Wonderful Christmas to All!

From T.J.’s heart to yours

I have done a lot of thinking this Christmas season knowing that one year ago I was in a long struggle between life and death. This year I have read and re-read the blog entries that my family posted and which so many responded to. I cannot read it without tears streaming down my cheeks and those of you who know me know that is not the normal TJ.

It is a gift to be at the end of oneself when only God has the power to heal. It is a gift to be the recipient of the thousands of those who prayed. It is a gift to know that a spiritual battle was waged and that God defeated the enemy. It is a gift to know that every day I have post January 14, 2008 is an undeserved gift from God. It is a gift to be a walking testimony to His goodness, mercy and grace. It is a gift to be able to look outside and see the beautiful snow that I missed last December. It is a gift to look forward to Christmas day with my family – no gifts are needed this year – being here together is the greatest gift I could have.

The past year has been a gift. To know my heart has been healed, to continue to recover my strength, to spend more time with Mary Ann. In addition God has graciously allowed me to publish my second book, Leading from The Sandbox and to complete a third, The Intentional Life, which will be published by NavPress in October 2009. One of the dedications for my third book is to each of you who so faithfully prayed for us.

Suffering is not something we ask for but it is an amazing gift. It focuses the heart and life like nothing else can. It clarifies what is important. It allows us to share in the fellowship of His sufferings and to understand our savior better. It sensitizes to the sufferings and hardships of others. I count the past year with all of its challenges as the greatest gift of my life along with Mary Ann, Jon, Steven and my relationship with God. I would not trade it for anything!

I do not understand why the physical and spiritual battle was waged but I do not need to know. What I know is that God is good all the time – and that would have been true had I not survived, that His mercy is amazing and that He is utterly sovereign. I can trust Him with each situation, every challenge, all disappointments and all the turns in the road of life. If I have just one more day to live, I will be forever thankful. He is the alpha and omega of our lives, the beginning and the end.

If you come to this blog from time to time it is most likely because you were one of the thousands who upheld my family and prayed for my healing when I could do neither. I thank you from the bottom of my heart. God used your petitions to strengthen my family over 42 long days, to heal my body and bring me back from the brink. I am forever grateful to you and one day will be able to thank and rejoice with each one on the other side of eternity. It will be a big reunion as we celebrate God’s goodness.

I start to travel internationally again on December 26. I am not as strong as I used to be – perhaps it will come back in time, I don’t know. But even if there is a new normal it will daily remind me of God’s grace and goodness. There remain some health challenges but given what God has already done, I can and do trust him for the future.

As I celebrate Christmas this year I do so with thanksgiving for you and your prayers. May He give you great joy as He has given us.

T.J.

Boma

When TJ was in the hospital last year I would get a picture in my head when I prayed for him. It was a man (I assumed to be TJ) sitting on the ground by a large bright fire. He was sitting with his right leg out straight and his left knee bent sort of leaning back on his left arm. His right arm was stretched out toward the fire with a stick in his hand. He was in an oval shaped shelter that I described as a hedgerow because it was the only thing I had seen that could describe it. It was a thick fence made of thorny sticks and seemed impenetrable so TJ was sitting there relaxed, yet alert and waiting.

A couple weeks ago my brother Will got back from a trip to Tanzania where he had the opportunity to visit a community in a very remote area accessible only by small plane. As he described the enclosure around the village, I realized that what I had seen when I prayed for TJ was really a Boma- as I understand it, a word used to describe the fence around a village and the homes in the village.
Here is an article that describes a boma: http://en.wikipedia.org/wiki/Boma_(enclosure)

I was really excited when I found the articles on bomas because it really fits the sense of safety I felt the picture I was seeing portrayed (albeit TJ was in a very small boma). We are supposed to go to Tanzania in March and I really hope we get to see a boma!

A year later we are still learning through the experience. It's not always comfortable -- there are many days when if would be nice to finally leave it behind -- but makes me hopefully eager at the same time for what else is in store for us due to that one, long, painful month.

Love and appreciate you all!
MA

Brief Update on TJ

TJ is feeling a little bit better. Early last week he drove down to Rockford, IL and came back up yesterday. Frankly, it's a good sign if he can site that long.

That said he is still quite sore which makes all-day meetings (such as today) more difficult.

As always we appreciate your prayers.

MA Doing Better

And I am up watching her eat breakfast, a real rarity indeed (I am up at 7:18 am). Yesterday she spend most of the day in the bed but was able to keep some food down.

IMHO it does look like food poisoning which is generally a 24-72 hour deal.

Thank all of you again for your prayers. If I have time later today -- and am awake for it -- I'll do a short post on T.J.

M.A. "Better"

At any rate she feals better after being on a drip to hydrate her.

She just got home (as of right now) . She doesn't really look better but I (JA) thinks she is just tired after over 6 hours at the hospital.

She says she is not over this yet. The doctors sent her home with some meds to help, but nonetheless...

I'll update when she feels (or actually is) better; or if she is worse. In the meantime just pray that she feel/is better than when she left for the ER.

Thank you all again,

-jon

M.A. Now Admitted

[Updated 10:15pm CST; just spell check]

M.A. Had a very sick night Saturday/Sunday. After waiting 3 or so hours in the waiting room she was admitted and got a drip for dehydration.

They think it is food poisoning but given the problems the TJ/MA have had recently I (Jon) would not be surprised if it more than that, although I hope that food poisoning is the extent of it.

At any rate prayers are greatly appreciated. TJ is with her at the hospital currently. Updates will be posted if there are any.

He's Home!

TJ was discharged today. While he still has significant discomfort, for some funny reason he is finding it much easier to find a comfortable position in his lazy boy in his study than in the hospital. Now time to start climbing to wellness once again.

Gratefully,

Mary Ann

Post Op Day 2

TJ is still in the ICU as there were no beds available on the neuro floor. The staff is incredibly friendly and they are really enjoying seeing some positive outcome from their work. I have been introducing him to some people of whom he has no recollection. A nurse walked in this evening and looked at me and said, “You look really familiar.” She had taken care of TJ a couple of times but did not recognize him without a tube in his face.

TJ is doing well although his neck and back still are very painful. The nurse practitioner from the neurosurgeon's office was in and put him on a new pain medication regime. She changed his dressing and the incision looks really good. He took a good walk and hopefully will be able to get some sleep tonight. The nurse who is on tonight had him several times in December and is a wonderful nurse. The plan is discharge some time tomorrow, but no one will make any promises.

Prayer requests are for good pain relief, some sleep, and once again an uneventful recovery.

Many thanks again for all your support!

Surgery Day went well

The neck surgery today went very well. The surgeon was pleased and felt that he was able to fully decompress the nerve roots on the right side. He got the MRI scans to review them and did not see anything on the left so he did not do anything on that side. It took a long time to get a room because TJ is on an insulin drip again. He has a little insulin pump he usually uses at home but the nurses in the hospital don't do the home pumps (about as large as a pager) so he was put on a drip. The post op neuro nurses don't do insulin drips and the nurses on the units that do drips don't do post op neuro patients so he ended up in the same ICU as he was in in December! One of our favorite nurses was in charge and it was great to see him again.

Now TJ is not in the ICU because he is so sick, instead it is a staffing issue for the hospital. TJ is doing well. He has no pain in his arms although the numbness on top of his right arm is still there. The surgeon said that the he expected the pain to go pretty quickly but numbness and strength in his right hand would take longer to improve. It is a huge praise that the pain in his arms is gone. He does have pain at the incision site but his very sweet evening nurse was on top of that. I expect that his night will not be comfortable and the ICU is noisy but he said that he can sleep when he gets home. It should be a one or two night stay. The insulin drip will be discontinued tonight so he will probably go to a regular post op neuro unit if there is a bed available.

Prayer requests would be for full recovery of feeling and function of his right arm and an uncomplicated recovery. We are really ready for uncomplicated right about now!

Grateful again for all your support.

