Only Karl

Most of you know that Karl Hamilton loved people and he loved to laugh. It didn't matter who you were, your background, age, sex – he just flat-out loved people. I think it was because whatever love he gave, it came back to him and then some. Take, for instance, the homeless guy who was in the bed next to Karl when he arrived at the trauma-burn unit at University Hospital Jan. 6. The curtain was always drawn between their beds, but a thin curtain didn't stop Karl from endless hours of chat when no visitors or medical personnel were present. Karl made such an impression that this guy came back twice to visit Karl. We found out later that Karl hid the guy's booze bottle under his bed while he went for a doctor’s visit and that later he and his buddy were kicked out of Karl’s room because they were having a party and were a little too noisy. Only Karl.

And then there were all the friends he made with the nurses and techs in the trauma-burn unit. One guy was going to take him to a Tigers' game when he got out. Another knew Karl from when he worked at the bike shop. Another nurse emailed photos of dogs she rescued and he forwarded the photos on to me and told me the amazing story of how she rescued them from a ditch and that they now belong to a famous Nashville song writer. One of the techs used to work for a company that harvested transplant organs. He told Karl all about it. One early morning as he came in to check Karl's vitals and Karl was sleeping, he awoke and told him not to get any ideas because he was still using his organs. Imagine the laughter that got! And then there was the nurse who spent hours with Karl; he counseled her during the weeks her sister was dying and then after her death. He was the listening ear she needed to get through. Only Karl.

On Feb. 13, Gloria Brooks and Marcia Bohannon planned
to visit. Rather than text them his room number, we decided 
to send them this photo instead.

After we found out the cancer had come back and his right arm/hand had lost nearly all function due to the tumor on his C-spine and that the surgery to remove the tumor was unsuccessful, his new nurse on the neuro floor was his newest victim. She had him for only four 12-hour shifts during what would be the last week of his life, yet he still played pranks and in that short time he had her wrapped in his love and laughter. She was there for some of his most excruciatingly painful times – both emotionally and physically – and yet she felt better for having met him. For example, she talked to him one day about going to a sub-acute rehab facility. His answer? He started singing the Amy Winehouse song: “They wanted me to go to rehab, but I said, a no, no, noooo.” Later she was flushing his IV while he was napping. His eyes opened, he feigned gasping breaths and then he turned to the side with his tongue hanging out, pretending he had expired. She let him have it…told him she’d kill him if he ever did that again, and then apologized to us because she was never that unprofessional. Of course we were laughing. No apologies needed. Only Karl.

God works in mysterious and miraculous ways. At the time of Karl’s seizure – one month ago today, in fact – and the day he found out he had run out of time, our dear friend Marcy was there. She had just gotten off her shift and came to visit. God’s timing was amazing and I’m so thankful He chose Marcy to be there when that happened. I'm so glad he wasn't alone. Before we arrived at the hospital, Karl had received the news. When we got there, Marcy was in the bed with him; they were holding each other, whispering “I love you” to one another, crying, laughing and just loving one another. Only Karl.

Karl’s surgeon, Dr. Orringer, who had the horrible task of telling us what was happening, met us in the hallway. Cousin Trese, who also works at the U, told us later that cases are usually delegated to other doctors who then report back to the head surgeon. But because of Trese's connection and because Karl was who he was, Dr. Orringer was there. Little could be done. So between Trese, Marcy, the chaplain, Mom and me, we had to figure out whether to keep Karl comfortable or to put a ventric in that would give him some time for goodbyes. Then it dawned on me; my husband Randy was in the room with Karl, comforting him and talking/laughing/crying. Randy is always so objective. He’d know what to do. And so as I entered, Randy said he knew what we were going to ask and that Karl was lucid and could make his own decisions. Karl chose to be able to say goodbye. How courageous. How selfless. Only Karl.

