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RON'S HEALTH (scroll to the very bottom of this page for the latest update) MY WEAK EYES One Sunday morning in August of 2008, I woke up to begin my weekly routine of helping Jeremy delivery newspapers and to put the finishing touches on the Sunday morning service. In the darkness I clearly saw light flashing within my eye. I remembered my father telling me 24 years earlier that if I noticed flashing or if I saw a curtain in my vision that I needed to be seen by opthalmologist immediately. And so, I went to the ER of the local hospital where I was put in contact with my present retinal surgeon and an appointment was made for the next morning. Dr. Purohit noted that I had two signficant tears in my retina in my right eye that needed immediate attention. If untreated I had a 100% chance of retinal detachment. In my left eye he noted a small hole that if untreated had a 10% chance of retinal detachment. That day he attempted to prevent detachment in my right eye using cryosurgery (creating scarring on the back of my retina through freezing - the scarring is like glue, holding the retina in place). A few days later I had laser surgery in my left eye to bring my 10% risk to .1% risk. The cryosurgery in my right eye was unsuccessful as ten days later I began to see a dark curtain in my peripheral vision. I made an emergency visit back to Dr. Purohit and late that afternoon I had major eye surgery (vitrectomy) under general anaesthesia. While I was in recovery, the Dr. gave other than an "everything went fine" type of report of the surgery to Joan. He indicated that this was one of the worst retinas that he had ever seen, that there must be some genetic condition that causes my retina to be so weak (along with my significant nearsightedness), that Ron needs to have his head down for two weeks and that non-compliance will result in losing not just my vision, but also blowing out my eye. The next two weeks were quite a challenge for our family. By the way, God provided in that Joan's parents were already on the way for a visit, their planned visit being one of "coincidence," knowing nothing of my detached retina until they were well on the way. They arrived at our home just a few minutes before I came home from the hospital that evening. The recovery was difficult, but successful. Shortly after this, two other holes appeared in my other eye. Those were repaired by laser surgery. The one side effect of the vitrectomy surgery was the need for cataract surgery. In March of '09, I had the lens in my eye replaced and my vision was corrected so well (not quite 20/20) that I required no corrective lens in my right eye. In my left eye, I now wore a contact. Things were looking great. Within a month the vision in my right eye was not what it had been. Perhaps my cataract surgeon had not inserted the best lens for me after all? More tests showed that wasn't the problem. Scar tissue had now developed in front of my retina in that right eye and it caused a good deal of blurriness. On June 11 (two days after we returned from our 25th wedding anniversary trip) I learned that I needed another vitrectomy surgery in order to remove that scar tissue. It was scheduled for July 20.
A NEW CHALLENGE On May 24 to June 9 of this year, our family took a wonderful trip to the east coast to celebrate 25 years of marriage and 25 years of ministry. We visited with friends, family, supporters, and those to whom we had ministered in the past. It was awesome! Within a few days of arriving back home I began to feel very tired. I assumed it was simply the common experience of "needing a vacation after one's vacation." I was also learning that I would need another vitrectomy surgery. Perhaps I was feeling tired because of the emotional stress of learning I needed another major eye surgery. From June 14 to 19, I was miserable. I had flu-like symptoms and was running a fever from 101-104. No medication brought the fever down very far or for very long. I finally went to the doctor during that week (and ended up in the ER for dehydration that same evening). To summarize, tests were run indicating no sign of influenza, but I did have elevated liver enzymes. I therefore had an ultrasound of my abdomen which showed an enlarged liver and a possible shadow. A week or so later I had a CT Scan of my liver, which showed no tumor. Several possibilities were considered including hepatitis and malaria (since I had been in Haiti just less than 1 year ago). The only test that continued to come back positive was my elevated liver enzymes. I continued to be tired. Because subsequent test showed that my liver enzymes remained elevated, I was referred to a gastroenterologist. The initial response of my GI doctor was minimal concern. He indicated that my situation seemed to be stable and that this could be a chronic condition