Raspberry Cookies and the Baby Smile Nasal Aspirator

Having been in the hospital for the better part of a week, there were two things that made me nervous about coming home.  The first was the actual ride home.  Part of the surgery had involved cutting through some of the muscles in the back of my head and neck in order to expose enough of the skull to cut out a portion large enough to give my surgeon access to the top of my brain stem.  As a result, my neck was weak.  My surgeon had made it clear that I would need to focus on regaining strength in my neck during my recovery.  So as I thought about the two hour long drive home through Los Angeles traffic, it was hard not to think about the time Kerrie was rear-ended on the 405 last year.  Or all the times, regularly, that crazy Los Angeles drivers had caused her to brake hard and even swerve to avoid the ubiquitous no-look lane changers.  Thankfully, Kerrie is an excellent driver and put on a defensive driving clinic when she took her battered and bruised husband home.  Post surgical whiplash would have been a nightmare.

The other thing I worried about was being away from the nurses.  I found that there was something very comforting about being in the hospital.  Yes, there were a lot of reasons I wanted to go home, but while I was in the hospital I knew that the most expert and professional help imaginable was just the press of a button away.  I had also adopted a very philosophical appreciation for the IV lines that I no longer had.  Every swallow was a fight for much needed calories.  When I had the IV lines, I knew that I was at least getting all the fluids I needed. And the arterial line in my right wrist was to me something of a fail-safe.  If push came to shove, they could pile a whole bunch of nutrients through that tube.  Now I was well and truly on my own.

It’s funny the things you think about in these little medical transitions.  Bad drivers and IV lines…

Getting home was awesome.  When Kerrie helped me into the house, I was greeted not only by my family but by a group of neighborhood kids as well.  There were balloons, plates of cookies, and cards.  Alexis, one of the most talented girl’s lax goalies I have ever worked with, brought a box of Raspberry Susan Cookies, the kind that had a soft shortbread base and a jelly center.  With a sip of warm coffee, a small bite of one of those cookies would dissolve in my mouth.  I had found my first new comfort food!

Several of the welcoming kids read Psalms to me.  Zach “G-mo” and Alexis read me Psalms 42 and 43:

Why are you downcast, O my soul?  And why are you disturbed within me?  Put your hope in God, for I shall yet praise him, my Savior and my God.’

The biggest challenge I faced on that first evening home was taking my meds.  When you are in the hospital, a lot of your meds are getting pumped into you via the IV lines.  Now I had to swallow everything myself.  And it was incredibly difficult.  My best-beloved would literally have a handful of pills for me several times a day.  Those first two days home I was taking a total of thirty pills a day.  Madness.

But my first day home was short and sweet.  I got home in the late afternoon, and was sleeping by dinner time.  My second day would not go so well.

Tuesday morning was a doozy.  The church house Kerrie and I live in was in the middle of having the downstairs bathroom remodeled due to a compromised, forty-plus year old shower pan.  The job was supposed to have been completed before my return from the hospital, but the shower pan had needed to be custom ordered and the supplier was giving our contractor the run around.  Dave our contractor is an incredibly competent and gracious man and was doing everything he could to minimize noise and disruption, but my poor confused puppy Pippin was in hyper-vigilance mode – she seemed to sense that all was not well with her human and she wanted those contractors gone, so she would go on these barking and howling fits as if to raise the dead.  It was a long day.

Kerrie’s parents were still with us and were so helpful.  The kids’ school years were just getting underway and I was such a complete drain on my wife’s time and energy that Dad and Mom were invaluable in creating stability and routine for the teenaged Bjerkaases.  What a blessing to have great in-laws.

Kerrie had made two significant purchases in preparation for my home recovery.  She bought two great big pillow wedges that I could configure in different ways to enable me to get support sitting up in bed or on the couch.  And she bought me a machine:  the Baby Smile Nasal Aspirator.  It was a machine with a suction tube on it – originally intended to declog an infant’s nose.  Well, this big old baby opened up the end of that tube as wide as it could go and I now had my own suction hose to help get rid of all the spit my now defunct swallow reflex was failing to address.  My dependence upon that tube at the hospital had become so complete that once home I wouldn’t even think about going to sleep until I had duct taped that new hose into my hand.   When I woke up with that drowning sensation I needed to know instantly and exactly where that hose was.  What a way to live!

And I discovered a second comfort food.  Kerrie’s parents bought me a case of Ensure Plus Nutrition Shakes.  They came in Vanilla, Chocolate, and Strawberry, had 350 calories each, and were much easier to swallow than the fortified chocolate puddings the hospital gave me.  The first week home was a constant struggle to get calories down.  Those Ensure shakes were a Godsend.

I had been well prepared by the surgeon for what the first two weeks post-op would entail – at least as far as the surgery itself went.  I was told that I would spend the first two weeks basically sleeping.  And that is what I did.  I would sleep for a couple of hours, be up for a half hour or so, sleep for a couple of hours, get up for a few, sleep again…  It was exactly two weeks after the surgery date that I would finally be awake more hours than asleep during a single twenty-four hour period.