Brother Kirk had already scheduled a flight to come home and say goodbye, thanks to Wally and Wendy Burr, but when I asked who else Karl would like me to call, he told me a few names. I emailed others. Between Friday afternoon and Saturday night, more than 100 people – childhood, high school, college, work and hometown friends, a legion of nurses and techs from the trauma-burn unit, his neuro nurse of four days, and family – all came to say goodbye. There were so many people coming to see Karl, that the front desk at University Hospital where there’s a capacity of almost 1,000 patients, made maps to his room. Only Karl!

One of his visitors on his final full day, Jen, got this final

photo with Karl. Thanks for the great last photo, Jen.

Generally intensive care units at hospitals like peace and quiet so that patients can rest, but the people in the neuro ICU at U-M were very understanding and encouraged us to keep folks coming. Karl’s vitals were always better when people were with him. Lot’s of laughter filled Karl’s room…like when Karl’s high school buddy Butch told Karl he looked “like shit.” And then another high school chum Charley chimed in, “I've seen him look worse.” A nurse who admitted she was an Ohio State graduate (what was she thinking? She was at U-M!), was emptying his foley catheter. Another friend said, “that’s a high-skilled job at OSU, isn't it?” Karl doubled over with laughter. He thanked everyone for coming. His kissed hands and cheeks and lips. He cried. He grimaced with pain. He told some he’d be okay. He told others he didn't want to die. He told others he wasn't afraid. He told people to drive safely. He told others he’d prepare a place for them. He made people promise they’d do better. He told people to focus. He told kids he’d watch over them. He told EVERYONE he loved them. Only Karl.

And then around midnight, Karl announced to Kirk that he was going to die. About 2 a.m. his vitals started lowering dramatically. He was in a great deal of pain so they started an IV drip of morphine. Around 3 a.m., Randy, Michelle and I headed to the hospital. Nikki stayed with Mom and was later joined by Marcy and Carol Partridge. We were met at the hospital by our family: Trese, Steve, Steven, Joe and Emily Kampmueller, Katie and Jeremy Castorena, and later by friends Rodney and Terri Partridge. As the shifts changed around 7 a.m., the nurse who was leaving grabbed me by the shoulders and told me she had never seen such an amazing display of love. Only Karl.

Later that morning Dr. Orringer came specifically to tell us how sorry he was. He gave everyone hugs, told us he wished he could have done something – anything – to have helped Karl. Apparently this is not the norm for him, but some how, some way, Karl broke through that emotional barrier I’m sure all medical professionals have to build in order to survive.

Around 10:30, Karl’s breaths were shallower, fewer and farer between. We all gathered around his bed. We urged him to go. We all gave him permission. We all told him we loved him. We told him to grab Dad’s hand, to grab Jesus’ hand. When many seconds had passed between breaths I said, “I think our boy is gone.” Then he took another short breath, and I said, “Well, I guess he’s got one more lap.” We all laughed. And guess what? Karl took his last breath in the moment we were all joined together in laughter and love. Only Karl.

Blessings and love.

Mom and I were among seven women in an ecumenical Christian clown group called the Clown Connection. We’d pantomime skits that had fun, but meaningful Christian messages or they’d tell a Bible story. We’d always end our gigs with the prayer below. I think it’s a pretty appropriate prayer for Karl, too.

The Clown Prayer

As I stumble through this life,

Help me to create more laughter than tears,

Dispense more happiness than gloom

Spread more cheer than despair.

NEVER let me become so indifferent

That I will fail to see the wonder

In the eyes of a child

Or the twinkle in the eyes of the aged.

NEVER let me forget that my total effort

Is to cheer people, make them happy

And forget, at least momentarily,

All the unpleasantness in their lives.

AND, in my final moment,

May I hear you whisper…

“When you made my people smile,

You made me smile!”