Mary Ann

Brief Update

Via MA, TJ is out of surgery, everything looks good at this point.

Hopefully we'll have something more to say tonight or tomorrow, but really, if things go well there won't be much to say.

Neck Surgery Scheduled

TJ has neck surgery scheduled for October 8th at around 10:45 am and we are very happy to have this scheduled. To bring you up to date on what has happened since the last update to get ready for the surgery. TJ had an EMG where they stick needles in your arm into the nerves that are inflamed, wiggle them, then send an electric current through them to see how the nerves respond. It was lots of fun. (NOT). A neurologist who was new to walked in and said, “It’s worse” and walked out. He also two advanced MRI’s that indicated that he has a narrowing of disks in his neck at two vertebrae leading to the severe pain and weakness in his right and now left hands. Specifically he has a small herniation at C7-T1 and interbody spurring and annular bulging at C5-6. It has made daily life challenging as he has been in significant pain making it hard to sleep and almost any activity that involve his arms hurts. He also has difficulty buttoning small buttons or lifting anything as heavy as a half gallon of milk. The actually surgery is a bilateral C5-6 foraminotomy and Right C7-T1 foraminotomy. The surgery should last about 2 ½ hours and is considered minimally invasive. Here is a link that explains the procedure: http://www.spineuniverse.com/displayarticle.php/article554.html . After the surgery he will need to take it easy for a month and can expect as full recovery as he will get in three months. He should be feeling pretty good by the first anniversary of his discharge from the hospital in January!

TJ had an echocardiogram a couple of weeks ago to determine why his pulse has been so high. The results looked great so he will not need the holter monitor. The doctor made a copy of the results for us and I felt like I was holding a miracle in my hands looking at it last evening. The reason listed for the echo was a “ruptured papillary muscle” and the results indicated normal heart function with mild mitral and trace tricuspid insufficiency. While we knew about all this in March, the wonder of it still makes me catch my breath. The doctor feels the reason for the rapid pulse is deconditioning from the hit in December. After his neck is fixed we will feel more freedom to push past the elevated pulse knowing that everything in his heart is looking good.

Last weekend Jon removed the remaining base cabinets in the laundry room and removed the remaining sheet rock to check behind it for mold. We are confident that any possible mold issues are taken care of (since there is nothing left to take out down there!). I am still feeling a lot of fatigue which according to the allergist may last a few months after the repeated exposures I have had. Jon and Steven have been incredible in helping with this big project.

This weekend, TJ’s brother Jon with some others are hoping to finish the siding and painting outside our house. It is going to look great! Jon is a saint- he and others have been here several Saturdays and evenings to paint and work on siding. We are so grateful for their help!

While life continues so have some challenges, God is always good and has showered us with blessings! In his leadership blog TJ recently wrote, “It is a gift to fully understand what it means to live by faith. When we have reached the end of ourselves and have nowhere else to turn but to confidence in a good, all powerful, loving and holy Father, we have received a great gift. It is at that point that what we believe in our head becomes truth in our bones! The gift is wonderful because "without faith it is impossible to please God."

Prayer requests:

Successful surgery with full recovery of function, strength, and pain relief in his arms and neck.

An uneventful recovery

A rapid return to full energy for me.

Praise for all the amazing things:

Resolution of clolt

Normal heart

Incredible support from our personal family and spiritual family!

Waiting for results

On Friday TJ woke up with swelling in his right arm pit an increased arm pain. His doctor wanted him to come in right away because of the holiday weekend and with the RNC in town next week access to the medical center will be limited. Dr. Corbett ordered a doppler (ultrasound) of his arm and shoulder since that is the side that was affected by the clot back in December. The good news is that the ultrasound showed that the clot has totally resolved and all the vessels looked good. The cardiologist had expected that the large clot would rubberize and become a permanent fixture in TJ's arm so it was great news that it is gone! He then had two MRI's of his neck and shoulder, but it will take several days for those results.

After things settle down in St. Paul TJ will be scheduled for a Holter Monitor to figure out why his pulse is running so high. He saw the cardiologist in March when they discontinued the Amioderone, started when he was in atrial fib in the hosptial, and has not had a cardiac follow up since.

The moisture issues in our laundry room are not fully dried up. I have been reacting pretty strongly to it so we have been staying with friends in Prescott and being wonderfully cared for. We may need to have a professional company come in for remediation. It is discouraging as I had just cleared the symptoms from being exposed to mold at school when we started having a problem at home! Here is a link to what the pulmonologist thinks I have; Until Jon gets on a creates a hyper link you will need to copy and paste it into your browser.

http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/ency/hypersensitivity_pneumonitis.jsp

This weekend Tim's brother and a crew he has assembled are painting the outside of our house. What a wonderful gift!

Prayer requests are:

Quick results from TJs MRI's and an issue that can be treated.

Reduced pain for TJ

A good solution to our laundry room and rapid resolution of my symptoms.

Jon and chip are back to college this week, both at Bethel


Deeply grateful for your encouragement and prayer!

Mary Ann

Continuing Health Issues

We are back to our "Life line!"

You may recall that last October before Tim got MRSA he ruptured a disk in his neck moving furniture. He saw a neurosurgeon earlier this summer and it was decided to hold off on any treatment at that point as it was not causing him too much trouble. In Montana after a long evening of fly fishing the pain in his neck became SEVERE with pain in his shoulder and down his arm. He also had increased weakness and decreased dexterity in his hand. He saw the neurosurgeon today hoping to schedule surgery to repair the C5-6 disk rupture. However, the surgeon felt that it is not so clear cut. He said that there is new muscle degeneration in his hand and that some of the symptoms in his arm are not consistent with simply a C5-6 issue. He scheduled an MRI of Tim’s neck and shoulder and an EMG with the neurologist. The possibilities he is checking for are a problem with his C-8 disk which would account for the weakness in his hand, a brachial-plexus mass, or a change in the C5-6, or diabetic neuropathy. Please pray that the tests can be scheduled quickly (preferably this week as activities and staff at the hospital are decreased next week due to the republican convention). Second, please pray for a clear cut and rapid solution. Third, please pray for pain relief. Vicodan is not doing much and Tim is up after about 2 am no longer able to sleep because of the pain. In addition, but not related, his pulse has also been higher that it should be and at times that it runs high he gets short of breath and fatigued. He was started on a beta blocker medication but probably will be going back to the cardiologist. This is getting discouraging.

We have several household issues going on that feel like spiritual hassle on top of Tim’s health. While we were in Montana Jon and Steven discovered that we had a wet wall, and therefore mold, in our laundry room. They took out the dry wall and insulation and bleached everything, but I am still reacting and am taking steroids again. I had cleared most of my symptoms while we were in Montana. Steven corrected a landscape issue today and we are going to add gutters to avoid future problems. Please pray that my reaction clears up quickly. When we got home from Montana our AC was caputz and we had to replace it last week (that did not help moisture issues). Then last night our main floor drain backed up into the laundry room. Fortunately, Steven was able to creatively clear it with the lawn blower. My car is making a funny noise, too. Please pray that nothing else goes wrong- we are feeling stretched.

Thanks for your faithfulness in praying!

Love, Mary Ann

Encouraging News and Update from T.J.

Thanks to each one for their prayers. We have heard back from the nephrologist and the creatinine level had declined from its significant levels back to a reading 1.3 which is very close to normal levels which are 0.6 - 1.2 mg/dL. It is possible that when I am tested again the levels will be in the normal range because of my low sodium low protein diet. This was better news than we could have expected, but God has proven himself good once again.

I am currently taking the sabbatical that I was going to start in December. Most of July, August and September will be spent working on our health, writing, reading, thinking, exercise and rest. My prayer is that when I come back to work in late September that I will have normal energy again. My take is that I came back to work too much, even though it has been a lighter schedule.