Wednesday was more of the same but Thursday morning was worse.  We woke up to discover that our dear dog had gotten up onto the table and eaten all of the remaining Raspberry Susan Cookies that Alexis had brought over – and then Pippin had lost those same cookies all over the dining room carpet.  Scrappy dog!  But to be fair, I think she was very stressed out.  Pippin is the first dog I have ever had – and she is only two years old.  As a new dog person, I have found that the bond between people and their dogs is something of a marvel.  She has clearly been agitated and she obviously knows that I am not myself.  It is as if she is one of the kids.  They have all been taking this fairly hard as well.  School out here in Ventura County (in the Oak Park District anyway), started on August 8th.  One week into the new school year, Dad has this complicated surgery.  Today (September 5 as I write this blog entry for August 21-24), all four of my kids are at school for the first time since my return home from surgery.  Nervous stomachs, fevers, headaches, vomiting… these symptoms have all plagued one or more of my dear kids on any given day for the  past two weeks.  It is a powerful reminder to me that not only is my suffering not my own, neither is my recovery.  Those who love us will sympathetically share in our misery – consciously or not.  They WILL share in whatever victory I am able to wrestle from this new set of challenges as well.

Even worse than Pippin eating all of my Raspberry cookies, Thursday morning also saw Kerrie’s parents fly home to Columbia, MD.  Boy, was I sorry to see them go.  Their presence here had been like having a warm blanket wrapped around the house.

Lord, thank you for such faithful parents – Bjerkaases and Williamses – who have shown Kerrie and me how to live lives of overcoming joy in both happy and sad times.  And help us be those parents to our own kids and every other soul you bring into our home.  Whatever our circumstances may be on any given day, you have given us all that we need for life and godliness – and may we never forget it! (2 Peter 1:3).

 

Tomorrow: Faces in the Carpet and Where is that Children’s Choir?

N.B.  The picture is of my replacement box of Raspberry Susan Cookies.  Look good, don’t they?

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Surgical Buyer’s Regret, an Eclipse, and The Reluctant Widow

The Neurological Care Unit was much quieter than the ICU. Fewer beeps and buzzes.  And fewer agitated patients – perhaps we were simply a more pharmacologically stabilized bunch.

For me, the two days I spent in this new unit were tough.  Not only was I making no discernible (to me anyway) progress with my voice, but now I was more lucid and better able to think about what was going on.

By far the most powerful feeling that I struggled with was regret.  What I now call “Surgical Buyer’s Regret.”  All of us have at one time or another made a purchase that we soon came to wish we had not made.  Hopefully it was something like a pair of shoes or a new wallet that we really didn’t need.  But what if it was a surgery?

Properly speaking, my attempted surgery – the microvascular decompression of the ninth cranial nerve, was elective.  It was not a “life saving” surgery.  I had been limping along dealing with severe outbreaks of intense pain for over three years.  In the months leading up to the surgery, I was taking as much Tylenol number 3 (with codeine) as my physician would permit (every four hours) and had two fairly potent epilepsy meds I took every day because of their nerve blocking properties.  The second half of July, despite what was by then a constant uncomfortable chemical fuzziness, was relatively pain free.

So now I was laying in a hospital bed after the elective surgery had, from my perspective, failed.  While the glossopharyngeal nerve pain that was so debilitating would be gone for good, it was so hard to accept that the surgery had been a good idea in light of the lost swallowing and speech functions.  I was not prepared for these types of thoughts. Who is?

My wife and I know of two people who have in the past several years had similar intra-cranial nerve related surgeries – both of whom ended up losing significant parts of their fields of vision as a side effect of their procedures.  Would they have gone forward with those surgeries had they known in advance that they would be trading their visual fields for freedom from pain?  For my part, I would never have willingly undergone my surgery had I known that I would be trading the ability to eat comfortably and speak freely for my pain relief.  These kinds of regrets quickly become irrational -they are not particularly susceptible to reasonable reflection. These feelings are like a panic attack – they roll in like a tsunami and carry all before them.

Kerrie was a trooper.  On Sunday morning as I hoarsely whispered my fears and regrets through the gaps in the hospital bed rail she mostly listened.  But she did remind me of two things.  First, this past April had been so incredibly bad – the pain would make my eyes lose focus – that I had actually said, “I wish they would just cut the nerve.”  And second, the doctors and therapists here at the hospital were guardedly optimistic that despite the changes in my condition, I would see improvements in swallowing and speech function.

I am almost never the patient.  I am almost always the pastor or the coach giving the encouragement to work one more rep, seek grace one more day, trust God in this new situation…  Thank you Lord for a wife who faithfully helps me in all of these things.

Sunday in the Neurological Care Unit was also the first day that Kerrie says I actually slept.  In the ICU it had been constant cat naps – with interruptions every half hour or so for doctors, nurses, meds, repositioning due to pain, etc…  Sunday is also the day I got to use the practice steps – a small flight of five steps I could walk up and down to build strength and restore balance.  The physical therapists were constantly riding me for letting go of the handrails and trying to keep my own balance.  I am a caustically stubborn Norwegian American and would try to let go of the rail the minute those guys looked away.  I might barely be able to swallow my food, but handrails are for sissies…

The only visitors we had all day were the family.  After church, Kerrie’s folks, and all four of the kids were able to spend over an hour with us in our new room. They brought one of our old laptops and a DVD from the fifth season of the sitcom Psych.  Crowding around the end of my bed, we watched an episode together.  It was sensory overload for me.  I zoned out and fell asleep.