The final climb

Many of you already know that Karl reached the summit on Sunday, Feb. 24, 2013 at 10:45 a.m. at University Hospital in Ann Arbor. But I know many of you want to know about Karl's final, turbulent climb. What really happened? This post will be a matter-of-fact one. I'll get into the unbelievable, amazing, beautiful stuff about Karl's last days (and post-death) in a subsequent post. Karl continued to amaze people until the very end. He was so courageous. His obituary can be found at http://www.handlerfuneralhomes.com/fh/obituaries/obituary.cfm?o_id=1988686&fh_id=14562

I'll try, to the best of my ability, to give you these events in chronological order. This is tough, but therapeutic

September 2012 -- After a great summer, that included swimming and taking a few steps, Karl starts to notice his legs aren't moving as well and are becoming more numb. He relies on the little bit of feeling and strength he has in them to transfer from chair to chair and in one case, to stand up and take three steps to and from a pontoon boat.

October 2012 -- Karl thinks perhaps the reason he is beginning to lose strength is because some of the hardware in his back is broken. A CT scan or MRI, not sure which, reveals that the hardware was still good, but no cancer appeared on the scans so Karl decides to buy a toy hauler, convert it into a wheelchair-accessible camper so he can go on the annual hunting trip -- which he had missed the four previous years -- with his buddies.

November/December 2012 -- Karl has lost all feeling and strength in his legs. His oncologist at U-M is concerned and contacts his surgeon at Mayo, Dr. Yaszemski. Dr. Y calls Karl on Christmas Eve and tells him to have a good holiday, but he'd like to get to the bottom of the issues and tells him he wants him to have an MRI, among other images. They will schedule it for after the new year.

Jan. 3, 2013 -- Karl starts off for Ann Arbor to get images. It is in the single digits temperature-wise. The door on his van won't close (it usually closes after going about 500 yards, but this time it doesn't). He comes back home and tries to start the other van. It won't work. By this time, he is freezing cold and comes inside. Mom starts to see the same symptoms Karl had when he had the pneumonia in 2010. She wants to get him as warm as possible as quickly as possible so she gets him in bed and puts a heating pad under his stocking feet because they are icy cold. She checks on his feet periodically and is satisfied that Karl is warming up and he begins to act normal again.

Jan. 5, 2013 -- Because Karl can't feel his feet and Mom's only thought was to get him warm, the heating pad was left on for hours. When Karl takes his socks off, well, let's just say it wasn't good. So Karl and Mom head up to Herrick Hospital. They think maybe it's frostbite because of how cold Karl's feet had gotten. The folks at Herrick decide it's a burn and tell him to go to U-M. We arrive at 10:30 p.m. After checking him out they decide they want to admit him because of the burns.

Jan. 6, 2013 -- At 4:30 a.m. Karl finally arrives at his room in the trauma burn unit.

January 2013 -- Throughout the month they take excellent care of Karl, debriding his burns, etc. In the meantime, he finally gets the MRI he was supposed to have on Jan. 3. It reveals a "mass" lower down near his spine along with one in the area he already had radiated. Dr. Scheutze tells Karl that if the mass in the area already radiated is cancer, there is little that can be done. However, the other mass further down can be zapped. That was a bitter pill to swallow. However, later on Dr. Scheutze talks with Dr. Yaszemski who thinks the mass of greatest concern is probably scar tissue and is likely the cause of the loss of function. Collective sigh of relief. In the meantime, a decubitous ulcer on his bum begins burrowing all the way to the metal in his back, AGAIN. We've dealt with that before. No big deal. We are told Karl will be released so Mom gets a Hoyer lift so he can get in and out of his bed/shower without irritating the decube.

Early February 2013 -- They continue to debride the burns on Karl's heals, which sometimes require them to take Karl to the operating room. At one point, doctors tell us that the wounds are so deep, the bone in his heal is nearly exposed and that if it doesn't get better, they would have to amputate. The way to grow healthy tissue is by eating massive amounts of protein. You can only imagine the copious amounts of meat, protein shakes, etc. Karl consumed. He didn't want to lose his feet. He can't go home because of the wound vacuum they put in each heel.