On the health front, both Mary Ann and I are doing weight watchers, exercise, and Mary Ann is doing a great job transitioning us to a low fat, low calorie and low sodium diet. We are in Montana for a month so we are enjoying the beauty of the mountains and of course the wonderful fly fishing.

Mary Ann continues to regain her stamina and strength as she recovers from her mold reaction. We are encouraged with the progress she is making.

Jon has secured a full time job working in information technology in the Twin Cities which will also serve as his business internship. Chip (Steven) is happily guiding kids in the Boundary waters of Minnesota as he uses that setting to share the Gospel and help kids grow in their faith.

My second book, Leading From the Sandbox: Develop, Empower and Release High Impact Ministry teams was published last month and is available on Amazon. I am currently working on a third manuscript which I hope will be completed in September. I would appreciate your prayers as I work on this project.

Words cannot express our appreciation for all of you who have walked through these months with us. We will keep you updated as we move forward.

Nephrologist

I [T.J.] saw the kidney specialist today. The good news is that my current lack of energy is not related to the kidneys and he thinks that the upward trend in my creatinine levels is due to some overlap in medications I was taking. He does think that I need to slow down and focus on recovery. He does also believe that there is compromise to the kidneys but, thinks that it is not at a critical stage. He will know more after he gets lab results back (hoping that the levels have gone down not up).

He will also look at a CT taken of my abdomen to see if there is a blood flow problem to either kidney. If he cannot get the information from that picture he will have an Ultrasound done to look at both kidneys. My diabetes could be a complicating factor in this although he does not know. Sepsis* in the hospital could have taken a toll due to decreased blood flow to all organs. So, all that to say, we are more optimistic than we were going in but won’t know what we need to know until the lab work is back and he has looked at some pics.

I will let you know what we hear on the lab work, hopefully yet this week. He wants to see me in about 6 weeks to talk about a game plan although he did affirm that weight loss, exercise, getting back in shape and insulin control is very important since diabetes can have a negative effect on the kidneys. I am also on a low sodium and low protein diet and that will continue. We will post results when we have them. Thanks for your prayers and concern, we are deeply grateful!

-T.J.

*madjon's [Jon's'] note: septic shock will always take a toll on one's body. I know I am not a doctor, but the septic shock must have had a negative effect on T.J., although, I, my family, my father, and many others remain confident in the complete full healing of T.J. through divine confidence and power. To me, this feels like nothing. It is something, but, to be as frank as I can, I don't have to worry about being down in the hospital within minutes. to me, this seems like nothing compared to such long December

God has proven His faithfulness -- even the ICU staff got that [in someway or another, but they did get it!] -- and I, the family, my father, the readers of this blog, expect that God will be faithful.

I have no idea what, but there is something yet in store for T.J...

Blog Subscriptions (Beta)

Jon just added a "widget" on the right side of the page. If you put in your email address you will get updated by your choice of:

• Email
• Skype
• AOL Instant Messenger (AIM)
• Twitter
• Microsoft Messenger
  
• Twitter
• Yahoo! Messenger

Note that this is kind of a test, I've never tried it before. But as the updates are more sporadic it might be helpful.

P.S. It looks like the updates are daily (if there are any)

Shortly after 1:30 AM in the time zone you selected we will send the updates for the day (if any) to your subscribers.

The timezone is probably EST, I don't see a place to change it...

Nephrology Appointment moved up

TJ will now see the kidney doc on July 1- at least it is a little earlier! No other changes to report at this point, except that I have made a couple of really good dinners with no salt at all!

His second book, Leading From the Sandbox, came out yesterday so that is very exciting.

MA

We need you again!

Last week we found out that TJ has pretty significant kidney failure. His creatinine levels were elevated while he was in the hospital, but have taken quite a jump. For you medical types, here are the numbers: Creatinine 2.68, BUN 39, and GFR 25. He can't get into see a nephrologist (kidney specialist) until July 9th, but from a bit a research I have done it looks like he is at stage 4 (out of 5) of kidney failure. stage 5 is where you start dialysis. The cause is probably from the lack of blood flow to his kidneys while he was in septic shock in December. We are taking a 2 prong approach. One is to start diet limitations of sodium, protein, and phosphorus to decrease the load on his kidneys. The other, and far more important approach is to storm heaven once again for COMPLETE healing. Hey, if the Father could repair his mitral valve miraculously, kidneys should be nothing!

1 Chronicles 5:20. "They were helped in fighting them, and God handed the Hagrites and all their allies over to them, because they cried out to him during the battle. He answered their prayers, because they trusted in him." We are crying out to God as the battle continues.

Other key factors are controlling blood sugar and blood pressure. His blood pressure is pretty well controlled and he gets an insulin pump tomorrow that will tighten his blood sugar control which has been pretty decent.

Please note, that we probably won't have much, if anything, to post here until we can see the kidney doc in July. However, if any of you have some great low sodium recipes please let me know!

On a similar, but less serious note, I have had a mold reaction from where I work that has not let up since April, and I have not been in the building since April. I am short of breath and very fatigued. I saw a lung doctor last week and had several tests but no results or plan as yet. We make quite the dynamo pair these days!

Jon is looking for work and recovering from a very strenuous school year. Steven is in the Boundary Water Canoe Area leading groups into the wilderness on canoe trips. It is through a ministry called Boundary Water Experience. Last year he had the privilege of leading a couple of kids to the Lord. It is the perfect summer for him.

We deeply love and appreciate all of you!

Mary Ann

Link to TJ speaking at Two Rivers Church

http://www.tworiverschurch.org/resources/recentSermons.htm

It is the one titled "Living Dangerously".

Update from TJ

Thank you to all who prayed for my trip to Hong Kong. I was amazed that I had the energy that I had even speaking twelve times with numerous meetings. I was very encouraged.

Yesterday I saw the neurosurgeon and it was decided that I did not need surgery on my pinched disk for now. PTL. I do have some abnormal kidney tests which will be retested on Wednesday. This has been an issue since I left the hospital.

I do have abnormal kidney funtion which is a concern to the doctors. This could be a result of septic shock which I had in the ICU. I have been referred to a kidney specialist to see what they can determine. We continue to ask God for complete recovery including this issue.

It is not my health that concerns me most right now but that of Mary Ann. When she went back to work after my hospitalization, she suffered a severe mold reaction and discovered that there had been a leak at the school in December which had not been remediated. Mary Ann has severe reactions to mold. Essentially she has been out of work (with a few exceptions) since then. She suffers from severe lack of breath, trouble breathing and so far the steroids and antibiotics have not resolved the issue. She will not be going back as a school nurse next year. Our concern now is that God would graciously restore her to full health. Please join me in praying toward this end.

Steven is heading up to the boundary waters in northern Minnesota where he will again be a guide for a Christian group that ministers to inner city kids. as an outdoors man he is in his element there. Jon is looking for a summer job and business internship. We made a contact yesterday with Medtronics (when I was being prepped for an insulin pump) and he would love to see that happen.

My book, Leading From the Sandbox: Develop, Empower and Release High Impact Ministry Teams should be available in about three weeks.

As you pray, please remember relief efforts we are involved in in Myanmar and China in the aftermath of the Cyclones and Earthquakes. There are massive human needs in both places and ReachGlobal will be partnering with national Christians and ministries to do long term relief, development and church planting in these needy areas.

This weekend I will be in Knoxville, TN for meetings and will be preaching on Sunday.

Thank you for your love and prayers. If you have not done so, please check out my new leadership blog at www.LeadingFromTheSandbox.blogspot.com.

Gratefully, TJ for Mary Ann and the boys

TJ's New Leadership Blog

For all those who are still faithfully checking for updates on this site, you may be interested in bookmarking TJ's new blog at www.LeadingFromTheSandbox.blogspot.com .

Those of you who know TJ understand how passionate he is about healthy churches, leaders and ministries, and this blog has practical application for all church leaders, missionaries, and ministry personnel.

We invite you to wander on over and check it out!