This inability to focus was an additional source of dismay.  For twenty years now I have been in the habit of reading two books a week.  I have a personal library numbering thousands of volumes of history, theology, philosophy, art…  I have a near phobia of Alzheimer’s, so I try to keep my mind sharp by doing diagramless crossword puzzles in ink.  Kerrie believes me to be excessively weird.  I knew I would be bored in the hospital, so I had books to read and several thin penny press volumes of my diagramless puzzles.  And I couldn’t use them at all.  I couldn’t read a sentence without forgetting the subject.  I stared at my blank puzzle sheets with complete mental exhaustion… where would the first word go?  The logical challenge of breaking the puzzle was too much.  Having never been a patient before, it was one more discouragement.  It is horribly easy to feel dreadfully sorry for oneself in the hospital.  And it can’t have been easy for my wife to have to supply all of the strength and optimism when these darker moods would crowd into our little room.

Monday morning the doctors said I could go home.  Of course that meant that we would be there until Monday afternoon, so we had to find ways to pass the time.  First, Kerrie and I cruised the new floor until we found a place from which we could view the partial solar eclipse. The nurses of the pediatric wing of the neurological unit were very kind to let this big overgrown kid crash the children’s courtyard!

Back at our room I asked Kerrie what she was reading.  She had an old Regency period novel by Georgette Heyer – “The Reluctant Widow.”  And so my wife read to me the first of several books I have now experienced through the dulcet tones of her sweet voice.

For all of you who are struggling through your own sets of unintended consequences to decisions you may regret to one extent or another, may God bless and comfort you.  I have replayed the decision process leading up to my surgery a thousand times.  Getting the surgery was absolutely the correct choice.  But in an imperfect world, sometimes we must embrace the difficult challenges of recovering from a lot more than we thought we were signing on for.  And maybe there will be things we will never really recover from at all.  But that does not mean that we cannot experience a renewal of purpose and identity that take us differently down a new path.

I thank God for the tears of Jesus Christ.  There is nothing grand or even particularly strong about stoic denial of unhappy results.  But there is something shockingly real and beautifully powerful about acknowledging the brokenness around us and in us, yet trusting that even in our own worst case scenarios we can and we will overcome: “we are afflicted in every way, but not crushed; perplexed, but not driven to despair; persecuted, but not forsaken; struck down, but not destroyed; always carrying in the body the death of Jesus, so that the life of Jesus may also be manifested in our bodies.” 2 Corinthians 4:8-10.

May God himself sanctify to you your afflictions, perplexities, persecutions, and wounds.  And dear friends, may you never be crushed, driven to despair, forsaken, or destroyed as you find your soul’s deepest rest and peace in the life of God revealed in the gospel of Jesus Christ.

 

Next Up: On Missing Nurses and Being a Bad Patient

N.B.  There are two pics in this file.  The first is a picture of me sleeping on Sunday the 20th – under a quilt that my mother and my daughter made for me from some of my old lacrosse tee shirts.  Some are shirts from teams I coached – like Oakland Mills, St Albans Phantoms, and Oak Park…  Others are from colleges I have cheered for and or had student athletes attend.  I love that quilt!  The other picture is of me and the eclipse.  Would you look at that hair!  Absolutely disgusting.  It would still be over a week before I would be allowed to wash it.

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Saying Goodbye to the ICU

By my third day in the ICU I was probably about as comfortable there as one could be.  I knew all of the nurses, the various doctors who would come through at least twice a day to check my vitals and shine their flashlights in my eyes now called me Bob instead of Mr. Bjerkaas.

I know that I was still pretty heavily medicated, but do not know what effect the drugs were having on my thinking.  Somewhere in my mind it registered that I hadn’t been to the bathroom in days.  This couldn’t be good.  I buzzed the nurse.

“I  am  not  going  to   the   bathroom.”

“No Bob, everything is fine.  You are on a catheter and you can just go the bathroom whenever you need to.”

I must have looked more puzzled than normal.  The nurse held up a large container of what was definitely not apple juice.  The hose feeding the top of the container was presumably connected to me.

“You have been passing water regularly.  When you feel that you need to go, just go.”

There are some things about being a patient that are so very humbling.  I found myself feeling completely ridiculous, like Steve Martin in Dirty Rotten Scoundrels – relieving himself right at the table…  It sure was nice to have that catheter removed later in the day.  It was a very strange thought to me that this was the fourth day since I reported for surgery.

For four days nurses had helped me – a perfect stranger – perform the most mundane and private functions with such grace and dignity.  They had been attentive to my pain.  They had helped me find my suction tube when I was in a late night panic – which, I should note, occurred several times a night.  They never scolded my constant entanglement in the dratted EKG leads.  God bless nurses everywhere.  Down the hall an older man was yelling at his nurse.  She walked briskly past my open doorway – crying.

The family came to visit in the afternoon.  Cubby wasn’t there because his job at Dunkin’ Donuts required his expertise.   For the first time, everyone could crowd into the room – Mom and Dad, Kerrie, and Maggie, Timmy, and Nat were all together with me for the better part of an hour.