Feb. 10th (ish), 2013 -- After one of these debriding surgeries, in which they lay Karl face down to do the actual procedure, he begins complaining of severe neck pain. We thought it was a charlie horse. Then the pain spread to his right arm and his finger-tips and thumb start getting numb. Then he loses strength in his right arm. His blood pressure and heart-rate become erratic and he develops a low-grade fever. They transfer him to the trauma-burn ICU. They decide to do an MRI with dye on his neck. It reveals lots of small masses and a larger one, about 2 cm, on his C-spine, C-4 to be exact. They also tell us there are cancer cells everywhere; his brain "lit up." They figure it is metastatic cancer, but until they do a biopsy, they won't know for sure. We are all devastated. They think they can "peel" off the mass, which will not restore function, but it will stop it from getting worse. They tell us if it is metastatic cancer, he can have chemotherapy and radiation. New hope.

Feb. 13, 2013 -- Karl is scheduled for surgery, but they can't fit him in. They reschedule it for Friday, Feb. 15. First case.

Feb. 15, 2013 -- 8 a.m.: Karl is taken from pre-op to surgery. They tell us it will probably be two hours before they begin the operation, which should last about 6 hours, but will let us know how surgery progresses. At 10 a.m. we are told the surgery has begun. At 11:30 we are told they are doing a biopsy. At noon we receive another call saying they were closing. We are, again, devastated. We know what that means. About an hour later, Dr. Orringer, Karl's surgeon, tells us that the preliminary biopsy revealed it was malignant nerve sheath sarcoma and that the tumor they were trying to remove was intertwined with his vertebrae and spinal column. He tells us they removed some of it to give Karl some relief but would endanger his life if he removed any more. He tells us there is no cure. Karl is moved to neuro ICU and is his usual happy self. I tell him the outcome of his surgery and his reply? "Well, that sucks." A nurse approaches me and talks about palliative care. I know what this means, but choose not to mention it to Mom or Karl. None of the doctors approach me about it.

Feb. 18-20, 2013 -- Karl is transferred to the regular neuro floor. I approach his nurse about palliative care. She said there has been talk, but that nothing is definitive. Karl has numerous doctors come in and out of his room. One radiologist tell Karl nothing can be done. Devastation. An hour later, the head of the department tells Karl they can shrink the tumors and perhaps even make them disappear. Hope again. One morning a resident comes in to talk to Karl. He is alone. She tells him to get his affairs in order. He is devastated. I am ANGRY! Later as it turns out, I am complaining to a resident about the situation. I tell her a tactless, moronic resident with no bedside manner, and the compassion of a serial killer came it and told Karl, without a shred of empathy and without any family present for support, to get his affairs in order. After she left, Karl told me it was her! I wonder if she got the message. Then a discharge planner comes in and tells Mom that Karl is ready for discharge to a sub-acute unit. They want him to gain strength so he can handle the radiation. However, she says there are no beds available and asks Mom if she can handle him at home. We are baffled by this.

Feb. 21, 2013 -- I tell the discharge planner I don't think Karl is ready to come home nor is Mom able to take care of him in his present state. At 5 p.m. Dr. Scheutze comes into the room. He tells us they still don't have the final pathology report, but that it is, indeed, metastatic cancer. He said they are unable to do chemo. He thought a seed cell got into the spinal fluid and it "took off." He said he'd never seen anything like it. I ask how many tumors and he replies, "Many." I ask how long. He tells us it depends on whether it's slow-growing or fast-growing. He tells us if it's fast-growing, it may be a month or two. If it's slow-growing, which he thinks it is, it would depend upon how Karl responded to the radiation. Again, devastation. But it typical Karl fashion, he decides he wants to get strong enough to go back out to Mayo to see what Dr. Yaszemski has to say. We agreed.