that I've dealt with for quite a while and only was uncovered because of my recent illness. I believe that the GI doctor assumed (in spite of my reporting otherwise) that I either drank alcohol on occasion or that I had been a drinker in the past. The test results were consistent with that type of lifestyle. On July 9 I had another follow up blood work. The response of my GI doctor to those results was quite different as they were now nearly quadruple what they had been. He insisted that I would immediately go to Springfield to the outpatient lab for a more complete workup and that I would be retested for hepatitis, etc. (July 15). On July 17 I called for results and was told that my liver enzymes were still high, but improving. But, I had another level come back (ferritin) that was very high (max should be about 200, mine was 1440). The challenge at that point was that I had an eye surgery scheduled for Monday, July 20, with my GI doctor out of the office until July 29. JULY 20 Last evening there were thirteen adults from our church in our home and praying for me. As one of our members put it in her prayer: "There is a lot of love in this room." Joan and I slept comfortably last night with the feeling that we had placed our anxieties upon the Lord and he was caring for us and our needs. One of our prayers for today's eye surgery was that I wouldn't need to be in a head down position for three to five days while in recovery. The larger prayer was wisdom in knowing whether or not I should have the surgery at all in light of recent results concerning my liver. God answered our prayer concerning whether or not to have the surgery. After hearing of the latest liver lab results, my eye doctor felt it best to postpone the eye surgery (which he regards as important, not just elective, but not of an emergency nature either). And so, it is postponed for now, hopefully can be taken care of in about a month. The frustration we're having now is getting final results and more information from the GI practice (the doctor following me is out of town). It seems prudent to be a little more assertive than we normally might be because of the combination of not knowing what is going on with the liver and because it is important for my situation to be stable should my eye condition change that emergency surgery would be needed (not an impossibility given my experiences within the last year). And yes, I continue to feel tired. And I do have this sensation (be it ever so slight) in my abdomen that concerns me. Something really does seem to be going on that needs atttention. I deeply appreciate your prayers. I'll try to keep you posted as we learn more. JULY 21 I am probably being optimistic to have the expectation that I'm going to have answers quickly. As the Physician's Assistant (PA) to the GI doctor told me yesterday afternoon, "There are three hundred things that can affect the liver." He also told me that, "only eight of them can we do anything about." He also gave me information on other things for which they had tested - all negative. As to where we go from here? The PA says the GI Dr. will have to look over all of these reports and make a determination as to next steps. I haven't been referred to another Dr. in the practice who may be covering for him (and it has been made clear that won't happen) - this Dr. wants to be the one to draw conclusions when he has a chance to see the test results. It seems I am being asked to assume that, though some of my results are not good, they aren't so bad that we can't wait until the Dr. is back in town. Here is my prayer request today: I need wisdom - wisdom in know if what I need most is patience (I definitely need that) or if what I need is to be a little assertive in somehow getting another GI doctor to look over the results (if only just to give me a little more peace of mind that waiting is just fine). And if my problem is definitely related to the liver, would it be best that I be referred to someone who solely specializes in the liver (or do the results I've received just not warrant that?). As I said, I really need wisdom. Thanks for praying.
JULY 21 - 4:00 PM
