight, as there is not a whole lot to say.

What is happening right now is slow recovery. The mild congestive heart failure and the chemotherapy have made me weak (starting in July), and recovery is a slow process. I'm just working on gaining strength, and as you all know, that's slow, tedious work.

Later this week should provide a good test of how far I've come. Joan and I will be flying down on Thursday afternoon to see our foster daughter, son-in-law, and grandkids in Key Largo, Florida. This visit will involve the longest time I have been away from home since I was in the hospital in late July, and will be full of activities, interpersonal interactions with someone other than Joan, and a good deal of walking. I'm interested to see how I will do with all this. We will be returning on the 20th.

That's about it for now. My second chemotherapy went well last week. Thanks for all your continued love and prayers.

John

John Comes Home to His TV (and his wife)

John got home this evening and is looking forward to sleeping off his time in the hospital. He came home on oxygen, and the nice set-up man just left. He has an oxygen concentrator (which pulls oxygen out of the air instead of using a tank of liquid oxygen), and can fill 2 small tanks from that. Each will give him 2 hours worth of oxygen, so he can leave the house for 4 hours at a time. The oxygen should be a temporary thing. He's still holding over 15 pounds of water - as that comes off, we expect him to breathe much better. So he's on Lasix to get the water off.

Biopsy results should be in any day now; as soon as we have it chemo will start. In the meantime John's job is to get rested up. Jethro will stay at the vet until Friday, when we will begin the adventure of having a puppy and oxygen equipment in the same house. We have lots of extra tubing in case he decides to chew it. And there's always duct tape. He'll be so absorbed in Daddy that it may take him a while to notice anything else; John will have a lap full of 50 pounds of excited dog!

What John is most excited about is having our home satellite TV and his own bed. He's enjoying the first and is ready to try the second. So we're off to sleep. Have a good night, everybody!

The Burg Cavalry Arrives Just in Time

Hi, everybody!

Sorry about the news gap - there just hasn't been any news until today. John got his chest tubes out today, got up and walked in the hall 3 times, and will go home tomorrow if his chest X-ray is okay in the morning. His left pleural space seems nicely cleaned out; we hope this will put an end to the twice-weekly pleural effusions. We don't have word back on the biopsy yet. Results should come in some time this week, but may be as late as early next week. I'll pass it on as soon as we know something. When we find out what we're dealing with they will start chemo ASAP.

For those of you that have been worrying, I'm doing fine. I'm not staying at the hospital too much - for one thing, John won't take naps when I'm there. It seems he likes to talk to me. Who knew. ;) So I've been ducking in and out so he can get rested up a bit. I'm eating and sleeping and all that good stuff, and feeling fine. The Goshen Hospital food is very good, and they have a by-the-pound salad bar. Today they had cookies, jigsaw puzzles, and conversation in the lounge for families, so I met a few people and got some puzzle time in. And ate a sugar cookie straight from the oven.

Thanks so much for all your messages, calls, and cards. They help more than you can ever know.

And special thanks to Jim & Audora Burg, who came over today and mowed the lawn, trimmed some bushes, and rescued the flower beds from the weeds. (I can't mow for the rest of the summer because of the broken collarbone.) It took a lot of courage to face our yard. It was a mess. And gluten-free chocolate cake is wonderful; Andy is right. Thanks so much!

I'm off to bed, so to all a good night. Love you all!

John Will Finally Get Fixed

Good evening! I'm here at a more reasonable time today.

John was admitted to Goshen Hospital this morning with another pleural effusion, had a liter and a half drained from his left lung, and feels much better. He still has a good bit of left-over blood and clots from the biopsy, so on Friday he'll have surgery to get it all cleaned out. This should put a stop to this cycle of going into the hospital twice a week, which would be very good.

He will be taking a LOA from work, since he may have to take a few weeks off to recover from the surgery. If we pick up the extra cost during the LOA he will keep his insurance - a clear priority right now! The financial picture isn't so good. But none of us have had good financial news in ages, so we're used to that, right?