The worst part about having the feeding tube removed was that now I had to take some of my meds orally.  And you would not believe the number of meds I was on.  I could not swallow pills or tablets, so the nurses would crush the tablets and empty the pill capsules out in small cups of applesauce.  They would stir the meds in – creating a nasty greenish brown colored sauce, and then I would swallow tiny amounts of this incredibly bitter concoction until my meds were done.  At least that is how most nurses did it.

There was one male nurse on the floor.  Ian came in to give me my meds in the late afternoon on Saturday.  He crushed up and poured out the medicine on top of a little pile of applesauce in a clear plastic cup and fed me a spoonful.  “Aaaaack…”  It had not been stirred at all.  Kerrie tells me that I said, quite audibly, “Dear   Lord   that    was   terrible….”  I have never tasted anything so repulsive.  And I have attended Sons of Norway Lutefisk dinners.

Poor Ian was at a loss and the brother started laughing.  I protested, “Are    you   laughing   at   me?”

Ian apologized, “I am so sorry, I am a terrible nurse!”  It was all too funny for me.  I felt the deep Bjerkaas chuckle coming on and…. I wheezed.

Who knew that you need your vocal chords to laugh?  Well, the wheeze was a good enough proxy.  So while Ian and Kerrie laughed, I just wheezed away.

Tyler and Lindsey came to visit.  Tyler is one of my elders at Church in the Canyon and is a tremendously gifted young man – one day he will be teaching apologetics and philosophy in Oxford.  He is one of the men who will be preaching and ministering at Church in the Canyon in my absence.  Tyler and Lindsey read Psalm 27.

Wait on the LORD: be of good courage, and he shall strengthen thine heart: wait, I say, on the LORD.

Later that day Ian came back.

“We are moving you to the Neurological Care Unit.”

The bed was reconfigured.  Somehow the metal tree with the bags, wires, and gadgets hanging from it was attached to the head of the bed.  Kerrie’s few belongings were stowed by my feet, I was told to keep my hands and feet in the bed, and Ian DROVE the bed down the hall.

And when I say drove, I really mean it.  We were moving so quickly that my scabbed up, iodine encrusted, forty-plus stitches and staples full, filthy hair was actually flapping in the velocity induced breeze!

By the time we got to my new room, I was grinning like a school kid. “That   was   the  most   fun    I    have   had   all   week!”  I rasped to Ian.

“Just remember it was the terrible nurse!”  Ian smiled.

Heck of a guy that Ian.

Unfamiliar nurses were coming in to see me.  They switched me into a new bed.  As a first order of business I had a nurse show me where this new bed had a suction tube like the last one.  A new doctor who was making her rounds gave me a now routine checkup.

This room was better than the last.  It had a shower in the bathroom that Kerrie could use.  And my hospital bed’s railing had gaps in it so that when I lay on my right side I could reach my hand through the rail and hold Kerrie’s hand.  And, if she were in the right position, I could even see her lovely face.

Thank you God for my first OK day.

 

Tomorrow’s Tale:  Can I go home yet?

N.B.  The hospital bed pictured is the same make as my ICU bed – a Stryker.  I don’t know if it is the same model.  But boy could that bed get down the hallway.  Kerrie had to trot to keep up with it when Ian got it going.

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Even More ICU Adventures: The X-Ray Swallow Test

The morning of the eighteenth finally arrived. The night had been perfectly awful and I had been so focused on trying to swallow that I hadn’t slept much – if in fact I had slept at all.

This morning Kerrie and I had visitors.  Dale and Rene visited from church. Over the past eighteen months or so God has done something really neat at Church in the Canyon where I serve.  He has brought along three very experienced pastors who are in various ministry transitions.  Dale is one of these pastoral veterans.  Providentially, I had been able to line these dear men up to supply the pulpit and continue pastoral care for the church during my surgery and recovery. But driving down to Sunset to visit the banged up pastor was certainly a step beyond the call of duty.

Later Bob and Marilyn from church wandered into the ICU.  What a blessing to have these dear folks come down to share some time and encouragement with me and Kerrie.

But I was also expecting a visitor whose arrival gave me no peace.  Heather.  She arrived just after Kerrie stepped out to get some Burger King for herself.

“Hi Bob, how are we doing today?”

I smiled and nodded, projecting my airy whisper as best I could.  “I   am    fine.”

“We are going to take you down the hall for your x-ray test.  Let’s get you up and into this wheelchair…”

And we were off!  And quite the entourage we were.  Heather was in the lead.  An orderly was pushing my wheelchair.  And a nurse was walking beside me with the large metal tree with bags and wires hanging off of it.

Down the hall, out of the ICU, a floor or two down in the elevator, another hallway and we were there.  My chair was positioned behind a very small machine that had a lens aimed at my throat.  There were no lead aprons involved, so the radiation must have been minimal, and the new swallow test began immediately.

“OK Bob, we are going to try ice chips again.  Are you ready?”

I nodded and started crunching that ice cube up.  In my mind it was last night again.  Swallow one, swallow two, swallow three…  Ignoring the numbness in my throat, I forced my muscles to do the closest approximation to a swallow that I could imagine.

“Wow, that was really good.  Let’s try that again.”

Again I swallowed the crushed ice.

“Apple sauce?”

Done.

“Chocolate Pudding?”

Done.

“Wow, let’s try a cracker.”

