LITTLE UPDATE

Rick is continuing rehab at a great pace. He's feeling well and is anxious to come home. We should learn by Monday, when his surgeon returns, when that will be. In the meantime, he's on the move and trying to keep active. Germany has a holiday tomorrow, Friday, May Day, which they celebrate much like our Memorial day. It will be a quiet day tomorrow for Rick with no classes, but he's certain to take a few trips into town to keep up with the exercise.

God continues to bless us daily.

Love, Polly

DETAILS FROM RICK AND JULIE

Walked to Kaufland(similar to Walmart) and back today, then to Husan's by the pension and back again. He's done all of his exercises and then some and overall says he feels good.

Dr. Rolle was going to inject dextrose into the lung prior to pulling the chest tube, but decided against it and as we know pulled the chest tube. Not sure why the decision against this was made because of the language barrier, but we just have to trust in Dr. Rolle's decisions. Rick had a question about this which no one could understand or answer, again because of the language barrier, and next thing he knew, they came in with the cart and pulled the chest tube.

He's glad to have that out and says the pain is much better now and he's sleeping much better as well.

Ivan emailed and said he experienced this same thing with his first surgery as his chest tube wasn't draining well. He said just delays things a bit, but does resolve and all should be fine. It's always good to hear from someone who's travelled this road before.

GOING TO TOWN

Rick walked into the town of Coswig today which is 1.3 miles total there and back. He had no complications, shortness of breath or other difficulties. He told me that he felt "good". Tomorrow, he may be allowed to ride the exercise bike. Rick feels capable and ready. :) These are terrific progress markers. Thinking back over the journal I kept, the strides in such a limited time are amazing. Of course, anyone who knows Rick, realizes he has great stamina and drive. Nothing gets in the way of the goal. These qualities have carried him through this surgery like a champ. Of course, we know God was carrying him.

Madeline and Julie have settled in nicely. Julie has not had too much jet lag and has jumped back into her routine. All of us continue to be blessed over and over for those of you who are caring for us. I repeat over and over to those extending their helping hands that we would do it for you too....no questions, no hesitation. There is that old song by James Taylor that has "just call out my name and you know wherever I am, I'll come running.......". This is our mantra and we mean it.

Giving thanks to God for the mercy and grace he continues to show us through you.

Love,
Polly

Shorty Post

Just got off the phone with Rick. Julie is on her way home and will arrive in Chicago around 3 p.m. Rick's chest tube is out now. He is happy about that. We will wait for a few days and then make travel plans for Rick's homecoming!!

Thanks for everyone who is posting and also for all of those helping to keep their lives in order while they are away. We could not have done this without all of you. Really.

One doesn't have to look too far to see God's hand everywhere.

Love,
Polly

ANOTHER LEG OF THE TRIP

Rick's post-

Due to the difficulty in communication, I am limited to the most updated information as things happen day by day. Removal of the last remaining chest tube has been challenging. The upper right lobe continues to be a little deflated even after all of the hard work I've been doing. I will continue with this. I've had the tube removed a few cms twice, but suction remains on as I sit in my hospital room writing this on paper for Julie to copy later, for Polly to copy to the blog. Sleeping is difficult because of the chest tube and pivot points of the ribs that were spread during surgery. Fortunately, yesterday and today I was able to walk outside with my friend the pole/suction machine. :( The temperature was around 70 degrees, sunny. One of my most difficult tasks so far is learning to be a patient patient. Did I mention I can't wait to get the chest tube out and get rid of this pole? After this I can then start planning my return home, to my wonderful life that I have been plucked out of. This is a very nice place, people are wonderful, and my care is fantastic, but it's not home and very foreign. We are here with other families from the United States having the same procedure, so that has been helpful in passing the time for all of us.

From Julie- I am returning tomorrow, Monday. Wish Rick was coming too or at least that the chest tube was out so that we could start planning for his return. Guess it was not to be. Had a lovely tour of Dresden today with a family here who we've met through a mutual friend back home. Such good people! Thank you all for your prayers and well wishes for Rick and our family. We feel the support and so appreciate it. Please continue to pray for Rick's recovery and health and if I can ask, my safe travels as I am coming alone and feel a bit apprehensive.