Feb. 22, 2013 -- I get a call about 6:30 a.m. from my friend Marcy who works at the U. She had just gotten off her shift and was visiting him. As she was about to leave, Karl had severe head pain and then a "staring seizure." Doctors decide to take him to get a CT scan. It revealed there was fluid in his brain. En route to the hospital, doctors called to tell me there was a serious change of condition for Karl. Upon arrival, Dr. Orringer is there to greet us. He tells us (by that time, "us" was Mom, Randy, Marcy, cousin Trese [who also works there], the chaplain and me) that there was little that could be done for Karl. He has hydrocephalus caused by cancer cells clogging the ability for his brain to drain. Normally, they are able to put a shunt that drains into the body, but because Karl has an open wound, they can't do that; he'd get Meningitus which would cause excruciating, uncontrollable pain. The other two options are to make him comfortable and he'd pass within 24 to 48 hours or put a smaller drain in, which would give him 48 to 72 hours. Karl was very lucid and chose to be able to say goodbye.

After countless visitors on Feb. 22 and 23rd, he announced at about midnight on the 24th to my brother Kirk that he was going to die. At 10:45 a.m., surrounded by family and two of his best friends, Karl took his last breath. And we were all laughing when he did. Can you think of a better way for Karl to go to heaven?

My next post, when I get the strength and time, will be about all the amazing things that happened while Karl was in the hospital and after his death. What an amazing dude.

Blessings and love,

Kerry

Love Lifts Us Up Where We Belong

Joe Cocker sings Feeling Alright, which are about the only words in the song that I can understand. Joe also sings With a Little Help From My Friends. Same thing. I can discern "I get by," which, of course precedes the song title. Most of the rest of his song lyrics sound something like "Omm nottfeeellintoo oood mnmniselv." You know what I'm talking about. Kinda like Ozzy Osbourne only a little easier to understand with less screaming.

The important words, "feeling alright" and "I get by with a little help from my friends," describe how Karl's doing right now. Each day he's been traveling to Herrick Medical Center where he's receiving his antibiotic infusions and making friends with the nurses and staff there. The daily trips are making him stronger because he has to get in and out of his wheelchair. During the so-called blizzard last week, Mom and Karl stayed with Randy and me so he could get to the hospital. We were afraid their country road would be drifted shut, which it was.

Last week we met with Dr. Scheutze whose medical assistant removed the stitches in his long incision. The shorter one has a small amount of fluid leaking, which they think is because he's been stretching and perhaps tearing the stitches a bit. Karl's getting a CT scan Wednesday and we will meet with Dr. Scheutze again on Thursday to see how it's healing.

Dr. Winder from Mayo called Karl to see how things were going. He said the nurses and staff there were asking about him. Of course we've been wondering about everyone there as well, namely Joline and Elizabeth. We hope all is well! Just remember what Joe Cocker sings, "Loveliftsusupwherrrre we beelong."

Blessings,

Kerry

Willie Nelson's Got Nothing On Us

On the road again, just can't wait to get on the road again...

If all goes as planned, we'll be on the road late tomorrow morning after Karl meets with the physical therapists to discuss what he needs in terms of a seat and a new power chair. We've had a flurry of activities the past few days. Karl's had his rear mapped and has been getting out of bed to build strength as well as giving all the nurses a rough time. Mom and I have been packing and she's been learning how to take care of Karl's wound. Stitches are due to come out on Monday.

Dr. Yaszemski, or should I say Gen. Yaszemski, left yesterday for a two-week stint with his Air Force group. Before he left, he told Karl what he thought about his condition: he hopes the infection can be controlled with the antibiotics and he has prescribed Karl eight weeks of daptomycin and another antibiotic I can't remember. If he can't tolerate that, they cut it back to six weeks. He will go every day to Bixby to get these drugs. We are trying to change that to Herrick, and if that doesn't work, perhaps Saline. After the IV infusions, he will go on oral antibiotics. We pray no new dicubitus ulcers form. If they do, Karl will have to come back for surgery to remove the hardware. We truly hope that doesn't happen because that could mean a very long stay for Karl.