John will be in the hospital for about a week this time, so I'll call the vet in the morning and get Jethro boarded for that time. Then I won't have to worry about getting home before his bladder reaches it's puppy-limit, and he won't be depressed about why Daddy's not home. Being boarded is vacation time for him. (June, if you read this tonight, I'll be calling you in the morning!)

I'll keep you all posted. Have a good evening!

John Causes Difficulties

Good morning, all! I hope I'm the only one up at this hour, and all of you are safely in bed asleep.

We've had another interesting week. Last Tuesday John had his lung biopsy done, but not without some excitement. First he had to have another 2 liters of fluid drained from his left lung. Then the biopsy itself got a bit messy. The tumor is in the left upper lobe, in the hilar region (near the center of the chest), which is quite vascular. So he did a lot of bleeding - coughed up about 1/3 of a unit of blood, and had quite a bit build up in his pleural space, which had just been drained. Blood is a very concentrated fluid - lots of cells, lots of proteins and things in the serum - so it draws fluid to itself. So Thursday night I took him in to the Goshen ER with another effusion which was drained on Friday, and was quite bloody. They drained all they could, but there was still quite a bit of bloody drainage left in the base of his left lung when he came home on Saturday, so tomorrow morning he will likely be going back to get drained again. This time they will probably insert a chest tube, which is more invasive and uncomfortable but does a much better job of completely draining the space around a lung. Hopefully, that will be that. When he has an effusion it gets big enough to restrict the filling of his heart, so he gets a lot of swelling in his feet and legs, and it presses on his ribs, which causes quite a bit of pain. So he's very ready to get this taken care of.

The good thing about all of this is that it got him into the system at the Goshen Hospital Cancer Center. It is an hour closer than the doctor we'd been referred to in South Bend, and is one of the best cancer centers in the world. We were determined to get transferred to Goshen, but his ER admission took care of that for us. We are very happy with the doctor he is seeing, and with the fact that they are beginning to work with him before the biopsy results are back. Those results will tell us which of 3 possible mutations has caused the cancer, and will determine chemo choice. But nutritional and lifestyle needs are the same no matter what, so we're getting started with that now.

Other that that, we're in the middle of a terrible heat-&-humidity stretch, when even the dog doesn't want set foot (paw?) outside. My flower beds are a mess, but they'll keep until the weather breaks next week. Nobody is outside to see them anyway. Thank goodness for AC!

Sleep well, everybody! We'll keep you posted.

I Have Good News & Bad News

Hello, friends!

We both saw our doctors today. My news is good, John's not so much. My collarbone is healing - slower than my doctor expected, but that happens after the half-century mark. I'm cleared to do whatever doesn't hurt. I'm having some vertigo when I move my head certain ways. It seems that the impact agitated my cochlear area, and it will take a few months to pass. In the meantime, I shouldn't move my head in those ways. I love my doctor; he's so wonderfully down-to-earth. But what would you expect from a man who had paper-trained iguanas as pets?

John saw his oncologist, and to the doctor's and everyone's surprise, he has stage 4 adenocarcinoma in his left lung, almost certainly another complication of the radiation he got when he was 19. There is a mass about 3 1/2 centimeters across in his left upper lobe (which caused the pleural effusion), and metastasis to his ribs and hip bones (which explains the persistent pain in his left side). The medical among you understand this; for the rest of you, I recommend lungcancer.about.com. It's concise, accurate, and in English. First, this is not small-cell lung cancer - it is more treatable than that. Second, lung cancer among non-smokers falls into 3 types. Each type has a slightly different prognosis and a very different treatment. So next Tuesday he will have a needle-aspirate biopsy of the mass to determine which type he has. After 2 weeks for the labwork to come back, he'll meet with his oncologist and make treatment plans.

Life will continue as normal around here, at least for a while. Just because he has the diagnosis doesn't mean that he feels bad all of a sudden. He'll keep working, and his boss will adjust his schedule as needed if chemo is planned. As long as he averages 25 hours worked per week, we'll keep our insurance and all will be well. Except, of course, for the insurance company, who must be wishing they had never heard of any Hockmans!