A MINOR GLITCH

Rick has a small pneumothorax(minor deflation of his lung/ not symptomatic just found on daily chest Xray) which has prevented the last chest tube from being removed. He's hooked back up to suction and there really isn't any drainage in the chest tube. Not a big deal but more time to wait. The restless bug has set in. The staples are all out and the incision is open to air. Nice and clean and dry.

Rick is otherwise feeling well. He has traveled the driveway in front of the hospital which leads to the main road and around the grounds which are a park like setting several times today. If you look at the photos in prior posts which show landscape, those pics are directly out of his hospital window. Go straight out about 1/4 of a mile and you get to the main road. That's the driveway he has walked. Great progress!!

Julie continues to be Rick's rock and stays close to his side all the time. Dave has made a few new friends while in Germany and has seen some of the sights in between visits with Rick. Both Julie and Rick can't wait to be home again. We all have felt that the care has been outstanding.

I am posting a photo of Madeline I took today out in the rain standing in our bog. The background is the horse pasture(very muddy). She has been fabulous here and we have been so blessed to have her. Thanks again for all of the posts. Rick and Julie have been enjoying reading them.

God is faithful.

Love,
Polly

LONG DAYS

With Rick feeling quite well physically, these days are especially long. The only thing that remains is the one chest tube and hopefully, it will be pulled tomorrow. They are very careful that the chest tube removal is timed perfectly. For the patient's health that is great, for the morale, not so good. :( It's so boring.

We are coordinating the tumor profiling here in the United States. That is going along smoothly. It is a tricky process that if we didn't have help(thanks Fernette), we would never have even known about this. Drs. Fernette and Brock Eide have been this pathway before and have paved the way for those of us who are new to tumor profiling. They also are heavily involved with the development of gifted children. Today, Fernette, e-mailed me about their webinar program. It sounds so interesting and will greatly benefit children all of the world. I am posting a description for you below:

Our Gifted Online Conferences - Day 1:Understanding Gifted Children, Day 2: Gifted with Dyslexia / Gifted with Writing Challenges, Day 3: Attention, Sensory Processing, and Social problems of Gifted Children -If you know anyone with a child who might benefit - if they register for the conference, they can listen to recordings of the conference(audio + Powerpoints + text-based discussion) - still for the next 3weeks - and we will make a DVD out of it and heavily discount it toanyone who registered for the conference. If you know someone who might benefit, pass the word along - you can registerhere: http://www.karinasfund.blogspot.com

What a blessing to us to be able to pass this information along to all of you. Stay tuned. Rick promised me a personal post for later.

Love,
Polly

FROM RICK HIMSELF

Pölly,

Please post on the blog. Thank you to everyone who has posted on the blog. I am doing pretty well and it is a real treat to have Julie here with me. I do have one chest tube remaining and I had a small air leak that seems to have resolved for the moment. If all goes well there has been talk of my getting the chest tube hooked to a bag today and the possibility of getting the central line removed. This would help me be more mobile and able to get around with ease. I am now attending rehab classes and continuing with the breathing therapies have been part of my rehab routine.

Communication has been very limited for me and continues to be challenging. I spoke to Madeline only twice since I have been here. The first time our conversation was shortened as we were cut off. The second time we had a very bad connection and could hardly hear each other. I think all of the incomming land lines that are here are just so very old and the cost of cellular communication is too great. It feels good to be able to communicate in any way that I can. Thank all of you so much.

Rick

From Julie:
Dr. Rolle told Rick that he is called the "patient" for a reason, to be patient.

Julie's Update from Germany

- Rick does not have the LC condition(LC is a condition called lymphoangio......./not good for prognosis and was a consideration when viewing the CT by Dr. Rolle in Germany/we were all freaked out by even the thought), milky white substance is a result of chemo, should resolve over time, Rolle says this is very important info. He didn't say, but I think this would make him a candidate now for the other side to be done as the LC would indicate widespread cancer over the entire lung, which is not the case

- Line in neck will be removed tomorrow, switching to oral pain meds

- Suction will be turned off, they will switch to a bag to hold the lung fluid, no longer attached to the pole which will improve mobility

- Working on snap freeze at the university, they are doing this special for us, currently only done for kidney cancer study. Will follow up

- Paraffin has not been sent, we have these, Rolle feels it's better to bring home and then send.