T.J.'s Testimony

This is the video of TJ speaking at church about three months ago. A (smaller) download optimized version for Quicktime/iTunes is here, and Windows Media Player here. (The Quicktime/iTunes file is of much better quality and is smaller).

Higher quality videos are easily available upon request. madjon@gmail.com

Update: Youtube link.

MRI results are in!

TJ called the cardiologist office today and got the results of the MRI of his heart-NORMAL! There is a very small amount of regurgitation in the mitral valve, but he does not need to do any follow up with the cardiologist. He started cardiac rehab to get his heart and lungs back in shape. He gets hooked up to a monitor and then follows a guided workout on various machines while staff watch his heart rate and rhythm and blood pressure. he will do this three times a week. The guy next to him couldn't figure out out how he did not have to have his broken mitral valve repaired- the cardiologist probably can't either. The miracle continues.

MA

Prayer update

TJ suggessted that we post the prayer update he sends out so here it is! Thank you so much for continuing to check and and pray. It gets kind of slow to try to post much since it is recovery in slow motion at this point for all of us, but this update will get you up to speed.

May Prayer Update

For security reasons please do not place this on the web

Dear Prayer Partners:

It is good to get back into the habit of communicating with you after these past challenging months. I am so humbled by those who have upheld our family in prayer.

On the health front, I think I am at 60% of normal energy with half my days being “good” days and half being “hard” days. On a hard day, the brain irritation that is a result of my long ICU stay causes significant fatigue and I simply need to stop whatever I am doing and rest. On a good day I can function well for six or so hours. Tomorrow, I start cardio rehabilitation to try to get back into shape. Last week I had an MRI to look at the heart valve situation, but have not heard back from the doctors. I will be seeing a neurosurgeon in the next week or so to figure out what needs to be done for my pinched nerve that has caused discomfort and weakness in my left arm and hand.

I would also ask you to pray for Mary Ann’s health (yep we are a great pair these days). While I was in the hospital, there was a flood in her school which resulted in significant mold. She has a severe mold allergy and was back home sick for several weeks while the school told us they were doing mold remediation. On returning to school she discovered there were areas that had not been taken care of and her doctor has said she cannot go back to the building for the rest of the school year. This situation has been frustrating to her and has caused her to live with significant discomfort.

On May 1, the manuscript of my new book, Leading from the Sandbox: Develop, Empower and Release High Impact Ministry Teams, will be set to get published. This book will be the team curriculum for ReachGlobal and hopefully for ministry teams around the world. Pray with me that the book will be available for the National Leadership conference the third week of June. The timeline was complicated by my illness.

One of the good things that came out of my illness was that the great leadership team of ReachGlobal ensured that nothing changed while I was gone and that no momentum was lost. I have chosen not to take back a number of responsibilities and to now concentrate on four things: Vision and strategy, leadership development of RG and national leaders around the world, resource development, and writing. I am deeply thankful for the wonderful team God has given ReachGlobal that makes this possible.

My major prayer “ask” for May is a two week trip that I will be taking to Hong Kong, May 17 – May 30. I will be speaking at a significant mission’s conference hosted by one of the international churches and will have a significant number of meetings with groups or individuals. This will be my first international trip after my hospital stay; I need significant prayer for energy and favor. This fits my second priority of influencing movement leaders globally.

Finally you will notice that my schedule is lighter – by design and by necessity. Thank you for your prayer. It is deeply appreciated – and needed.

May 1 All day consult with Gary Hunter on key ReachGlobal priorities

May 2 Preparation for Hong Kong

May 3-4 Home

May 5-9 Stay at Home week (one week per month when all members of the national office are in the office): meetings and preparation for HK.

May 10-11 Home

May 12-16 Preparation for Hong Kong

May 17-18 Travel to Hong Kong

May 19-30 Training, meetings, networking and speaking in Hong Kong.

Again, I thank you for your prayer support. It means everything to us.

TJ

TJ Doing Great / In My Life

Obviously we have neglected this site for sometime now (since February 23rd, to be precise). (I (Jon) had come to the poor assumption that by this point visits were minimal. Well, in the last week we have had 191 visitors from 13 countries (and some of the visitors are new!)

TJ is up and running and all in all, doing great. His beard is most definitely back, he is back to work, a couple of weeks ago he spoke to a class at Bethel, and is traveling again (not international yet). He still tires more easily than he did before, and his voice is softer than it was before this whole, uhm, event. The doctors did not expect him to be back at work for 6-9 months after he was released. It is completely and undoubtedly evident that people are still praying for TJ, and that God is faithful.

Per the voice, that is expected to come back after some time. There isn't any physical damage to his vocal chords, etc. They just were roughed up a bit after being vented for so long.

Oh, and he is finally doing Facebook. He now has 251 friends (and still growing, thanks largely to a Facebook group Chip started), which is more than me! (At least Chip beats him with 600!) If you do Facebook, you can find him under "T.J. Addington."

It is weird to be posting again at all, in some ways this blog is the only remaining evidence that anything happened at all. Things are almost too normal. Maybe I am just still processing it (as well as rushing to finish last semester's work before I fail the whole thing, which wouldn't be cool.)

So thank you all for your prayers! I don't like displaying my emotions in public (much less in front of hundreds of people!) but it is so hard not to, this has been one of the most amazing things I have ever seen, and it was in my life.

P.S. I'll have at least one more post that shows the visiting stats, one almost needs the visuals to get a grasp on how much of a global event this became.

Surely Indeed!

Yesterday TJ was officially discharged from physical and occupational therapy, which means he can go back to work without a doctor's note (which he was told he would otherwise need). And next week, he plans to do just that.

He says he currently has more ambition than energy, and it can be a little difficult when you look fine, look like you should be able to keep up your old schedule, but just don't have the energy to do so.

He also said (in a reference to another post regarding his mental status :-) that he is up to 92%.

Praise God!

Slowly but surely...

It is getting harder to do what feels like relevant updates as recovery continues because this is much less dramatic than illness, but here is the latest:

TJ saw his primary physician last Monday (the internist and endocrinologist) who was pleased with his progress. He did some medication adjustment and is facilitating follow up with the infectious disease doctor and cardiologist ( this was missed at discharge by a different doc). Dr. C's clinic has an excellent diabetic education program with the goal to keep people's blood sugars in very tight control. We attended a 2 hour class on Monday afternoon on Advanced Carbohydrate counting where we learned how to count every gram of carb TJ eats so it can be covered with a short acting insulin. This doctor also checks his blood clotting times to be sure the Coumadin is the right dose to continue to dissolve the clot without causing other bleeding issues. He said that this will continue for several months and the biggest precaution is to avoid hitting his head. Dr. C also took a good listen to his heart and said that he has a grade II (out 0f VI) murmur which is not a big deal. The docs will still want to to another TEE at some point.

It has become apparent in the last couple of weeks that TJ's C5-6 herniation is still an issue and he will see the neurologist next week for that.

TJ had a video study of his vocal cords done on Tuesday to determine why he is still hoarse. This showed no damage to the cords or surrounding muscles, but there is some tension in the cords as a result of the physical trauma from multiple tubes getting shoved through there. He will have a few sessions with a speech therapist to work on this. He also only has one more PT and OT session scheduled, but needs to do exercises at home.

In answer to some questions, TJ is walking without a problem. If he is on a slippery sidewalk, he does not recover quite as quickly as before, but has not hit the ground either. We have had a series of fine snow falls and cold temperatures which make sidewalks treacherous, and he has done fine- I just hold my breath some times! He also started driving last week. He limits his driving at night or if he is tired, but having him drive frees both of us up and makes his life closer to normal. He has been doing some work from home and in meetings with his coworkers over coffee or meals. We both get tired way too fast (in my opinion!). We are amazed and very thankful for the speed of his recovery.

I started at work on a very limited basis this week (2 five hour stints) and will do the same next week. I will go back to my regular schedule on 2/19. My absence has taken a real toll on the two wonderful women I work most closely with so while they are very supportive, they are anxious to have me back.