Karl's physical therapists think some of the metal in his back is digging into the muscles in his rear when he sits. We agree. And when he transfers from uneven surfaces he sometimes lands with force on his bum. So he also has to work on building up his strength. The therapists have advised us to have Karl fitted at Mayo (since they are about the only hospital in the world that does this kind of surgery). Of course we want to be sure he gets the appropriate power chair that fits him best to prevent further injuries and ulcers. This process will take about eight weeks and since Dr. Y wants to see Karl in April, we figured it makes sense for Karl to get fit here in Rochester.

In terms of Karl's overall health, his heart rate is still a bit high, but his blood pressure is normal. His kidneys are the best they have been in over a year (creatinine was 1.9 today!). His INR (blood thickness) needs work and he'll be giving himself heparin injections until he gets that in check. His hemoglobin is still low, but higher than it's been in quite some time. His heels have healed significantly with the new boots in which he's styling. The Rooke boots, designed by Dr. Rook, a Mayo physician, look like mukluks. Karl said they are very comfortable.

Anyway, we are hoping to be home sometime tomorrow (Thursday) night and we are all looking forward to being home. Thank you all for your prayers and good wishes. Oh, by the way, Karl's neighbor, Joline, is doing much better. I have absolutely no doubt that your prayers helped her turn the corner. Today I walked by her room and saw her chatting on the phone.

Blessings,

Kerry

Holding pattern

Dr. Yaszemski came in bright and early today to tell Karl he wanted him to stay in his Clinitron bed to heal. The large amount of steroids Karl is on causes him to heal a little more slowly than most. The steroids are also the reason Karl's skin breaks down so easily when stressed. The internal medicine doctors think the added stress on his body is causing his heart rate to jump. To counter that, they've given him more steroids and a bolus of fluid. It's a Catch 22. Even with that, Dr. Y feels Karl's incisions are healing well and he said he'd like to try to get him out of here by the end of the week. Yay!

Dr. Y also told Karl he is not concerned about the new bug (staph coagulen negative) they found. In fact, he thinks it may be a contaminated sample because it grew on only one of four cultures they took and it also started growing well after the enterococius (strep) they feel is the major culprit. When they discharge Karl, he will probably need 6-8 weeks of daily IV antibiotic therapy, which brings us to other challenges the staff is working on.

Medicare will not pay for at-home IV therapy. They WILL pay for IV therapy at a hospital. This makes little sense. It's neither cost-effective for Medicare (nor you and I as tax payers) nor convenient for Karl. Daily trips to Herrick for the next 6-8 weeks will probably not be good for his rear end, but he'll do what he has to do. Another issue is Karl's special bed and mattress, which provides Karl constant air movement and pressure relief. The problem is, Medicare mandates that Karl have a stage IV pressure ulcer (to the bone/metal) in order for him to keep it for more than three months. They apparently are not thinking of prevention.

So Kelly, the unit CNS, is going to draft a letter to Medicare asking them to make an exception with all of the reasons mentioned above, plus all the medical jargon explaining Karl's situation. She will then run it by Dr. Y and he will sign, hopefully as Assistant to the Assistant US Surgeon General, Air Force Brigadier General and Mayo Surgeon. It's so good to have him on our side.

Now for a special prayer request: Karl's neighbor in the room next door, Jolene, a 31-year-old mother of two, who is also a patient of Dr. Schuetze's in Michigan and who had a hemi-pelvectomy recently, isn't doing so well. If you could send a few prayers up for her, we'd all surely appreciate it.

I'll let you know as soon as we know anything.

Love and blessings,

Kerry

Bugs

We finally have some results to share with regard to the deep tissue cultures they took from the hardware in Karl's back on Monday. On Wednesday Dr. Yaszemski told us there was, indeed, some bacterial growth. We were not thrilled by the news. But on Thursday the infectious disease folks told us they could get rid of most of the bug with intravenous antibiotics and then keep it under control with oral antibiotics. He would have to undergo another four weeks of I.V. antibiotics at home and then would continue on pills.