-Incentive spirometer up to 4000

God is good all the time.

UP AND ABOUT

I just got off the phone with Julie. Rick is up and about freely now and may have his central line out today. In addition, every other staple is being removed today. They have walked through the park which is right outside the hospital and we are awaiting the results of the chest x-ray. They have videotaped the surgery and Rick will bring that back to the United States. This is standard practice with Dr. Professor Rolle.

Rick will have Respiratory Physiology and Respiratory Gymnastics(PT) again this afternoon. Several of the nursing staff and auxillary staff speak English well so the language barrier isn't overwhelming. Rick is giving this his all has recovered nicely thus far.

Please send extra prayers their way. These days are challenging as they want to be home with their family/work families. Julie can access her yahoo account so feel free to send her e-mails there.

Love, Polly

The first post operative day!! What a trooper.

Love,

Polly

SAFE TRAVELS

All of us made it to our destinations safely. Julie and Dave arrived to Coswig yesterday and have reunited with Rick first thing. Randy is home near Appleton and I'm back at the farm. We are all grateful to God for safe landings.

Rick continues to progress. He is walking around and around and around. He has a small air leak that the Dr. doesn't think will create a long term problem. The plan is for it to heal by itself. Rick is eating well and having some special treats too including his Snyder pretzels, trail mix and chocolate. He's great overall.

We await the impending pathology results which have been sent to experts around the world. Tumor profiling is also been initiated in Rick's case to help determine if there is some target based therapies that would apply to his tumors. Those results are pending as well.

Another family from the USA arrived yesterday. The patient, a young mother of 3, will have her 2nd metastectomy this week. Meanwhile, the young man, 23 years old, will leave this week. In all, there have been 5 families from the USA there during our brief time in Coswig.

We thank you for your prayers and thank God for His unending love that just continues to show us grace and mercy.

Love, Polly

OUT OF ICU!!

Hello: Rick is out of ICU and on a "regular" floor. He had one of the chest tubes removed today instead of yesterday and has minimal drainage now out of the remaining tube. His IV lines are all out except for his central line. His pleural block fell out this morning while he was "marching"(really) at the bedside wanting to go for a walk prior to MD granting him more than just a bedside standing pass. His pain remains controlled with a medication through the central line. We are grateful for that. He has walked the unit here and looks very good. His has been advanced to a general diet and had a beer last night with dinner.

We have been fortunate to have met some people who have been here four times. The patient is 23 years old and just had his 4th metastectomy. He is doing well and will go home next week. He and his mother have oriented us beautifully to the hospital both as patient and family.

Finally, Randy and I were exceptionally fortunate today to take a trip to Dresden with a penpal of Rick and Julie's neighbor/also a member of our church. The penpal in the US(Mary) set up a meeting with the penpal in Germany(Heidi) so that we would have help if we needed it and if we had time to travel a little, that could happen be too. They were wonderful tour guides and then they came back and visited with Rick. The best part is that they will take Rick, Julie and Dave next week when Rick has his walking paper orders. This could be as early as next Saturday. But, no flying.

Thank you again for all of your prayers and wishes for safe travels. We continue to be blessed by God and in awe of God as He puts everything in place for us.

See you soon.

Love, Polly


By the way..........3000 on the incentive spirometer today.

PROGRESS!!!

Rick has really exceeded all of the expectations thus far. He had his PT(gymnastics) this morning already, incentive spirometer to 2500 easily today,bath, ate his entire breakfast, respiratory physiology and pain quite well under control.

In the next hour(we were asked to step out for an hour or so), he will have one chest tube removed and will take his chest tube vaccuum and IV etc. to the bathroom. They call this mobile unit a "dance partner" or "mercedes". All systems are working.

Rick made the comment that the surgery is much better than chemotherapy.

Pathology will be delayed until next week because the Pathologist at this hospital would like to examine the tissue longer. Thus far, no preliminary other than the remarks from my earlier posts. We have to remember to be still. God remains in control.

Thank you for your posts to him. He will see those in a day or so. There is no internet from the rooms, only at a kiosk which he cannot go to as of yet. Rick is very excited to have Julie here. He plans to call her today.