And done.

Heather wheeled her chair from behind the screen and showed me the video of my swallowing.  Not a single bit of ice, water, apple sauce, pudding, or cracker crumb had gone down the wrong pipe!

“That was amazing!” Heather, with her non-poker face, was genuinely pleased!  “What did you do differently?”

“Well,” I exhaled, “I stayed up all night long praying and practicing.”

A short trip back to my room in the ICU and Kerrie is there – back from the Burger King.  “I passed the swallow test!”

In short order the feeding tube was removed and the duty nurse brought in a couple of lunch items.  Diced peaches, an applesauce, a cup of chocolate pudding, and a boxed juice.

It was my first win.  Swallowing was hard.  Unbelievably hard.  And it wasn’t pretty.  First I would work hard to get all the food to the right side of my mouth – without being able to move my tongue to the left to pull it over.  Then I would literally squeeze every muscle in my lower face to push the food down.  And, then my eyes would apparently bug out  as the food went down!  Sorry, no picture of that.  Awkward, painful, unsightly… but I could swallow.

My father and mother in law, for as long as I can remember, have had hanging in their living room a small piece of artwork in which a beautifully biblical doctrine is simply stated: “Pray Devoutly, Hammer Stoutly.”  As Nehemiah modeled the life of faith when Jerusalem was rebuilt after the Babylonian captivity, we work and pray.  I had begged God for my swallow and worked in expectation of his blessing.  Thank you, Lord.

The remainder of this day involved a couple of walking trips around the halls of the ICU.  The nurses by now knew that I was a lacrosse coach and were quite impressed with my quick turnaround on the swallow test.  I am not going to lie, I was quite pleased as well!  I pushed hard.  Every walk was further than the last.

After school got out, the kids came down again – and again brought another one of our great neighborhood friends – Jacob.  Reading the Psalms together and praying with my family was the highlight of the ICU experience.  But every day after the kids would leave, I would find myself battling weariness and frustration at how much work remained for me.  And how would I get my voice back?  Would I sound like me?

 

Coming Soon: Leaving the ICU for the Neurosurgical Unit.

 

N.B. The top photo is a photo of me walking shortly before the feeding tube was removed.  It sure was good to get rid of that.  In the picture I am trying to be a hero and go one-handed on the walker so I could wave at Kerrie.  The physical therapist to my left did not approve.

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More Adventures in the ICU: No I will NOT go out this way – WHERE IS THAT SUCTION TUBE!

The speech therapist who came on the seventeenth shortly after my surgeon visited returned later that same day.  I was currently on IV fluids and had a feeding tube running up my nose and then down the back of my throat – I had not done any eating or drinking on my own since the evening before my surgery – probably close to forty hours earlier.

Her name was Heather, and she was impossibly young.  She gave me some exercises that were very helpful.  First she gave me a straw.  “Now blow into this straw and hum – try to hum a low pitch – about 220 megahertz.”  I hummed through the straw as requested and I actually had a pitch to my voice!  A broken, quavering, painful sort of pitch.  But it was no longer pure air.  She challenged me to try to modulate the pitch up and down as best I could – sort of as if I were playing a kazoo.  The results were difficult to attain and even harder to listen too I am sure!

Twice Kerrie helped me sing the first lines of Amazing Grace to visiting nurses.  They were very encouraging of my efforts even though I couldn’t make it through the second line before completely gassing out!

Then Heather administered my first swallowing test.  “OK Bob, I am going to give you this ice chip and I want you to break it up and swallow the water when you are ready.”

Piece of cake.  I chew up the ice chip, swallow, and choke all over the bed-sheets.  Not a single drop went down.  “Here let’s try that again.  Take your time.”  This time it was a smaller chip. Same results. And again.

I could not swallow.  Not even a drop of water.  Heather assured me that this was not a disaster and began arranging for an x-ray swallowing test to be performed on the following Monday.  Thankfully, she was able to schedule the X-ray machine for the very next day instead.  With that machine we would be able to see in real time what was going wrong and why my swallow function was zero.

After Heather left I felt sick.  I wish I could have played a hand of poker against her.  I would be rich.  The concern read on her face like the word KAZAAM in a Batman comic.  Good Lord, I couldn’t swallow.

Later that evening, the kids came by after school – and brought two of the neighborhood boys with them: Big Z and Old Willy.  Yes, come around my house one too many times and you earn fridge rights and a nickname.

In preparation for my surgery, I had bought a book of Psalms.  And whenever visitors would come by, I would ask them to read me a Psalm, tell me about their favorite verse and sign their names next to the scripture they read.  Willy went first, he read Psalm 73:

“… Whom have I in heaven but thee?  And there is none upon earth that I desire beside thee.  My flesh and my heart fail: but God is the strength of my heart, and my portion forever…”

Big Z read Psalm 139.

“O LORD, thou hast searched me, and known me.  Thou knowest my sitting and my rising, thou understandeth my thoughts from afar off. Thou compasseth my path and my lying  down, and art acquainted with all my ways…”

We prayed and visited.  I was deeply moved by their taking several hours to visit me and their ministry to my soul.  Night fell and I couldn’t sleep.  The nausea was under control.  The pain was mostly manageable.  But I couldn’t’ swallow.  God, help me swallow.