Praise the Lord! God has answered your prayer for me (see above paragraph). I felt led to search for a new GI doctor. I placed a call to (what appears to be) the other major internal medicine group in Springfield. Here is the good news. I have an appointment tomorrow afternoon at 2:40. It is the only opening in GI for about a month. To add to the significance of this provision, this doctor "happens" to be THE member of the group who specializes in (drum roll) the liver! JULY 22- 8:00 PM (CT) Praise God with us! The new GI doc was awesome! My (Joan) prayer before going was that he would either get things rolling, resolved or reassure us that Ron is not in liver failure. Being a pastor's wife I become very good at alliteration! I was thinking that maybe God would do one of those 3, but I think He answered them all for us. After 1 1/2 hrs with the new doctor going through everything, he ordered more extensive blood work and depending what it shows, he may want Ron back down there tomorrow for a liver biopsy. His biggest suspicion is that Ron did contract viral hepatitis and that was connected to his acute illness 5 weeks ago and his liver greatly reacted to the infection. He is hoping he sees lower numbers today to verify his possible diagnosis. If not, tomorrow he will do further study with the biopsy. Because of Ron's high numbers he does need to have them monitored closely because viral hepatitis can cause permanent liver damage, among other things. He told us he would call with the results as soon as he has them tonight. About 1/2 hour ago, he himself called to say that he did not have the results yet, but wanted us to know that he is still waiting. Is this guy great or what? I know we are both feeling somewhat relieved just to know that we actually have a doctor overseeing his case and not out on a two-week fishing trip with no one covering. JULY 23 One concern about the previous GI doctor I was seeing (or should I say, "not seeing" because he wasn't around) was that we weren't getting information - I needed to keep calling to get results of labs. We don't have that concern with this new doctor. As he promised to do, he personally called me as soon as he got results from the lab - just as we were peacefully drifting off to sleep - almost 11 PM. I've gone from feeling neglected to having some feelings of discomfort that maybe I'm receiving more attention than what this deserves. As Joan says, we definitely were feeling the need to be reassured that someone is on top of this. That need is being met! And we are thankful (not complaining at all). Anyway, he informed me that the levels remain high. In spite of that, he is choosing not to do the liver biopsy just yet and maybe that won't be needed. He thinks that the lab work he has ordered (the majority of which has not come back yet) will lead him to a conclusion as to what is causing this inflammation of the liver. And, as he told us yesterday, there is no indication that I'm having any kind of acute liver failure. He promises to stay on top of all of this. He is giving me good reason to believe him! And so, we are back to waiting. And I'm finding already that there is a big difference between 1) waiting while being cared about, having reassurance about the truth of one's situation and a good measure of hope and 2) waiting without those things. I think there is a sermon in there somewhere - something about it being easier to persevere when surrounded with faith, hope and love. And then there is the eye surgery (at times I almost forget about the eye surgery). The Dr. says it is the right thing to put that on hold, just to make sure my liver isn't unnecessarily put at risk. He didn't defnitely say that in an emergency I should proceed, that I'd probably be just fine, but he came close to saying that. Back to the reassurance factor - great to know we know who to call. JULY 24 My GI Dr. continues to stay in contact. No significant news to report. Recent lab results not yet diagnosing the problem, but not all test results are in. I continue to feel okay but with some fatigue. I'm taking it easy and hoping my liver continues to successfully fight whatever is going on so that I can get back on track with having my eye problem taken care of. JULY 25 In the musical, "Fiddler on the Roof," Tevye is being nagged by Golde to go and talk to Lazar Wolf, the butcher. He is resistant, doesn't seem to know why he should - doesn't have any animals to sell him, etc. In that little dialogue Tevye says... "What do I think? I never really liked him. Why should I? You can have a fine conversation with him if you talk about kidneys and livers." Sounds like the "fine conversations" I'm engaged in these days. One friend responded to my praise (that I had found a GI guy who specializes in the liver) by saying, "Now if you can only find a GI doctor that specializes in the liver AND onions." If you haven't caught on by now, all of this to say that I don't have anything new to report today, except that I'm trying to maintain my sense of humor through this (RD says that is the best medicine), and I'm also extremely thankful for friends like you who would stop by to have me share my thoughts and in turn keep me in prayer. It means a lot to me. JULY 28 I am feeling a little better and my abdomen is not as distended as it had been. Another test came back on Monday morning - something about the auto-immune being elevated somewhat. I thought I understood what that might mean, but I think I'm not really catching it after all. What I do know is that, with the liver enzymes remaining elevated and this test being