Again, thanks.

Love, Polly

BETTER BY THE HOUR

As suspected, Rick is doing better by the hour. His first respiratory therapy session this morning, he passed with flying colors. This also includes physical therapy and it wasn't passive range of motion. He worked it. :) He is doing his "breathing trainer" which is incentive spirometry for us well. This morning, up to 2500. He also a terrific nebulizer session too.

The most interesting and WOW experience as of 1000 this morning was the rounding of 10 people including surgeons, anesthesiologists, nurses. They all said that he was doing very well and remarked to one another that he was making great progress. They were amazed at his range of motion and his spirometer. Rick will stand today for the first time, no doubt he will manage fantastically. Tomorrow, they will pull one chest tube.

Last but not least, especially for the men.....the foley was removed today!!! He REALLY did not like having that. His arterial or peripheral line may also come out.

Rick is getting a room- mate now because the ICU is so full. I will try to post his beautiful photos later today. You'll be amazed.

Love, Polly

Back at the Pension

Tonight we are back at the Pension. This is a lovely place that resembles a "boarding house" style with a bathroom in each room and a beautiful breakfast served every morning. The ICU Chief offered me the opportunity to stay in the ICU overnight but Rick thought we should all get some sleep tonight because his exercise physiology class and pulmonary classes tomorrow. Rigorous for him.

He continues to do well. His chest tubes are draining minimally. His pain is controlled. This has been an ideal day of surgery. He brushed his teeth tonight before we left, drank tea(they don't offer water) and liquid cream soup out both out of a sippy cup. The IV electrolytes are in a separate bottle from the IV solution(.9 NS), they have a whopper PCA pump that has five tubes all on their sides in a row(up to down) which include 3 pain relievers, heparin, and electrolytes.

We have met with Ivan and his mother, Olga. They have been invaluable. Ivan is one week out and walking and biking already.

By the way, the milk provided daily for the patients/family comes directly from the cow...still warm. mmmmmmmm

Love,
Polly

Post operative news

What a day. It is 1720 here in Germanzy and our day started at 0530. We are being taken care of beautifully as both patient and family. I can't begin to tell you how much those caring eyes mean to me when we all speak different languages.

Rick is done with surgery already for five hours. He is having pain because the epidural was unsuccessful despite five attempts. He is currently on three pain medications. He is also trying to exercise...he has sat up, done leg pumps, foot circles, mild right arm lifts....the surgeon, who is the head of Cardio Thoracic surgery now for the entire country of Germany(how interesting) has told him to rest and me not to talk to him much...I am really not actually. Perhaps, he can see my tendencies.

So, the day continues our odd ball saga so those of you who like research....please. This is what we know today.

1. Rick has three different appearing tumors in his lung. (now removed) Histologically, they all appear the same at initial glance.
2. The hazey appearance on his scans is atypical of sarcoma in texture and appearance. This has not changed in one year.
3. The Pathologist here has no idea what this is. "It is not characteristic of leiomyosarcoma". YEAH!!
4. We must wait a few days for pathology and have already sent samples to the USA. We had a very special biopsy sent at a snap freeze temperature of -80 degrees.
5. 21 tumors were removed.
6. His lung was so interesting, they took photos.



Thank you for all of your kind words and prayers. He is being well taken care of.
Fernette, I am sorry for that early call.

Love, Polly

Ups and Downs

Today we met again with Dr. Rolle and met Dr. Krasler(chief anesthesiologist) for one hour. Bottom line is that Rick has a bizarre presentation in his lungs like they have never seen. For information sake, they see 7000 patients per year.

This is what we know.
1. Rick has terrific lung and heart function.
2. Surgery will be tomorrow at 0900 which and we have the anesthesiologist's phone number to call him at 13oo to find out the progress.
3. Histological samples will be taken from multiple tumors since they all appear unusual and dis-similar.
4. Tension is high as we await the surgery and a definitive diagnosis.
5. We miss knowing people and the language at home.
6. We miss our support factor at home too.

Please, please pray for Rick's safe surgery and for calming peace for all of us.