About two weeks ago I got a call from a 17 year old single mom I have worked with over the last four years. It is a long story of abuse and addiction in her family. She and her 2 year old daughter (A) had been living with her boyfriend and her father (S) came to live with them last month to help out. Her boyfriend became abusive, got arrested, then kicked the other three out. With a lot of help from Chip and our church and extended family, her dad has gotten a job and place to live and B and her daughter are living with TJ's brother and his family. It is a huge adjustment to transition from a life of chaos surrounded by addiction to a healthy family. There are many strongholds of evil with grips on this family- generations of sexual abuse, addiction, and dysfunction so please pray for Becky, A and S as they start a new life and for protection for the families that are supporting them. Becky and S are believers, but have never been in a situation to grow in faith.

Prayer requests would be:

For continued recovery and healing for TJ. Pray that the murmur is totally resolved and other complications do not arise.

Resolution of the C5-6 herniation.

For renewed energy for all four of us- OK, I know this was traumatic, but like I am ready to tackle normal life, but we all run out of steam before we run out of stuff we need to get done! Jon will be tackling his incompletes from last semester as well as a very full coarse load. Chip has a bit to complete for his last semester sculpture class and also a large credit load.

For wisdom in what priorities TJ picks back up related to work and other ministry. This is a rather unique opportunity to choose what projects are the most strategic for him to put his time and energies into.

For me as I go back to work on the 19th. Becky's story is not unusual with the kids I work with and there is a back log of things waiting for me. I need to be wise in setting limits but please pray for a relatively peaceful couple of weeks when I go back ( like no new pregnancies, suicide attempts, or other big crisis in the lives of kids at the school).

We have had several meals with family and friends reviewing the events of Tim's illness. This blog and all of you who read it and pray plays a huge role in that story.

Once again with deep gratitude,

Mary Ann

Life Approaches Normal (At least relatively speaking)

We haven't been very faithful at keeping this updated, you all have our apologies.

TJ is getting up and running faster than expected. Yesterday, he met with one of the men on his leadership team (ironic, considering he is on "sabbatical"). In contrast, a month ago he was in the ICU, half conscious, and not communicating. Today his voice is still hoarse, his short-term memory still isn't up to par, but he is gaining strength back, and overall, his cognitive ability has to be at least to 90% of what it was before.

Yesterday I had a doctor's appointment and it came up that my dad had been in the ICU. I gave a very brief rundown of the experience, and my doctor repeated at least three or four times that it was his sincere conviction that TJ is alive due to prayers and the grace of God.

For the rest of the family, I (Jon) just finished my January course, as Chip has as well. We both have until Monday before school starts back up. I am going back to work next week as well. Mary Ann, too, is going back to work on a part-time basis.

I think we all are starting to get our energy back, although it is coming slowly. But life is starting to finally fall back into a predictable cycle.

Our prayer requests are:

• That TJ and the family continue to regain strength and energy
• That Chip and Jon are able to start school again rested
• And that Jon can finish up last semester's work without too much trouble
• That TJ's memory comes back to full strength, quickly
• That TJ's voice returns to normal

Thank all of you for your prayers and faithful checks of the blog! We are still getting hundreds of hits a day, apparently even from new visitors as the individual people that have come to the blog has gone past 11,000 now. Over 500 people downloaded the audio file of TJ. You all are amazing! Second only to Him that brought us through this, and continues to uphold us as you do through prayers.

Specifics update

At the end of the first week of outpatient therapies we thought some specific updates could be useful. Overall, TJ tires quickly and still describes himself as weak, but slowly and steadily gaining strength. His physical therapist said she won't be seeing him for long and gave him a list of exercises to be doing at home.

Occupational therapy noted that his right arm is only about 1/3 as strong as his left-most likely due to the neck injury (C5-6 herniation) that he suffered about 3 weeks before getting sick. He cannot lift a 1/2 gallon of milk with his right hand and his neck is often sore. The OT also gave him home exercises. He thinks it will take a couple of hours a day to do all the things they gave him to do. No complaining- just the way it needs to be to make progress. He is also having noticeable "discomfort" in his right arm where the clot is located and will be on blood thinners for a long time.

TJ is seeing two speech therapists. One has a goal of working on short term memory, which is steadily improving but testing showed some deficits. The other is a vocal specialist. TJ is quite hoarse and she thinks there may be some paralysis of one side of his voice box. We thought they were going to use a scope to visualize the vocal chords yesterday, but that has been scheduled for February 5th. She also gave him some activities to do to increase breath capacity- the inspiration phase of breathing is still rather short.

TJ's internist/endocrinologist (he is both) has put him on a rigorous regime to keep his blood sugars in tight control. He checks his blood sugar by finger stick at least 4 times a day before meals and at bedtime. He has a correction scale of short acting insulin based on the immediate blood sugar. We also have to figure out the grams of carbohydrates he eats at each meal and then he adds more of the short acting insulin for the amount of carbs he has eaten. He also takes a long acting insulin twice a day. (Hurray for tiny needles!) There are many, many people who do this everyday, but we are still getting the hang of it. For me the adjustment is more detailed meal planning so we can figure out the carbs. Since I like to cook "ad lib" I have to pay more attention to what I am adding to a meal as well as paying attention to the total number of carbs. Time for a Sam's club tomorrow to load up on colorful low carb food.

For the many of you who are encouraging TJ to take the time he needs to recover, his work schedule has been cleared through March. He is meeting with some of his team either in person (so far at home) or by phone, and working on his laptop. He has no international travel scheduled until May. Between several hours of therapy per week, lab appointments, and doctor appointments life stays pretty busy! We really appreciate all the encouraging comments and continued prayer-they add octane to the fuel to keep us going!

Steven is now an official card carrying "woofer" or wilderness first responder. He successfully completed all the testing for the class yesterday and has a full week off before the new semester starts on February 4th.

Jon is still pushing hard on his racial reconciliation J term class. I can't believe the number of papers he has to do to meet the class requirements. He has always had a strong sense of justice so there is a big emotional investment for him in this class. His class ends of Tuesday and he has at least two papers to complete by then.

Our specific prayer requests would be :

~Healing of his neck injury
~Resolution of the clot
~Full recovery of his voice
~Strength and patience for the rehab process
~Sleep- TJ has not been sleeping well at night- not a big surprise given the discomfort he has and this whole experience.

With our deepest gratitude,

Mary Ann

TJ Speaks Again: The Nature of Grace

On Sunday TJ spoke at our home church, Rockpoint. I got a copy of the audio which you can download as an mp3 here. I was extremely proud to watch him get up and speak, welcomed by a standing ovation.

We've had at least one request to share some more details in general on how the family is doing, even "mundane" ones. So here is a brief post on mundane things.

Mary Ann is still getting used to the new way things are, and some days feels like she is, "wading through oatmeal." She is TJ's home nurse for the time being, as he continues to regain strength.

I (Jon) am taking a January course at Bethel that may yet kill me, hence the time of this post. It requires more way reading and writing than I have energy to do.

Chip is taking a January course through another school (I forget which), which is wilderness first response training. I know he has been pumped about the course for awhile, but it is 8:00am-5:00pm everyday, and in Minnesota, these have not been warm days. (It has to have been at least a week since we hit double digits.)

It's hardest for me to speak for Chip as we haven't connected much, but for at least my mom and I the last several weeks are hitting. Through December we were running on borrowed energy, and we are now paying that back plus interest.

We will be trying (for real) to be posting more often, even mundane details, and probably more detailed details, but currently it is a struggle to find the energy wake up and go through the day, much less post at the end of it. But, if you are all willing to be praying for us, we are more than willingly to be posting!