positive, the doctor is saying I should have a liver biopsy. This will give some indication (if I understand correctly) as to whether or not I've suffered any liver damage. It may also help with diagnosis and suggest a treatment plan (if applicable). I'm told that a liver biopsy isn't that bad. Initially I pictured that as involving general anaesthesis, being cut open or whatever. Fortunately it isn't like that. At this point I'm waiting for the biopsy to be scheduled - the procedure will probably happen within the week. JULY 29 My liver biopsy is scheduled for August 11. I'm thinking that I may not learn anything more about my liver challenge or my readiness for eye surgery until well after that. The name of the game seems to be patience. I assume the bright side is that no one is regarding any of my conditions to be in the emergency category (for which I am thankful) or some things would be pushed to the top of the list. AUGUST 1 In the last few days I've felt a lot more energetic - for which I'm thankful. I'm very hopeful that I'm getting on top of this. Here's what may have happened: A virus caused me to be very sick seven weeks ago. Part of what the virus did was cause my immune system to become disoriented and I began to attack my own liver. Fortunately the effects of the virus are dying out and things are retuning to normal. I imagine that the liver biopsy will tell us whether or not that "story" is fact or fiction. It will also show whether or not there has been any longterm damage to the liver. August 5 I had more blood drawn today to check up on the liver enzymes. If they are significantly better, the doctor might put the liver biopsy on hold for now. We'll see. I do feel a lot more energetic than what I did a few weeks ago - not sure that I'm back to where I was before all of this began but I'm thinking that is going to take some time. Just happy to have things moving in the right direction. August 10 I want to share with you the good news that my liver enzymes continue to improve. Though they are still somewhat abnormal, they are not anywhere close to what they had been. I'll continue to post any updates on my liver and any news as to when my eye surgery might be. Perhaps it can take place in another month or so. I think I'll talk to my eye surgeon tomorrow and (assuming he is agreeable) see if I can get on the schedule. August 11 My eye doctor doesn't want to schedule me for surgery until I'm absolutely cleared of the liver issue. I get lab work done on August 19. I'm really hoping and praying my liver enzymes are back to normal by that time.If so, I'm probably looking at a September or October eye surgery - unless an emergency situation developes, in which case my liver doctor says I could have surgery immediately. August 19 My liver enzymes are still not back to normal, but at least they are going in the right direction (the last time they were three times what they ought to be, this time twice what they ought to be - compare this with their being 15 - 20 times what they should be at their worst). I expect to hear from my liver doctor in the next day or two - perhaps he'll clear me for eye surgery just the same? Don't know. August 28 This morning (finally) I've gotten the go ahead from the GI doctor (based on results from August 19). I'm doing well enough that I'm cleared for surgery. And so, I will have my eye surgery on September 14 in Springfield, IL. The timing is good (assuming my eye hangs in there until then). Between now and then our son is participating in a local Bible Bee competition, we're going to the Creation Museum with another family in our church, we're starting a Speech and Debate Club for home school families in the Lincoln area, and our church is building a ramp for our home (for Kari). While I'm not looking forward at all to this eye surgery, I know it is needed and I'm thankful to have lots of exciting things to distract me until then. September 14 It's me, Ron, sitting up at the computer and writing this e-mail. That means that my head isn't down - Yeah! It's 10:45 AM and my surgery went well. I have an eye patch and I need to keep it there until I see the Dr. back in Springfield tomorrow morning . I am very thankful to God that things went so well. I'm hoping this is the end of surgeries for my eyes for quite a while - if ever again. So far, things have gone much better than I would have imagined. Today I plan to take it easy - not supposed to mow the lawn or clean the garage (not that I was planning on any of that - :-)). I'm a little out of it from the anaesthesia. Hope this update is coherent. Joan's parents are here to help out. Thanks for your prayers and concern. September 15 Follow up appointment today from my surgery yesterday. I had the eye patch removed, Dr. examined me and said "things look perfect." I have my next appointment a week from today. Dr. Purohit