Love, Polly

Moving Forward

Yesterday was a quiet day here at the hospital. We met up with the 23 year old young man, Ivan and his mother, Olga. Ivan was up walking about after only 5 days. He looks great. He is still having some pain but is transitioning to oral pain medication from intra-thecal pain medication. Dr. Rolle and Dr. Kras-Ler (chief anesthesiologist) will see us today. But First!!!! Lung function tests already at 0745. I'm pretty sure Rick is riding the bike in there. We have had a delicious breakfast, shower...ready for the day.

Sleep and Breakfast

After a night of chocolate almonds and onion/garlic pretzels/trail mix, sleep came quickly and easily. The beds were comfortable and we all slept. I was blessed yesterday sitting next to a woman for 6 hours on the plane who loved Jesus and shared many scripture references with me to help our stay be more peaceful or as peaceful as possible. She was sent from God, no doubt.

We all learned to sleep on the benches at the airport. :) That was new to all of us. Boy, those benches were comfy.

Love, Polly

We are now in the city of Coswig Germany. Boy does it feel good to take a shower and shave after such a long flight. Tomorrow I will check in to the stupid hospital and I have to perform whatever tests that they have planned for me. One hell of a vacation don't you think? If I'm lucky I will get sauerkraut and bratwurst for lunch. Happy Easter everyone. I enjoyed my box lunch on the plane. Yum, Yum.

Regards,

Rick

This blog seems to be a pill for posting to. So, if any of you computer savvy people want to post and then post directions on how you did it, please do. If not, follow along and stay tuned. Thank you to all those who have made special calls or visits to wish us well. We leave with the continued faith that we are led forward and not settling for complacency.

We will be leaving tomorrow in the mid-morning for Chicago. Our flight flies out at 1545. I think we all have our bags packed with some very special things we hold close.

One of my friends(Kimmer) sent me this wonderful message tonight from the Good Friday services that her husband, Charlie, preached to his Good Friday congregation. I hope you find it as meaningful as I do.

In that day you will say: I will praise you O Lord. Although you were angry with me, your anger has turned away and you have comforted me. Surely God is my salvation; I will trust and not be afrThe LORD, the LORD, is my strength and my song; he has become my salvation." 3 With joy you will draw water from the wells of salvation. 4 In that day you will say: "Give thanks to the LORD, call on his name; make known among the nations what he has done and proclaim that his name is exalted. 5 Sing to the LORD, for he has done glorious things; let this be known to all the world. 6 Shout aloud and sing for joy, people of Zion, for great is the Holy One of Israel among you." Isaiah 12 1-6

Polly

This was sent to us as a send off from Lori Trapp. Thank you Lori and Bill for all you have done for Rick, Julie and Madeline. Everywhere you go you plant God's seed. Blessings.

http://www.tangle.com/view_video.php?viewkey=8cf08faca5dd9ea45513&sp=1

Prayer Service, Friends, and Preparation

We had a wonderful prayer service today at work for Rick. There were so many people who gathered to celebrate Rick, life and a travel that holds so much promise. We laughed, we cried and we met full of hope and well wishes. It was a blessing to see so many people joined not only by profession but also with the bond of love. Our cup overfloweth.

The pieces are all in place. The surgery date should be on Wednesday(Tax day) at 0600 Germany time. That makes it 1100 p.m.. on the 14th for you. Please, bend your knees in prayer for Rick.

Church tonight was somber and thought provoking. Listening to what Jesus went through was painful. A reality check.

Saying goodbye to some of my co-workers was heart wrenching. I have worked with many of these people for 15 years. Looking in their eyes was difficult. Rick did the same thing today but on a different floor, different office and with many different people yet we were all under the same work roof. What a family.

"The next hour, the next moment, is as much beyond our grasp and asmuch in God's care, as that a hundred years away. Care for the nextminute is just as foolish as care for the morrow, or for a day in thenext thousand years--in neither can we do anything in both God isdoing everything. Those claims only of the morrow which have to beprepared today are of the duty of today; the moment which coincideswith work to be done, is the moment to be minded; the next is nowheretill God has made it." George MacDonald (thank you Fernette)

It is by God's grace that we are led to Germany. Thank you to everyone who has been working so diligently to get Rick to travel safely and comfortably. We are indebted to each of you.
We're great as a team. If you need any one of us...just call.