And so I practiced.  Swallow one, swallow two, swallow three…  all the way to one hundred.  Again.  Again.  Spit and drool are all over my face and bed-sheets.  I am vomiting in the spit up bag.  Again.  Swallow one, swallow two, swallow three…  I must have swallowed one thousand times as best I was able.  I had nothing to show for it but phlegm and soaked clothes.  My salivating was out of control.  I buzzed for the nurse.  “Was it morning yet?”  No it was only three a.m.  “I feel like I am drowning in my spit,” I croak slowly.

And then this rare, seraphic creature in hospital garb blue handed me what would become my constant companion for days to come.  There was a suction tube with a button on it – like the suction tubes the dental hygienist uses for teeth cleanings.  It was actually connected to my bed!  She placed it in my hand, showed me how to use it, and I went back to practicing the lost art of swallowing.  Swallow one, swallow two, swallow three… to one hundred.  Again.  And Again.  And again.  I don’t know if I actually swallowed a single drop of spit all night.  But it was not for lack of effort.  Swallow one, swallow two, swallow three…  It was a long night in the ICU.

 

Next Up: Even More Adventures in the ICU: The Coach

N.B. The picture is a photo of the Psalm book my visitors have been reading to me and signing.  It is fast becoming a very dear possession!  It is a wonderful volume but I wish it could be bought in a translation other than the old KJV.

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Adventures in the ICU: The Bare-Assed Pastor on Floor Five

The ICU was a place of highs and lows, breakthroughs and frustrations, education and resolve.

I have always been something of a thrasher when I sleep.  This is enough of a problem when the most significant consequence of my tossing and turning is a cold wife bereft of her fair share of the blankets.  Things are more complicated when buzzers continually go off bringing nurses untangling me from EKG leads clipped to my chest and back, reconnecting IVs (yes, I pulled two out), and putting those evil little sponges back up my nostrils…

And covering my butt.

My room was the best.  It was the second private room on the right hand side of the hallway directly across from the nurses station.  My bed was closest to the door.  Moving deeper into the room was the small family area with a window looking west down Sunset Boulevard where Kerrie stayed with me throughout my entire stay and our kids and visitors could gather.  The bath room had no shower, but one can’t have everything.

My preferred position was to lay on my right side.  For two reasons.  First, that is where Kerrie was.  And second, the nearly forty stitches long wound beginning at the back of my neck went straight up the back of my skull and then curled off towards the left side of my head.  I was (and still am two weeks later) rather averse to resting on the yet tender wound.  So, if you are following along with the geography of my slice of ICU heaven, you will realize that an active sleeper with an open backed hospital gown generally had his ordained derriere pointed directly at… the nurses station.  More than once I heard, “Here Mr. Bjerkaas, let’s just cover that up…”  And me without my wedding ring on.  Oh, the temptation those dear saints must have endured…

I don’t know if I slept that first night.  Nausea and pain were the great difficulties for the first ten to twelve hours.  Early on the morning of the 17th my surgeon came in.

“Good morning Bob, how are you?”

“I… am… ok…”  I breath out as clearly as I can.

“Well, I have to tell you I am so glad to see you here this morning. Last night I had a nightmare that I continued to try to massage that artery into place and lost you on the table.  But you are going to be just fine.”

That was the first time I considered my surgery from his perspective.  I regarded him through one eye.  This man had spent an entire day of his life laboring over my opened skull.  Making life and death decisions.  Perhaps feeling ambushed by less than accurate intelligence regarding my arterial network.  Could that have been my fault?  Had I minutely shifted during one of my three MRIs that would have otherwise shown that offending arterial branch?  All feelings of disappointment in him evaporated in an instant.  Life happens.  So does death.  This dear man is as subject to the laws of God and gravity as any of us.  And he had stayed with me.  On his feet.  All. Day. Long.  Yes, he had needed to make an exceedingly difficult decision regarding the recension of that nerve.  Maybe I could wish he had chosen otherwise.  But Christ be praised I am alive.  And I did not stroke out.

Dear Jesus thank you that you gave me this surgeon who was able to bring me through a difficult surgery.

My surgeon shared with Kerrie and me what had happened once again.  And I learned several things.  First, and most concerning, I could not move my tongue to the left side of my mouth.  But the doctor says I can get that range of motion back.

And I learned something about nerves. It seems that nerves are more like bundles of nerves-  they have parts. Not all nerves, or parts of nerves, are exactly the same.  Some contribute to motor functions – like moving your tongue.  Others are sensory in nature – they communicate things like temperature and pain.  My surgeon had labored long in that cold operating room and cut only those parts of the ninth cranial nerve that carry sensory data.  Apart from loss of sensation and some range of motion relating to my articulation and swallowing, nothing was paralyzed.  Even the nerve connected to the left side of my vocal chords was still there – and functional. I simply couldn’t feel it anymore.  49 years of knowing what it felt like to speak was clipped short.  49 years of knowing what swallowing felt like was gone.  I could recover.  It would never be the same again.  I would need to relearn how to feel normal again.

A speech therapist came in to see me next.  I exhaled more questions.  Yes, it was true that I would recover a voice.  It might more or less be the one I have left behind.  And it might need a mechanical assist from time to time. She mentioned injections in the left side of the vocal chords to “puff” them up so that my fully functional right chords could more easily vibrate against them.