Karl's labs are better than they've been in almost a year. Doctors are thinking Karl doesn't produce enough of the protein albumin. Albumin helps the body to absorb fluid and may be why he constantly needs a bolus of I.V. fluid to up his volume. They are going to study that further and may be able to improve those levels with a supplement of some sort. We were also told Karl needs a new Roho cushion and power chair so that the skin on his rear doesn't break down as easily. His backside will be mapped on Monday to figure out the pressure points. After that and if no other culture grows, we could be looking at Tuesday or Wednesday for a discharge date.

Today, however, the infectious disease doctors reported that they, unfortunately, found another type of bacteria. It is a slow-growing bug and I.V. antibiotics are effective, but there are no pills to keep it under control. We don't know what exactly Dr. Yaszemski will recommend. We're pretty sure he wants to avoid taking out the hardware because that's major surgery. And if Karl can't get along without the hardware, it will require another surgery to put it back in and at least a month or two of hospitalization to recuperate.

Dr. Y is gone until Monday. We know whatever he decides will be in Karl's best interest. When we find out, I'll let you know.

Blessings,
Kerry

Surgery day

Today Karl got wheeled down to surgery about 11:30 local time. Soon after he left, Mom and I went to the Canadian Honker for lunch. We don't know what time he got into surgery, but we know as of 2 p.m. CST his surgery was in progress. He was upbeat and confident all would go well.

Dr. Yaszemski stopped in yesterday and said they would take out the metal if it was at all loose. If it is loose, and Dr. Y thinks it is based on CT scan images, that means Karl isn't using the hardware and that means it has a good probability it won't have to be replaced. We are all in agreement that that's the case.

Anyway, I'll let you know when I know more. Until then, here's a photo of Karl taken this morning just before he was wheeled down. Thumb's up!!

3:30 p.m. CST: Just got back from a visit on the 1st floor with Dr.Yaszemski. He said Karl is just fine and is awake in the recovery room. In fact, he just gave Dr. Y thumb's up. Dr. Y said everything went fine. He checked all areas for pockets of infection but couldn't find any. He tugged on the hardware to see if it was loose, but it wasn't, so he left it intact. They took deep tissue cultures and decided the wound was caused from outside in rather than inside out. They cleaned up some of the bad tissue, found and removed the gauze (about 4 inches worth) and then sewed him up. He should be back in his room by 4:15.

Thank you all so much for your prayers and good thoughts. We still aren't done here, but we are a little closer to getting the answers we need.

Blessings,

Kerry



Just in case

I don't know about you, but there are times when the right words for a prayer escape me. But last night's blog Post triggered a response from a long-time friend who ALWAYS seems to have just the right words. If you're in need of a prayer that addresses Karl's needs, Cathy Jenkins wrote the prayer below that hits the nail on the head.

I am praying for Karl, and I pray in the NAME of JESUS, that the doctors will find the infection, get it cleared, once and for all. That the kidneys, the heart, and all chemicals, cells, tissues, organs, and body systems line up with the WORD of GOD that says... "HE sent forth HIS WORD, and healed him, and delivered him from all destructions, rescued him from the grave, and makes all bitter expericences sweet."

I agree that Karl can live normally with no hardware, and that his body returns to good health. I agree his surgeries all go well, with no infections, inflammations, blockages, or any pain or further problems in JESUS' NAME. Amen, and Amen!!!!!

Indeed, Amen and AMEN!

Exploring options/Preemptive prayers

We just found out Karl will have surgery on Monday to debride and wash the decubitus ulcer, take out the gauze that's stuck in there, check out the wound more thoroughly, and take deep tissue cultures to pinpoint the cause of the infection. He will likely be the second case of the day, which means surgery will begin late morning or early afternoon.

Dr. Winder, who is Dr. Yaszemski's resident this quarter, told us the surgery would take approximately two hours and would help them determine the type of antibiotics needed to defeat the infection as well as how to proceed with the hardware removal. Plastic surgeon Dr. Mardini (who worked on Karl in 2008) and Dr. Y will be present.