Specifically:

• That TJ continues to recover and gain back his strength and voice
• That Mary Ann, Jon, and Chip find the energy to get through the day, and are able to rest at night
• That the daily and scholastic pressures don't suck us down
• Finally, that God's goodness and the miracles we have seen are not forgotten during these days when we continue to need to lean on God
  

AN INVITATION

[This post is intentionally incorrectly dated so it stays on top for a bit]

As TJ and our family have begun to discuss all that has happened over the past month, we have realized in a very new and fresh way the need for the prayers of the body of Christ.

We realize that the vast majority of you have prayed for us because of the critical nature of TJ's illness. We are so appreciative of that expression of love and your prayers.

We have heard from several commenters who want to continue to pray for TJ's ministry and our family. If you would like to explore that possibility, will you please send an email to Arthur Ellison, our personal prayer team leader, at arthurellison@aol.com. Arthur will get back to you and further explore with you via email your interest.

For the time being we will continue to post updates a couple times a week through TJ's recovery period. While TJ was in the hospital I found myself checking blog comments first thing in the morning and last thing before I went to bed. Your prayer support and comments gave me what I needed to face the day's challenges and the peace to sleep (at least a little) at night. We are still in awe of how so many around the globe have prayed and are deeply grateful.

Mary Ann

My Turn, from TJ

God is good, all the time! That is a core conviction of mine and would have been true no matter what the outcome of my recent illness. But I am thankful that he is also a God of great grace and that his power is greater than any adversary, physical or otherwise.

This will not be a long post as my fingers don’t always cooperate with my mind. However, I wanted to personally thank you for your prayers and concern. I am deeply humbled to have had thousands of people praying for my recovery. Just today I learned that the EFC of Congo and Hong Kong were corporately praying and I have heard of other movements and people who interceded on my behalf. This does not include the thousands who have been accessing the blog on a regular basis (Thanks Jon for your ministry through the blog). I still find it hard to get my hands and mind around that but I am exceedingly grateful. Given the chain of events, I am convinced that it was prayer that made the difference as I hovered between life and death for many days.

I know from Mary Ann that at one point one of my physicians stood at the foot of my bed and said quietly, “we really need outside intervention at this point.” God provided that outside intervention. One of the most remarkable things is that when I was at my worst, one of my heart valves was leaking like a sieve and they were sure I needed heart surgery. Today none of the physicians can hear any issues with the valve. The cardiac specialist said, “It looks like you dodged that bullet. I don’t know how but I can’t hear anything.” Yes, God can and does heal, even miraculously today. I am a walking billboard to his power and his grace (even if I am walking a bit wobbly).

One of the T.J quotes that my staff often hears is “Nothing to prove, nothing to lose.” It means that I don’t have to be right, or prove anything to anyone, nor do I lose by being weak or wrong. I was amused to hear that I kept repeating that out loud as I woke up from my drug induced coma. It was appropriate because I had no strength, could not do anything for myself and faced what we thought would be a long recovery. It was a humbling place to be. I am so thankful for the support and help of Jon and Steven and Mary Ann who have been magnificent in their help, for family who spent nights with me on a rotating basis and for close friends who dropped everything to support the boys and Mary Ann. It was much harder on them than it was on me as I spent much of my time in a drug induced coma, unaware of the circumstance I was in.

It has been so good to be home. A friend provided a new bed that adjusts so sleeping is more comfortable. Next week I start outpatient physical therapy. Today I made what is usually a weekly trip to Borders Bookstore (it has been 45 days). Yesterday I got a much needed haircut and was able to go out to dinner with friends. While I am weak, it has been a surprise to everyone how quickly I have made progress in regaining strength (please continue to pray that it will continue). Before I left the hospital, Mary Ann and I went down to the ICU to thank the personnel there. The head nurse just kept saying “wow.” She could not believe that I could look so normal after being that sick. Again, I attribute that to prayer.

More than ever I am aware that every day is an undeserved gift from God. That I owe Him my life and that He has graciously granted me additional time to serve Him. I don’t deserve it but that is the nature of grace.

About the Diet Coke. One could assume from the blog a fixation on Diet Coke. I admit to enjoying it. The real issue was that for weeks I had nothing to drink except through my feeding tube and my mouth was constantly parched. What I craved was anything wet and cold to quench my thirst. Early on, after I was awake, Jon walked into my room when an unnamed nephew was visiting and there I was laying on the bed, clutching a Mountain Dew like it was the most precious thing in the world. Totally illegal from a medical point of view and I don’t even like Mountain Dew, but it was wet and cold. It was not until a week ago that I was allowed to have thin liquids. Until then I had to have “thickened liquids” which kind of ruins any taste that it had.

As I regain my strength I will be working to complete my book on ministry teams that I wrote this past year and hope to get it out by June.

I will keep you updated on progress. For a time my days will be filled with physical therapy, doctor visits, manuscript revisions and rest.

Again, I want to personally thank you for your prayer support. Now I need to go find a Diet Coke!

Something Like an Update

Jon is back in school and Mary Ann is both busy and tired getting into a new semi-normal routine, so we have not been posting as often as we have meant to.

First, as we have not posted this officially yet, TJ was discharged on Monday at 2:45pm. He is physically capable of everyday tasks -- sans driving -- but is still very weak (his words). He is feeling alright but still just exhausted in general, and so is settling into a new routine that includes a lot of naps. Nonetheless, he is quite happy to be home again.

Based on some of the comments it also seemed good to me to post something about the blog. As a family we are still discussing what to do with it. Do we shut it down including blocking off future access? Do we post every couple of days, once a week, etc. in the meantime? We're not sure yet, but will probably have an answer soon. In the meantime, we will update every couple of days (or so, as people who said they would update the blog (like me, Jon) forget...) with whatever news we have.

We do appreciate your continued prayers, especially regarding recovery. TJ has already been recovering faster than he is "supposed to," but this is something that will probably take months to complete.

The truth is there is still a long road ahead for us a family. It seems odd to not be running on adrenaline 24/7, and I don't think that this experience has really hit any of us yet. In the middle it's not real. In the middle you don't have time to let it hit you, and if you do, you don't have the energy. Mary Ann prepared herself for a good cry one night, but ended up falling asleep on the couch before she could get to it. We are all going to live through this for real, for the first time as TJ continues to want to learn more about what happened. It's been a long December, and it's not even over yet...

Weekend Update

I (Jon) was supposed to do an update last night and then forgot, my apologies.

Today, for the first time in a very long time we were able to sit down for a Sunday dinner *together*, at home. IT was wonderful.

Tomorrow morning TJ will officially be discharged from the hospital. He is weak (his words) and tired easily, but moves around without a walker or other aid, including stairs. His post-ICU progress truley has been amazing, although there is still a long road ahead.

I promise that we'll have at least one or two more posts in as many days. We still don't know what we are going to do with the blog. It feels so intertwined with the whole story it almost needs its own closure. But we'll sort that out later.

For now, thank you all for your prayers and support. As a family, we don't know how to communicate how much it has all meant to us. You carried us through this by asking for the hand of God, and as other times acting as it. Thank you.

Quick Question

Quick question for a few of you while people are still tuning into the blog: When was the last time you can remember TJ staying in the same city for so long? This aimed specifically at LN, RP, and TJ's mother, all people who more or less kept track of this during different time periods, and that I know watch the blog.

My guess is that TJ hasn't spent this much time in the Twin Cities (or somewhere else on vacation) in one stretch in at least 10 years. We are at 39 days in the hospital, 43 days in the Twin Cities...

By the way...

TJ told me today that from here on he is going to celebrate his discharge date as his second birthday.

Coming home very soon!

In rounds today the team decided that TJ should come home for a day pass on Sunday (like a trial run) and be discharged on Monday afternoon! Yippee! Antibiotics finish tomorrow- earlier than planned as he is responding so well which means NO tubes after tomorrow and no IV meds at home. He did stairs inside and outside in PT and walked some long halls. He was totally exhausted at the end of the day- but just 7 days ago it took 2 nurses to move him from a chair into bed! We will get the specifics of outpatient therapies at discharge, but probably all three-"SPOT"- about three times a week.