As far as prognosis goes, here are the stats - remember that they have no meaning when it comes to one case, only to large groups. This kind of cancer has a 10% 5-year survival rate, and only half of the patients are alive 9 months after diagnosis. John is on the good end of that, because he is relatively young and is active and in good health otherwise. And we've had ample time the last couple of months to realize that our lives are in God's hands always. On May 31st I did a low-risk thing (going to the dentist), and wound up in a mess. I was in a high-risk situation (not breathing for 5 minutes), and came out fine. Our times are not in our hands, and the Lord's ways are not known to us. It doesn't have to make sense. There won't be a test on it!

We ask, as always, for your continued prayers. We will keep all of you updated when we know more. Thanks for caring about us!

John Loses 15 Pounds (by John)

This is John writing tonight. It has been a few days since the last update, and I thought we should keep everyone current.

My healing continues apace. I still have to be careful with remembering to take Tylenol, as the insertion point into the lung where the fluid was drained gets sore easily. And then that pain spreads to the rest of my side. But as long as I stay on top of the pain, it is not a problem.

The most dramatic change for me in the past week is that I am now 15 pounds lighter than I was last Sunday. Indeed, I am probably the 15 pounds lighter since just last Wednesday, when the fluid was pulled off from my lungs. The weight of the fluid itself has something to do with this, but I seem to have been holding a lot of water otherwise. My cardiologist prescribed Lasix (a powerful diuretic) to prevent fluid retention, and it has certainly done its work.

Part of the effect of the Lasix is that I now feel sharper mentally, and even though I am fatigued from the past week, I can feel myself getting more energy with every passing day, and expect to be more active than I was before the hospital stay occurred. I guess that not packing that much fluid helps!

Other than that, the news for this week is that I will be seeing an oncologist on Wednesday for follow-up. My family practitioner is being cautious, and wanting to be certain that the lung fluid does not indicate some form of tumor on my lung. But given my response to the Lasix, it is much more likely that there is a minor problem with my mitral valve.

Joan continues to recover apace, and besides having friends over tomorrow afternoon, we hope to go car shopping tomorrow, looking for a replacement for the mini-van.

John Makes Jethro Happy

John came home this afternoon. It's amazing how much good it does a person to get a liter and a half of water removed from one lung! He's feeling much better. The test results aren't all back yet - a machine at the South Bend Medical Foundation went down last night, and we're waiting on it's repair. John will be following up with 3 doctors over the next 3 weeks, and they will try to figure out what caused this, but some pleural effusions remain a mystery.

We have a very happy puppy. Jethro did well the first night John wasn't here, whimpered some at the beginning of the second night, and last night spent an hour with his head on John's side of the bed whimpering for his daddy, until I gave him a new chewbone to distract him. Now he's following John around and crawling up in his lap whenever possible. Sometimes Mom just doesn’t cut it!

We're off to bed; none of us has slept well this week. I'll pass the word along when we know if we know what caused this. The good thing is that it went away quietly!

The End of Teen Wolf

Hello out there!

John is feeling much better after his thoracentesis - they drained a liter and a half from his left lung, and as you can imagine, he's breathing much easier now. He had a CT scan of his chest today, may have an MRI tomorrow, and the fluid was sent off for loads of lab tests. So we're waiting on results now.

On the home front, I will look respectable in a couple of hours. I had to cancel a haircut appointment when I was in the hospital, and for the last 3 weeks couldn't face the thought of exposing my collar bone to the hair-wash basin. But I'm braving it tonight. I look like something that escaped from Teen Wolf. (No, there will be no photos.) The last remaining crisis is trying to get my little plants into the window boxes with one arm. I was going to try it today, but we've had strong storms most of the day. So I got a brief reprieve.

Thanks for all the messages, email, cards, and caring!

Joan.

It's John's Turn to Have a Calamity

Hey, everybody!

John is still in the hospital, and will be for a couple of days at least. It turns out that asthma wasn't the problem after all. His cardiologist looked him over, got a chest X-ray, and he has a large pleural effusion on the left side (lots of water in his left lung, in English). Tomorrow Dr. Du Pratt (interventional radiology, and very good - I got to know him when I had all those abdominal abcesses when I was septic) will insert a needle and drain the fluid off, which should make him feel much better. After the fluid is out of the way they'll get a CT and MRI to be sure nothing else is going on in there. The fluid will be sent off for tests as part of the process of figuring out why he has fluid there.