Karl was taken off his current antibiotics to allow cultures to grow and received a liter of fluid last night to bring his heart rate down, his blood pressure up and his creatinine levels more in line. His creatinine was just a bit high and they want to keep Karl as close to normal as possible so that surgery will go smoothly. He also got a new pair of Rooke vascular boots that will hopefully help the tissue on his heels to heal quickly.

His nurses and therapists keep filtering in to say hello as they get the news that he's back. They offer him words of encouragement, knowing that our prayer is that he can function without the need for hardware in his back. It would solve so many problems, we think. So, if you need something specific for which to pray, ask God that Karl's surgery on Monday reveal the information his doctors are seeking, that the wound be completely cleaned, and that everything goes smoothly. And then if you want, it probably wouldn't hurt to send up a prayer or two asking that Karl's next surgery go well, too, and that his body supports his weight without the need for hardware. Call it a preemptive prayer if you like, but every little prayer will help!

Have a wonderful weekend! I sure hope it's warmer where you are (the high tomorrow will be 4 degrees).

Blessings, Kerry

Happy New Year! Getting to the "bottom" of it (heheheh)

If someone had asked what we hoped the new year would bring, we'd all say, "Good health for Karl," right? Well, we're hoping we took a step in the right direction by bringing him out to beautiful, sunshiny, incredibly cold, Rochester, Minnesota, home of the Mayo Clinic.

Today we met with Karl's orthopedic surgeon, Dr. Yazsemski who, we hope, will figure out why Karl continues to get deep, decubitus ulcers that run from the surface of his rear all the way to the hardware in his spine. The first ulcer, you may recall, was "fixed" during a trip to Mayo in August/September. A new surface ulcer appeared soon after Karl made a trip back out to Mayo over the Thanksgiving holiday to have a suspect mass on his kidney oblated. (All is well in terms of masses/tumors/cancer stuff, by the way). Early in December our dear friend, or should I say, angel, Gloria Brooks came out and suggested we have a doctor look at the ulcer as it seemed to be tunneling a bit.

Because Karl's oncologist, Dr. Schuetze, is so wonderful, he agreed to be Karl's primary care doc/quarterback. He kindly ordered home care and after an initial assessment, it was decided Karl needed physical therapy and visits twice weekly by home care nurses. On the first visit by the home care nurse, she discovered that Karl's wound had gotten dangerously deep. During that visit, a piece of gauze used to pack the wound became entagled in a screw or piece of hardware in Karl's back. That was on Dec. 23. Taking no chances, we went to the emergency room at U-M where they said Karl needed to have all the hardware in his back removed because it was causing continued infections, which would never ever go away. They said surgery wasn't needed immediately and told Karl to go home and enjoy Christmas, which, by the way, we did!

Karl decided he would rather have the doctors who put in the hardware assess the situation and so a call was made to Dr. Yazsemski. The response, as usual, was, "When can you get here?"

Today Dr. Y's first question was, "Is it easier for you to be in the hospital or at your hotel room for lots of tests?" That was an easy answer. And all the folks up here on the 8th floor are giving Karl the welcome and smiles he always gets. I guess if we can't be home with our family and friends, it sure is nice to be where we know Karl's going to get fantastic care and true concern.

So, what's to come? At the very least we know the gauze has to come out, but we don't know how much is there or where it is. So Karl will get a CT scan, perhaps even tonight. After running tests to pinpoint the source of mild infection, Dr. Y will consider ways to treat it. He said he suspects surgery will be on the horizon. He thought that it probably was the hardware causing the problem and said he'd probably take it out. Then he'd wait to see how Karl did without it. In this case, Karl relies on the structure to help him transfer from bed to chair, etc. After a week or two, if Karl can't live without the structure, Dr. Y will put it back in.

Dr. Y wondered how long we had planned to be in Rochester. We told him we were here as long as it took to get the problem solved. He said, "Good. Everything's worked well for Karl so far, but now it's time to make some adjustments."

How long will Karl be here? We don't know, but we do know that we're in the right place and 2011 promises to be a whole lot better than 2010! Thanks for your continued prayers.

Blessings,

Kerry