Monday morning the infectious disease specialist has a conference call with the head of MRSA research at the University of Minnesota and the Minnesota Department of Health to figure out what this super bug is that made TJ so very ill.

God is so good. Our gratitude to all of you prayer warriors is inexpressible!

Pass the Diet Coke, please!

TJ passed the video swallowing and can eat and drink without restrictions and without danger of an aspiration pneumonia! The first thing I did was pour a diet coke on ice- he has several more lined up against his window to keep them somewhat cold. He really does not usually drink all that much diet coke- a 12 pack can last a long time around home, but he has been so dry it is what he has been craving. I left him with a lot of ice water as well.

The doppler of his arm showed no change in the clot. The doctor explained that some swelling may reoccur as one of the vessels in his arm is almost completely occluded. He will be on blood thinners for a long time. He is pretty exhausted with the therapy schedule, but making great progress! He was not, however, impressed with the counting money exercise in OT today.

My apologies with the lateness of this entry. A dear friend and her son came over to move furniture and clean to make room in what has been TJ's study to become our temporary bedroom. We have a splint entry home so if we left the bedroom where it is he would have to do a lot of stairs. Friday is the day they do "rounds" (or a care team meeting) on rehab to discuss progress and determine an estimated time line for discharge. I am working to be ready with the rearrangement at home by Monday or Tuesday at the latest!

Oh yeah, one more big item- the beard is growing back quickly. I really do love his beard as long as I don't have to try to trim it!

Many blessings and much thankfulness.

Q & A About the Clot

Somebody Asks:

I have a medical question, more for your consideration than for my needing to have an answer. I apologize in advance for the length of this. A little background first: My daughter had Thoracic Outlet Syndrome last year which basically was a clot in a vein in her right shoulder caused by compression of the vein. Because of this I think about TJ's clot issue.

For my daughter, they very aggressively tried to dissolve as much of the clot as possible within a week of the first occurrence. After that she was on Coumadin for a number of months.

So my questions ...
1. My impression is that the longer a clot remains the more it tends to adhere to the vessel wall and become permanent. Are they concerned that the clot has been there so long that it will be difficult to get rid of by dissolving, which could possibly lead to permanent issues for TJ's arm if no other method for eliminating the clot is recommended?

2. Is the clot in a vein or an artery? My daughter's doctor said that arteries are very sturdy and can be operated on successfully much easy than a vein can, at least in my daughter's case. I just ask this if they consider a surgical method of clot removal.

1. The doctors haven't indicated at this point that they are worried about it becoming permanent, and haven't been taking action that would suggest that they are worried about it. The good news about it adhering more strongly is that it is less likely to break up (see the next answer). However, I can't answer this question beyond that.

2. The clot is in three veins, one in his right arm, his right jugular*, and his right sub-clavian vein. Both the jugular and the vein in his right arm dump into the sub-clavian, much like two rivers coming together. From there, the sub-clavian goes into the Superior Vena cava vein, which goes straight to the heart's right atrium, which pumps the blood into the right ventricle, which sends the blood to lungs, and then back to the heart.

The significance of this is that if the clot breaks loose into pieces instead of dissolving it goes straight to the heart (in seconds). If that does not cause a heart attack the piece continues to the lungs which can cause a pulmonary embolism, which can also cause sudden death (or lesser symptoms). And if there still are no problems it goes back to the heart. Hence, having it adhere strongly to the wall is a good thing at this point.

No one has discussed whether a surgical operation is possible at this point, the need for it has yet to arise. The difficulty is (as I, the non-medical understand it) is that they usually go in through the sub-clavian for such operations, exactly where the clot is, which could limit options.

Below are some illustrations from Gray's Anatomy of the Human Body (20th Ed) from 1918. This edition is in the public domain and so can freely and legally be redistributed. Handy, as human veins haven't moved in the last 90 years...


These show the path the blood takes (all downward), and should give you an idea of the size of the clot.

*Technically you have multiple jugulars, right, left, internal, external, anterior, etc. TJ's clot is in his right internal jugular, which is the big one you can feel on the side of your neck.

Evening Update

Today was an intense and tiring day for TJ as each OT set a functioning baseline and goals. TJ is pretty much exhausted. The video swallow test was put off until tomorrow, so still only thickened liquids to eat.

In the meantime his right arm has started to swell up again, probably due to the clot, they will be doing another doppler scan of his arm tonight.

So our prayer requests for the night are:

• A rehab without further complications so TJ can be home by early next week
• A successful swallow test
• No problems with the clot

Thank you all!

Miracle Man

And it's not our words this time. TJ was moved up to rehab today and the evening nurse greeted him with "so you're the miracle man!" Indeed. Apparently a nurse from the last station was trying to convince them how sick he was and they wouldn't believe it based on what they saw.

Tomorrow TJ starts intensive rehab, occupational therapy (OT), PT, and speech therapy (ST? how about SOPT for all of them?), OT and PT twice a day according to the evening nurse. Speech therapy mostly be swallowing at this point, as speech isn't too much of a difficulty. He is going from croaky to hoarse, like someone with a bad cough... like him.

As far as the mitral valve goes, the cardiologist says they don't need to check it again for another two to three months.

Personally I've (Jon) have seen noted improvement over the last 48 hours. He now has control over his fingers, even if he is still a little shaky, can get up out of bed and use the walker, and get back into bed.

I think how sick he was is starting to kick in, with some comments from the doctors. TJ told me that the doctors -- all of the doctors that have had him -- told him that he should be dead. I've been thinking this for awhile, but wasn't sure it was a good idea to blog it. Well, now I have Md backing.

Specific prayer requests would be for continued progress in recovery and for protection from anxiety as the reality of how close he was to dying sinks in. Also please pray for God's continued work outside of TJ through his experience. And, of course, don't forget praises for a not-dead TJ!

Evening Update Will Be Around 10 CST

Sorry, I know that's a little late...

Monday Update-BIG NEWS on Mitral Valve

Today was both uneventful but exciting. The nurse practitioner from the Pulmonology group said SHE COULD NOT HEAR A MURMUR!!! (murmurs=leakage). I did not see the cardiologist, but in his note he indicated that his only plan right now is to do a TEE as an outpatient to follow up on the mitral valve! It feels like the docs are all being cautious because the evidence was very clear for mitral valve damage that could only be repaired with surgery, and they are not too sure what happened. Keep praying and when the outpatient TEE confirms that healing has happened you will hear us yelling all the way in Hong Kong!

TJ was pretty exhausted today after pushing himself hard yesterday. Pulmonology, Neurology, and I think Cardiology all signed off (meaning they will no longer follow him in the hospital). A Rehab doctor evaluated him for rehab and said that he should be able to move to the rehab floor tomorrow. Most patients spend 5-10 days on the rehab floor to work on strength and activities of daily living. Among other things, he has to be able to do stairs before he can go home. It will be a very intense therapy schedule with PT, OT, and speech for swallowing and complex memory. His goal, of course, is to be home by the end of the week. (What's that quote? "Never underestimate the power of our determination..."?)

TJ will have another video swallowing study tomorrow or Wednesday. He got a diet coke today by mistake- he should not have thin liquids until they know that it all is going down the right pipe. That's OK by me- I really do not want to TJ to experience another pneumonia. However, there is a six pack of diet coke in the fridge next door to his room when he has clearance! He has moved up a step on the diet from pureed to very soft.

He is trying to grasp what has happened to himself. How do you comprehend thousands pf people worldwide praying for you and doctors telling you there is no reasonable explanation for your survival?

Specific prayer requests would be for continued progress in recovery and for protection from anxiety as the reality of how close he was to dying sinks in. Also please pray for God's continued work outside of TJ through his experience.