In the meantime, he's breathing comfortably on 2 L of oxygen, as long as he doesn't do too much. His main complaint is that he's bored. Dog and I are doing fine. I'll keep you folks posted.

Sleep well!

Joan.

I Am Declared Neurologically Normal

Good evening, all! This is Joan this time.

I'm doing much better. I saw the neurologist today and he pronounced me "neurologically normal." I think I should get a signed, notarized statement to that effect. I'm cleared to drive, do light housework, generally keep working up to my usual.

Being cleared to drive is very good, since John is providing the excitement this week. He's had an asthma flare-up going on since Friday night and got stubborn about going into the ER over the weekend. So he went to the doctor this morning, and by that time his lungs were so irritated and he was so tired that he had to be admitted to Memorial Hospital in South Bend. He's in on a 23-hour admission, so they expect to send him home tomorrow afternoon. He's spending the night on bi-pap, to let him and his lungs get some rest. (Bi-pap lets you begin a breath whenever you want, and adds pressure to the air you breathe in so you get more for less effort.) He drove to South Bend this morning, then to the hospital, since I wasn't cleared to drive. I got him into the ER and walked across the street for the neurology appointment, then was cleared to drive myself home tonight, where I arrived just in the nick of time in regard to the puppy's bladder capacity. This will be his first night here with one of us away for the night, so we'll hope Jethro sleeps (and lets me sleep).

I'll update all of you tomorrow on the latest John news. I hope to no longer provide such entertainment myself!

Take care, and sleep well,

Joan.

Road Trip - A Knitting Shop

Good early-Sunday-morning to all!

I'm making slow but steady progress. Yesterday I finally made it to that dentist appointment that I was on the way to on May 31st. I and my colorful bruises were of great interest to all. I was feeling good enough to want to go have some fun, so John & I went on up to Holland, MI, to my favorite knitting shop, and spent about an hour, where again I had to explain just what I'd done to make myself look like that. (You may be knitting too much when: you're known by name and knitting projects in more than 4 knitting shops.) I'm making socks as gifts to the 2 first responders that saved my life; I have Kim's almost finished, and at Lizzie Ann's I found some very manly yarn for the socks for John (the EMT, not my John). And I bought some other yarn just because I fell in love with in in October and it's been discontinued; I will find something perfect to do with it. It may turn into a cowl.

So today I slept late and woke up really sore, which was made much worse by the shower. So I took it easy today - simple meals, 2 loads of laundry, watering plants, puzzle therapy (also slowly improving), and of course knitting. John is off tomorrow and can drive me, so we may see some of you at church, but this time it depends more on him that on me - he has bronchitis and may not feel up to it. We'll work that out as we go.

Monday I will see the neurologist for the first time, and get assessed by him. (I've seen him lots of times, but never yet as the patient.) I don’t know what to expect as to driving restrictions, but it's pretty moot until the sling comes off in 2 1/2 weeks.

To sum up: My head is better - puzzles are slowing getting better, I'm not dizzy until evening, no ringing in ears, short-term memory almost back to normal, interpersonal skills almost normal (I.e. the dentist's office and the yarn store.) Shoulder is healing but has some way to go. Pain in collar bone area, neck, left upper arm, right lower arm, sternum (breast bone) very sore and tender, various bruises and hematomas in a variety of stages and colors. Not needing any pain medicine except at bedtime.

I'm in very good shape for the shape I'm in. (And I should know - I just dropped in to see what condition my condition was in.) Feeling grateful, feeling under God's care. Beginning to feel ready for social activity. And badly in need of a haircut.

Have a good Sunday, y'all!

I Can Type!

Hello to all! It's Joan this time.

Thank you so much for your prayers, encouragement, and good wishes. I can't tell you how much it has meant to both of us.