reminded me that I have had major surgery and I am not to do anything strenuous in the next three weeks. Also, need to shield the eye 24 hours a day. And taking lots of drops at various times during the day. In some respects my vision is a lot worse than it was before surgery and yet in at least one way my vision is a little better already (the doctor was happy to hear that). The doctor doesn't care about how well I see over the next week, as long as I keep seeing something (no darkness or curtains). It will take a while for inflammation to diminish. Chance of scar tissue developing again and needing another surgery on this (right) eye? About 10%. I'm feeling very blessed, and very hopeful that all this will soon be behind me. Thanks for checking in on my progress. Thanks for your prayers. September 23 I had my second follow up appointment with Dr. Purohit yesterday. After looking into my right eye he once again said that everything "looks perfect." Here's what I think that means and what it doesn't mean. It means that there isn't any obvious risk of detachment, holes, tears, abnormalities, scar tissue build up, excessive inflammation, etc. It also means that things are going in the right direction and that I really can't ask for more at this point (eight days post op). It doesn't mean that there isn't inflammation (there is, and though it creates a good bit of distortion, it is subsiding) and it doesn't mean that I'm not at risk for further complications (possibly leading to more surgery). A week ago my Dr. told me there is a 10% risk of complications. I'm assuming that this percentage hasn't changed a whole lot at this point. One simple test performed says that vision in my right eye should be correctable to 25/20 (near "perfect" vision). Whether or not I would need some kind of corrective lens to get there or if my vision will be close to that without eyewear assistance remains to be seen. You might imagine how ready I am to have all this behind me. At times I wonder if after all I've gone through I might not still lose my vision completely or have it not correctable. As I walked into the office I braced myself with the possibility that I might receive news that I need another surgery right away. Generally I'm hopeful that we're near the goal, that my vision in my right eye will finally be just fine and I'll look at all these experiences the way I look at having had chicken pox or mono (yeah, I kind of remember that, it was real but far enough in the past that I rarely think about it). My next appointment is October 23. In the meantime, there are eyedrops to take and other post op precautions for two more weeks. October 9 I am 3 1/2 weeks out of surgery with two more weeks until my next appointment. I'm seeing better than i did prior to the surgery, though not as well as I'd like. But if I never improved, I think I'd be okay with that, as long as my vision remained this good and I didn't ever need another surgery on that eye. In other words, I'm not sure if I should be seeing better than this or if I'm right on target for how one normally recovers from such things. I'm thinking I won't have more to report until the 23rd. I'm seeing little change from day to day. October 23 Had an appointment today and everything remains on target. My vision in my right eye is 20/50 and hopefully will improve as the inflammation decreases. The complete recovery takes three to six months. Vision in my left eye (with a contact lens) is 20/20. I'm very thankful that my left eye continues to do a good job of bearing the load during the weakness of the other eye. December 09 My next eye appointment is just before Christmas. My next liver appointment is on the 14th. On both counts all seems to be well. December 22 I had my liver enzymes checked and they are absolutely normal. Yeah! I was really hoping they would be, but before the bloodwork was ordered my Dr. said that just because I'm feeling well at the moment doesn't mean there couldn't be some lingering issues. And today, I had an eye apointment and my doctor said things are going in the right direction, that the swelling contines to decrease and my vision in my right eye was 20/40 (compared to Octobers 20/50). The bad news (if there was bad news today) is that my eye probably won't improve more than it already has. The good news seems to be that, with corrective lenses (hopefully the right contact), my vision in that eye might get close to 20/20. That would be awesome. It appears that I'm coming to the end of this period of wrestling with my eyes (and for sure with my liver). Praise the Lord with me. January 5, 2010 Optometrist appointment today - I'll be getting a contact lens in my right eye as well as my left, and when I do I will have 20/20 vision in each of my eyes! I so look forward to this. It feels like the end of a long struggle - one that began in August of '08. |