I wish I could say this was encouraging. Frankly, I was horrified.

Almighty God, you can raise up a witness for yourself from the very stones of the ground.  And the heavens declare your glory.  Give me what voice you will.  I will make a noise.

 

 

Next Up: More Adventures in the ICU: No I will NOT go out this way – WHERE IS THAT SUCTION TUBE!

N.B.  Kerrie did not think it wise for me to attach a photo of my posterior…  I imagine she is once again correct 🙂

 

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Brain Surgery Part 2: What Went Wrong?

Hands and voices everywhere.  Quietly – “Let’s lift, two, and three…” The left side of my body was being swabbed with something wet.  Not cold or warm, just wet.  “Mr. Bjerkaas? Mr. Bjerkaas?  Can you hear me?”  Unhhh…

“Let’s turn him over now and replace the bottom sheet all at once…”  Something smelled like iodine.  Someone placed a large mildly adhesive patch to my lower back.  What was that?  “Mr. Bjerkaas I am going to ask you some questions now.  Can you open your eyes?”  A bright light.  First my left eye, then the right.  “Squeeze my hands.  Try to push my hands away from you.  Wiggle your toes.  Good…”  Soon the exam stops and the nurse lets me know that I am doing fine and that my wife will be in to see me shortly.

As I lay waiting I am aware that I am connected to more tubes and wires than I could account for. But thank you dear Jesus – I was not intubated.  That meant that it was still the 16th of August. My surgeon had speculated with me that should the surgery go too late they might let me see Kerrie and the kids and then put me back to sleep and remove the breathing tube on the morning of the 17th.

Kerrie came in and held my hand.  Kissing my forehead.  Asking how I felt.  I couldn’t reply. My voice wouldn’t work.  I tried to breath out some words but a strangled whisper was the best I could do.  The kids come in one at a time.  We squeeze hands, I know I am loved.  The kids will all be returning with Dad and Mom to stay at the house tonight.  Kerrie will stay with me here in my private ICU room.  What had her day been like I wondered?

The waiting room was large but packed.  Everybody who was at the hospital for any surgery was waiting for their patient’s procedure to be completed in that one room.  Kerrie and the kids camped out in one corner.  Several people visited.  The first people to arrive were Sammy and his mother Allison.  Sammy just graduated from Oak Park High School this past May – a senior Captain on the Lacrosse team and one of the hardest working kids I have ever known.  Then came John and Theresa from church.  Sammy and Allison had to leave, but not before Sammy’s dad Mark arrived – he would stay until the very end.  Kathleen and Judy from church came next and would stay for several hours.  After school Chrissy and her four Robinson boys sat with the family for a couple of hours.  All of my families were represented.  Kerrie’s parents, the lacrosse team, my church, the neighborhood…  I am so glad that Kerrie and the kids had some company.

The kids slept, read, and played some games.  The adults chatted, prayed, and watched the boards where the surgeon’s names were lit up in order to let the waiting families see where the surgeon was at any given time.  I was one of the first patients in.  My surgeon’s name went blue on the boards – he was in the Operating Room.  Other surgeons’ names turned yellow – they were moving into post-anesthesia care.  Then they turned another post care color and families could visit.  My surgeon’s name stayed blue.  Six hours was our perfect time for the procedure. That would be going in, taking care of business, and getting out.  The waiting room was nearly empty when, ten and a half hours later, my surgeon came out to speak with the family.

He invited Kerrie and her parents to visit with him in a small room and explained everything he did to try to move the artery away from the glossopharyngeal nerve.  Unfortunately, it could not be done.  The MRIs had not shown that at the very place that my abnormally enlarged vertebral artery impinged upon the nerve and caused such excruciating pain, there was another artery branching off that fed the spinal cord.  Moving the enlarged artery was causing twisting in one or the other arteries which would then become kinked, which could lead either to paralysis or stroke.  After consultations mid procedure, it was determined that the microvascular decompression of the nerve could not be done.  The nerve would need to be cut.

It was 6:30 p.m.  Kerrie was told I was doing fine and that she could see me in an hour.  Mark, John and Theresa pray with my family.  An email is sent out to family and friends giving an update.  Soon it is just family.  At 8:00 p.m. Kerrie is told I am being taken in for a CAT Scan.  The family moves to the waiting room for the fifth floor ICU.

It isn’t until 10:00 p.m. that the kids squeeze their dad’s hand and head home to Oak Park.

What now Lord?  That five percent chance that turned into ten, and then twenty…  The nerve was cut.  All of this registered with me as I lay there with more wires and hoses than a Rube Goldberg contraption.  I had missed the break and landed on the wrong side of the statistical line.  Thank you Lord that I am alive and have not had a stroke.  But that nerve…  I speak for a living.  I am a gospel preacher.  I am a lacrosse coach.  I am and have been Uncle Bobby B to hundreds of kids… I whisper sweet nothings in my wife’s ears and sing her eighties music.  I am Dad.  I need my voice.

 

To Be Continued: Adventures in the ICU –  The Bare-Ass Pastor on Floor Five

N.B. The picture was taken by my wife on the evening of the 16th, my first night in the ICU!