Today is the first day that I've felt like myself. I felt good enough to put on real, going-out clothes, do my hair and make-up (which only covers so much now - my corneas are bloody so I look like Peter Cushing's vampire movies), and go out with John to do some shopping in Topeka and at WalMart. After we got home I did some housework then took a long nap. I've done more today that I have the last two weeks put together, so I guess the nap was in order. Today is the first time that a messy house has bothered me; that's a very good sign for the anal-retentive!

I can't believe it's been two weeks since I left for a dentist appointment. It seems like only a few days, and my memory is very spotty. I remember driving through downtown on May 31st, then I remember Jim and Audora Burg walking into my room at Parkview on the afternoon of June 1st. After I got home on June 2nd I remember pieces of days. Full memory kicked in last Sunday afternoon. I've now gone a whole day without saying the same thing twice to John!

As far as how I feel: The clavicle is still broken, but it feels much better since I got the splint. I'm only taking pain medicine at bedtime (sleeping on my right side all night gets uncomfortable). The brain injury is healing well. I had no dizziness or nausea today until this evening, and my right ear hasn't rung all day. Sunday I was able to knit socks with cables, and last night I was able to read Psalms. And I think I'm typing coherently, but you folks will determine that!

I'm so grateful to John for all he's done - keeping all of you posted, being patient with me when I said the same things over and over, taking care of the house and the dog, and generally looking after a wife that's more mentally incompetent than usual. These two weeks were his vacation; he didn't have any fun this year, poor man. I'm grateful to all of you, for the email, cards, calls, visits, food, and many other ways you've showed so much kindness. And I'm grateful to be alive, not in a vegetative state, and in one (though multi-colored) piece! The clavicle should heal without surgery, and I have a good chance of returning to my former mental state with no loss of function. And somewhere around Thanksgiving my corneas will look normal and I won't scare small children - hey, I just thought about the Halloween possibilities . . .

I will be limited for several more weeks. John will have to drive me, so on days that he works my range will be as far as my feet can get me; but here in Topeka, that covers all the necessities. I'll see Dr. Englert (neuro) next week, and will have to be cleared by him to drive. But I'll be in the sling until I see Dr. Caruso (family practice) in 3 weeks and get my clavicle X-rayed again, and he clears me also. Then after I can drive we'll go looking for another car. Tomorrow I'll start walking Jethro again and slowly begin to get back in shape. I guess we're having an unusual summer!

If you've made it this far, thanks for reading all of it! We'll keep you updated, but won't clutter your inboxes every day unless there is something happening. Blessings to all of you!

Joan.

Joan Wears Clothes (by John)

A quiet day for Joan today, and the update will be short, as compared to all the news yesterday.

Joan's collarbone is hurting much less, at least when she is able to leave it in the sling. She cannot use the sling at night in bed, so it hurts her some then, but that is what pain meds are for. The rest of her bruising is getting less and less colorful, and shrinking in size.

Joan also felt good enough today to put regular clothes for the first time since the accident, with the exception of going to see the doctor last Thursday.. Because of the bruising and swelling, she has been wearing loose clothes (like housecoats) around the house. But today, she got into a regular shirt and sweat pants.

That's about all to report tonight. Another report tomorrow.

John Continues to Correct Himself (by John)

Well, there's nothing like talking to people who were there to set you straight on what happened at a traffic accident.

While I was a Great Vespers tonight, the first two responders to Joan's accident, the aforementioned Kim, and another EMT named John, stopped by to talk to Joan, and see how she was doing. From them, Joan got the straight story on what happened.

First (and hopefully once for all!), Joan was hit by a car coming from the north, not coming from the south. The car actually T-boned her on the passenger side right over the back, sliding door on the mini-van. The car that hit Joan had a low, strange bumper, so its bumper actually went under the mini-van and flipped the mini-van in the air. The mini-van landed on its driver's side on top of the truck that was sitting at the intersection waiting to go eastbound. (The driver thought that the mini-van was coming into the cab). The truck was pushed back twenty feet by the impact, and the mini-van bounced off the truck hood and landed twenty feet away from the second impact, on its driver's side.