Blessings and great gratitude,

Mary Ann

Addition to Last Night's Update

I realized this morning that there was a detail I left out, on Saturday TJ was having difficulty using his individual fngers. Grasping a cup took both hands, and it was as if his four fingers were webbed together. Yesterday, he wastoo weak to do much, but had individual control over his fingers.

This is a small thing, but really important. Also, somebody recently asked if apraxia was still on the table. As far as we know, not at this point.

Evening Update

I meant to post this early, I am sorry for the delay.

TJ was up again today, and looked like he had more energy. He got his diet Coke with some ThickenUp, and read portions of the New York Times while sitting in a chair.

His ng tube was finally removed today, as he can swallow thick things (Mary Ann also brought in some real food). Finally, with the aid of a walker and a physical therapist he was able to walk 50 feet and back, which is a big deal.

TJ's personal goal is to be out of the hospital by the end of the week.

So that's the news for the day. Give thanks for the progress, and prayers that it continues!

P.S. For our unknown friends in Lincoln...

Status of the clot

They did a doppler study of both arms on Friday and the left arm is clear but the clot on the right is essentially unchanged so they restarted blood thinner shots again yesterday. TJ is not fond of the pureed food at the hospital. He needs to eat more to exercise his throat for swallowing safely to get the feeding tube out. The tube is really in the way of getting food to his mouth since it goes through the nose and hangs down. I put some Irish stew in the crock pot last night so I can puree that for him and the aroma woke me up- I think it will definitely have a lot more flavor than hospital food! I am also going to make some chicken (which will be pureed) and mashed potatoes and gravy for him. I make awesome chicken, mashed potatoes and gravy. We might just have to have you all over for some when this is all over. I won't even puree it.

Blessings!

Mary Ann

Another Step Forward

The steps going forward still aren't fast, but they are still moving forward.

TJ was tired today, but not in a bad way. He said he couldn't believe how little energy he had. I just explained that this is what happens when someone spends so much time in the hospital, at least in bed and unable to move.

He got the short story of why he was there, from pneumonia, to septic shock, to ARDS, etc., and handled it well. It's not traumatic if you don't remember it, at least not in the usual sense.

On a rather bright note, the doctor said he might be able to go home in as little as a week. I'm not holding my breath yet (I am not sure the statement warranted it) but just to hear something so optimistic was pretty cool.

So that's the news for the day. Give thanks for the progress, and prayers that it continues!

Not Really An Update...

Shortly after writing that we would have more to say, I realized that we really don't.

TJ was at least as awake today as he was yesterday, conversing, and still after a diet Coke they won't let him have.

It will still be a long road to recovery, and as noted, we still have that whole mitral valve bit.

The visitor policy is still limited, we really wore TJ out today.

Thank you all for your prayers, past and continuing, they really carried us through this.

TJ Out of ICU

They just moved him. We'll go for a further report later. He failed the swallow test again, but is allowed to eat things that has a consistency of honey at room temperature.

He is still talking, has had more than enough visitors so he's tired. But heh, life is getting good.

And for anyone counting (me), 32 days in the ICU. We actually got hugs leaving...

Morning phone call

I am going in a little later today but I called his nurse who has taken care of him for a whole 5 days in a row now! She said he slept very well after being up in the chair twice yesterday and is already on his quest for a diet coke. She asked him if drinks a lot of diet coke and he answered, "religiously." A video swallowing study is scheduled for around 11 am where they look at how much of what he swallows goes down the esophagus into the stomach and how much leaks into the trachea and then the lungs. Diet coke does not do much for pneumonia. This leakage is common after a long intubation and the tongue, mouth, and throat muscles are all weakened by the tube itself and lack of use.

Blessings!

Mary Ann

Renewed Request for 24 Hour Prayer for Healing of TJ's Mitral Valve

In talking to the cardiologist recently it appears that the plan for TJ's mitral valve is to wait until he is deemed stable enough for surgery and then go in -cracked sternum-open chest-open heart and replace the valve. The time line could get moved up considerably if for some reason his heart can no longer tolerate the level of leakage. The cardiologists are also somewhat vague on how they define "able to tolerate surgery." They have referenced "well along" in rehab, whatever that means (next week?)

Psalm 5 says:

1 Give ear to my words, O LORD,
consider my sighing.

2 Listen to my cry for help,
my King and my God,
for to you I pray.

3 In the morning, O LORD, you hear my voice;
in the morning I lay my requests before you
and wait in expectation.

With this attitude we would like to request a renewed 24 hour call to prayer (see side post) to pray specifically and expectantly for the healing of TJ's mitral valve. God has done amazing and truly miraculous things in TJ's illness, but he is not finished yet. For the sake of Your kingdom, Your name, and by Your grace we ask and wait expectantly, oh God!

Timeline

There is no real good reason for me to be up right now, but here I am.

I just finished putting together a timeline of TJ's hospital stay, which you can find here. It's hard to say too much about it except so much happened the events in the middle are already fading memories, almost like the shadows of dreams.

TJ Wins

For a guy in his position, he's doing pretty well with politics.

Too bad about the diet Coke...

Can I get a Coke in that Drip? (No, sorry!)

"Who is going to win the Iowa caucus, Hilary or Obama?"

"Obama."

It was kind of a croak, but it was an answer to my question, as TJ watched CNN's endless coverage of the "event."

When I walked in TJ was speaking to our head pastor, as he did when Mr. R N visited, and his brother J and his wife. Oh, and finally -- finally -- the neurologist (I threatened to shoot him if he didn't cooperate!) He really was looking the best since he's been in (31 days), vitals all good (heart rate a little high, but ok), including sats.

Over the three hours I was there (about 3:30 - 6:30) I watched and listened to TJ actually have conversations, including complete sentences. If you recall, three words yesterday were a big deal. For the most part the convesations weren't philosophical, although R N mentioned that he was having to read about phenomenology. As far as I could tell, he also was comprehending everything.

At one point he asked what I was drinking in my mug and I told him coffee, then asked if he was thirsty and he said yes. So I told him I'd try to find something for him to drink and asked if he would like a diet Coke if I could get it; he gave me the thumbs up. I got the PCA to come in with a cup of water, and watched TJ take several large and fast gulps -- until the nurse came in and confiscated the water. Apparently TJ failed his swallowing test this morning (the PCA hadn't gotten that message yet), he is aspirating (inhaling) some of what he swallows still.

I'm not sure how his short term memory is, when I came in I gave him a quick overview of why he was there, mentioning pneumonia, a staph infection, and his heart. When I left I asked him if he remembered why I said he was there and he replied, "bad stuff in the lungs." I asked if he remembered who was there when I came and he didn't know, when I asked if he remembered the person visiting he said yes.

On the other hand, he certainly couldn't forget the offer for diet Coke. When the nurse came in again later he said, "The service here is really bad."

"Are you giving me a hard time?"

"I can't even get a diet Coke!"

When I left the room for a couple minutes he pointed at K and said, "Do you know where to get a diet Coke?" I'm not sure how many times Coke came up in the time I was there, but he was hellbent on getting one. I'll almost be surprised if he doesn't manage to get some by morning (if not, I'm sure we'll all hear about it!)

So that's the news for the day, and the best news of the last month. Give thanks for the progress, and prayers that it continues!

Evening Update Will Be By 9:00 CST

And it has good news. But I am hungry and am going to eat first.

Late morning update

The main infectious disease doctor has not been in for a few days and was very encouraged with TJ's progress. He told TJ that he had "been on the brink" but expects him to recover fully with a lot of rehab. He also commented on the notable heart murmur (mitral valve leak). VS are all looking good. TJ worked more with the speech therapist. He also tried to look at the New York Times. The swallowing study may not be until tomorrow, but that is probably good. When I was working with him with some ice chips today (like 2 chips) it looked like he swallowed but still had some leaking into the "wrong pipe." The staff was about to get him up into the chair again using the lift. Baby steps continue in the right direction and we are very pleased. I have not heard any plans to move him out of ICU yet.

Blessings!

Mary Ann