Witnesses calling 911 noted that Joan wasn't breathing. And when John and Kim got there, they found that was correct. They estimate that Joan had not been breathing for 4-5 minutes, which they took from the time given by witness accounts. (For the medically inclined reading this Email, Joan was blue and in the decorticate position). Kim and John scrambled hard to get Joan's neck back into place to let her breathe. They finally did so, but it was difficult. (Again for the medically inclined, they tried to insert a nasal trumpet, without success). John and Kim managed to stabilize Joan and get her breathing, but what amazed them was that after being without oxygen for so long, Joan woke up while she was being transported to the helicopter, and was actually fairly coherent during transport, and on the helicopter to the hospital.

It turns out that Kim and John were so amazed by Joan's quick recovery that they texted each other all night talking about it. And, quite frankly, it is amazing. People without oxygen for that long are not supposed to live. And if they do live, they should be in a vegetative state. So I have a lot to be thankful for. Joan is alive, and she is quite functional mentally. She has no also decided that is OK to cut herself some slack, since her mental function is not exactly what it was pre-accident. She has also decided that after such a length of time without oxygen, it might take her awhile for all her mental processes to get back up to snuff.

And, of course, what I can say, "Thanks be to God!" for her survival. This really does seem to qualify as a miracle, so I am thankful that God exercised His infinite power to keep Joan alive, and her brain intact in the face of the oxygen loss.

That's it for tonight (that's probably enough!). I will Email you again tomorrow.

Thanks for all the Emails, prayers, thoughts, and cards.

John.

Joan Replaces the Bra with the Sling (by John)

A quiet day for Joan today. As I suggested last night, we did not go to the nurse practitioner today. Joan was tired and sore after yesterday's trip to Mishawaka, and was not really up to going back.

The sling on her arm helps the collarbone quite a lot. Joan says that it makes it difficult to use her left arm much, but the break was doing that anyway.

Speaking of the break, I misinformed everyone in yesterday's Email. In talking to Joan I discovered that what really happened with the collarbone was that somewhere in the accident, her left shoulder was jammed against something hard enough to push the collarbone into itself, instantaneously creating a break, and then pushing the two halves of the bone into each other. The collarbone is best left alone at this point to heal, but it may eventually heal while being a 1/4" or so shorter than the right collarbone. This shouldn't lead to any real problems.

That's about it for tonight. Will talk to you again tomorrow. Thanks for all the cards, letters, prayers and thoughts.

John.

Joan Goes Bra-less (by John)

OK, first thing for those of you who were concerned about this: Joan managed to get to the doctor's today without wearing a bra. And she was very comfortable without it.

Next, she did well on the trip over and back, but did tire easily. She slept for much of both the trip over and the trip back, which is a good sign, because the combination of healing and pain meds let her relax enough to do so.

But we did find out something today that was unexpected. Our family physician looked closely at the CD of the X-ray of Joan's left shoulder, and noticed that there was a lot more blood and swelling than would be accounted for by a hairline fracture of the collarbone. His conclusion is that Joan's left collarbone was actually completely broken in the accident, but that during the roll of the mini-van or its landing on the pavement, the two parts of the collarbone were pushed back together end to end, so as to leave only the appearance of a hairline fracture. What this means practically is that Joan is now wearing a sling on her left arm, and will need to wear it for at least 4 weeks until the bone is X-rayed again.

Joan has said tonight that the sling helps with the pain, and that she is glad to find out what was making her collarbone hurt so badly. It probably won't make that much difference in her ability to use her left arm; she couldn't use it much anyway!

Also, we are most likely not going to our doctor's appointments in the morning. Joan is very tired from today's trip, so we will probably just stay home tomorrow, and let her arm and body rest.

Thanks for all the prayers, cards, Emails, and thoughts. I will post up something again tomorrow.

John

Joan Doesn't Do Much of Anything (by John)

This was a quiet day for both Joan and me. Joan is learning that taking it easy, and taking pain meds more regularly, are some the keys to her recovery. I just needed a day to not do much, and when the weather is 95 degrees F, it's not hard to convince yourself to do stuff inside.

Tomorrow and Friday will be interesting days for Joan. She is seeing our family physician tomorrow, and on Friday we are both seeing our allergist/immunologist nurse practitioner for a routine follow-up. These will be Joan's first forays since the accident in getting dressed, and having to wear some kind of bra. The painful thing for her is that the bra strap will sit right over the hairline fracture on her left collarbone, so we will need to figure out a way to reduce the pressure in that area. We will try to keep these trips as short as possible, so as not to wear Joan out.

Other than that, not much news. Perhaps sometime soon we can go to every other day reports, but I will let you all know when this happens.

Thanks again for all the cards, thoughts, prayers and Emails.

John

Joan Gets a Social Life (by John)

Beloved of Christ,

A good day for Joan, with signs of improvement. Some friends of ours from Hobart, IN, Mitch and Diane Bright, came by this afternoon to visit. It was a great visit, and Joan did well with the time spent with someone other than me. Mitch also brought his young puppy Atticus with them. Atticus is a blond Labrador Retriever, and he and Jethro had a great time romping in the yard.

Joan's bruises are continuing to spread, and new ones are sprouting. The ones in her upper arms and chest are spreading, and new ones have appeared on her knees and legs. The main pain continues to be centered in the hairline fracture of her left clavicle, which makes it difficult to lift anything with her left hand. However, the petechial hemorrhaging around her eyes is rapidly going away.

One good thing that has come out of all this is that Joan has found a local charity to which to donate some of her knitting time and effort. Parkview Hospital gives knitted and crocheted afghans to their STICU patients, and Joan, when she is knitting better, is going to start donating afghans to them.

That's about it for tonight. Another update tomorrow.

John

John Begins to Correct Himself (by John)

Beloved of Christ:

It is early in the morning, or late at night, depending on your perspective on such things. But whichever it is, I wanted to send out a brief update on Joan.

Joan was tired today. She thoroughly enjoyed all the visits yesterday (and all the food!), and was sleepy today. She took several naps while I was at work, and went to bed before I got home. But she is slowly getting better.

One item of interest: It turns out that Joan's concussion and bleeding were all on her left side. When the neurosurgeon and I had first been talking about Joan's head injuries, we had been comparing the injuries in her head to what lead to my partial right temporal lobectomy in 2005, and I thought he was saying that the bleeding was on the same side of Joan's head as it had been on mine. But it was really the opposite, i.e. left, side. Joan also is going to show me the CT they did of her head (we have it on CD), and she says that it's the largest "small" bleed she has ever seen.

The bleeding on her left side (by the way, for those who know, it was a sub-arachnoid bleed) is what is causing the slow recovery from her short-term memory loss. The bleed was largely in the left temporal lobe, where a lot of the brain's memory storage resides, so damage to that area of the brain will affect the brain's ability to have short-term memory, and to translate the short-term into long-term memory. But as the bleed heals, so will her memory.

That's all for tonight. Thanks again for all the prayers and thoughts. Talk to you again tomorrow.

John.

Joan Changes Colors (by John)

Beloved of Christ:

Tonight's update will be short, as will the next two nights. Tonight I was running the St. Mary's bulletin for Joan, and wound up wrestling with the copier. Finally got it to work right, but it took some time. The next two nights I will be working 12-Cl at Panera Bread, so the updates will be somewhat late as well.

Joan's first full day home was pretty good. We slept a little late, she took two naps (I took one), and she did some suggested cognitive therapy by working Sudoku puzzles. The therapists have told her to stop when she gets frustrated with any of the puzzles, but she did just fine. Also, while I was out picking up the dog from the kennel, she played several of her favorite games on the computer, and won all but one of the games first time through.

Joan's body is continuing to sprout new bruises, and the existing bruises are starting to expand over more of her front torso. She is showing the most wonderful colors in her bruises, everything from green to purple to red to blue, all the colors normally exhibited by bruises, but you don't normally get to see them on one person all at the same time!

And speaking of bruising, I was misinformed by the staff at Parkview about the bruising around her nose. This bruising was not due to a hit on the steering wheel; this is petechial hemorrhaging. Petechial hemorrhaging occurs around the eyes most routinely due to oxygen loss when the subject has a blocked airway. On TV shows, this kind of hemorrhaging around the eyes is a dead give-away to the ME that the victim was strangled. In people that are still alive, it's a sure sign of suffocation. We don't know how long she was suffocating before Kim got her head in the proper position, but I'm so glad that Kim came along.

Well, that's it for tonight. Thanks for all the Emails and prayers.

John.

Joan Sees Herself in the Mirror (by John)

Beloved of Christ:

Thanks be to God! Parkview released Joan this afternoon, and she is home. She is hurting some (especially her left collarbone), and is appalled by how many bruises she has (had not seen herself in a mirror before this afternoon), but overall is she doing well, and is just glad to be home. And so am I; it is good to have her home.

A few things I have learned today about the accident. First, I have seen the mini-van. I got to retrieve stuff from where it was towed. It is now obvious to me that the first report was right; Joan was hit by a northbound car. The impact point was on the left rear of the mini-van, between the gas cap and the tailgate. It was this force that spun her into the second car, and then into the roll.

Also, Joan's bleed in the right temporal/frontal lobes was a contra cous injury. She hit her head on the left side of the mini-van's front window, and the bounce of her brain in response to that impact caused a small amount of bleeding on the opposite side of the impact point.

Third, we found out from Kim (the EMS who got Joan breathing again, and saved her life) that she actually crawled in the passenger side of the mini-van (which was up in the air) to straighten Joan's airway. Kim came by for a visit today with Joan at Parkview during a time when I wasn't there. Kim told Joan that when she ran up to help, she saw Joan struggling to breathe, and that the windshield was not broken out enough (it's still not) for her to get to Joan that way. Instead, she went in through the passenger side of the car (about 2'-3' up in the air) to get Joan to breathe again. Thank you, Kim.

That's all for now. I will still send an update tomorrow on how Joan is doing at home. My thanks to all of you for your prayers and thoughts.

John

Joan's Accident (by John)

Beloved of Christ:

This is John. Some of you know this already, and some of you don't. Joan was involved in a traffic accident about 8:45 this morning. For those of you who know the Topeka area, the accident was at the intersection of CR 600 S and SR 5. Joan was crossing the intersection going westbound when she was struck by a vehicle going north on SR 5. The impact spun our mini-van around, and it struck a vehicle headed eastbound through the same intersection. That second impact caused the mini-van to roll over twice, and come to rest on the driver's side of the car. First responders used the jaws of life on the passenger side of the car to extract Joan, and she was flown to Parkview Hospital in Fort Wayne.

Now to get to the important news: Joan is really doing quite well. She is black and blue over most of the upper half of her body (bruising from the seat belt she was wearing, and two impacts with the steering wheel), and she will have "raccoon eyes" for the next few weeks, as the second impact with the steering wheel bumped her on the nose. She does not have a broken nose, just bruised. She also wound up with a hairline fracture of her left clavicle up near the shoulder joint. But that only hurts when she moves it wrong.

She will be staying at Parkview for 2-3 days for observation. This is due to the fact that she has a concussion, and an attendant small amount of bleeding in her right temporal and frontal lobes (for the non-medical, which is most of us, this area is located in her brain close to directly over the outside part of her right eye socket). However, her neurosurgeon is not particularly concerned about what he saw on the CT scan. He is holding her at Parkview to make sure nothing "goes south" in the next few days.

Joan's only troublesome problem seems to be one common to concussions: She is experiencing short-term memory loss. She told me at least 10 times today to make sure that I send out this Email, and she didn't remember at all my being with her in ICU this afternoon. But after a trauma like hers, especially with the concussion, these sort of things are not uncommon, and will only be a long-term problem is they don't show lessening of symptoms in the next few days. Hence, another reason for keeping her for observation.

Thanks for listening, and thanks to all for the prayers I know that you will be sending to our Lord Jesus Christ. Please feel free to contact me by return Email anytime you want; I will be updating Joan's progress every night by Email.

Christ is risen! Truly, He is risen!

John