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Brain Surgery: An Ordeal Remembered

So, about that brain surgery…. As many of you who are friends and family have heard in bits and pieces, all did not go exactly as planned.  It was two weeks ago tomorrow that Kerrie, the kids and I rolled up to the highly acclaimed Kasier surgical facility on Sunset Boulevard.  Each of us carrying our own sets of fears and expectations.  My check in time was 5:30 a.m., and as I rid myself of all clothing, personal identification, and even my wedding ring, I recall a sense of some huge, inexorable push moving me forward moment by moment.  I was resigned to what in simple terms boggled my mind.  I would be having my head opened up, various elements essential to my nervous system shifted about, arteries moved, Teflon pads inserted…

“Mr. Bjerkaas, may I put a line in?”  Of course.  How did this so-so-young girl Tracy know how to pronounce my name?  “You’re going to feel a pinch and…”  No worries, take your time. “Let’s try that again.  Can you please make a fist for me with your left hand?”

“Good morning Mr. Bjerkaas, can you verify with me your full name and date of birth?”  This nurse was older.  Almost before I could finish a young man came in.  “Mr. Bjerkaas, may I call you Bob?  I am going to set up a drip in your right arm so we can begin to relax your body before the procedure.  When we get you all lined up here we will have your family come in.” OK, thank you.

More medical professionals.  “Can you tell me what we are doing today… Okay I am going to draw a circle on you right here…  The anesthesiologist will be in shortly…”

Kerrie, Maggie, and Nat come into the room.  Kerrie’s parents, Mom and Dad Williams, have not yet arrived in the second car with Cubby and Tim.  Small talk, how is the waiting room, did you bring enough reading and games to keep you occupied?

“Mr. Bjerkaas, your surgeon is here.  He will be in to see you shortly.”  The coach in me sized him up one more time.  Does he look me in the eye.  Does he appear confident – is he game day ready.  As ever he does.  He has the top reputation as the local neurosurgeon available to me.  He is particularly recognized for dealing with brain stem related issues. He is my guy today.  We repeat the same conversation about the procedure, its goals, challenges, risks…  We have had this conversation a number of times now, each time slightly different as new bits of data become available through different tests.  “…And so in light of some of your particular anatomical challenges, we are looking at about an eighty percent success rate…”  This was the new fact this time.  On my first visit it was ninety five percent.  Then ninety.  Now down to eighty.

My mind flashes back to the winter of 1988.  I am in the used car offices of the Normandy Ford on Route 40 just west of Baltimore.  The numbers keep changing throughout a conversation about a 1984 Tempo.  The car dealer’s name was Ken “Pops” Robinson.  Such a friendly guy.  I bought the car.  Big mistake.  Eighty percent.  Eighty percent…

Kerrie and I nod at each other.  I realize I am still holding my wedding ring in my hand, and ask her to keep it for me.  She puts it on her finger.  I ask the doctors and nurses if I can pray with my family.  We pray together.  “Oh dear God show us your grace and favor.  Bless us this morning.  Give wisdom and skill to all of these dear men and women who are helping frightened people become well.  Heal me.  Thank you for loving me.  Please forgive my sins.  Help me to love you and others well…

I tell my children I love them and that it is our highest calling in life to take Jesus with us on this life’s journey.  I am so proud of them.  My wife kisses me softly.  The gurney wheels are creaking.  People are talking.  I remember a cool breeze.

 

To Be Continued: What Went Wrong?

N.B. The buildings pictures are the Sunset Boulevard Neurological Buildings.

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Anxiety and the Christian: Part One

“You don’t have anxiety at all do you because you’re a pastor.”

I have heard various iterations of this theme dozens of times since it was determined that I would need a surgical procedure to address the debilitating nerve pain that intermittently shoots from the back of my throat down to the left side of my neck.

Well, as I write this post, that surgery is scheduled to take place in just twelve days.  And guess what?  I am anxious!

I worry that the neurosurgeon might have quarreled with his wife the evening before, not had a good sleep, been cut off in traffic on his way into the hospital…  I worry that he might slip – just a fraction of an inch and my vertebral artery is cut, my dura is punctured, the nerves that control facial expression, articulation, or swallowing get severed…  Will I have a stroke, will I keep my job, will recovery be painful…

And like Jesus, I have on many occasions asked God to take this cup from me.  Even with tears (more times than a male Norwegian might want to publically acknowledge).

As Christians, you and I must aspire to be like Christ (1 Corinthians 11:1; Ephesians 5:1; Philippians 2:5).  And this Christ-likeness involves such things as being hungry, weeping at friend’s funerals, and agonizing over upcoming trials.  To never experience these things in a world that is subject to so much brokenness would mean that we have become something less than human.  As Christians we should remember that it is in heaven that “every tear shall be wiped away.”

And so when people ask if I am nervous, or worried, or anxious I simply tell them, “Yes I am.”  You see, the question for me as a Christian is not whether or not I experience very human reactions to very difficult or troubling developments in my life.  Following Christ makes the most of my humanity, it does not erase it.  The question should always be, “What I am going to do with my emotional reactions to life’s difficulties?”  What will I do with my fear, my worry, my anger, or my anxiety…

Earlier this week one of my parishioners came into my office for our standing lunchtime meeting and with great enthusiasm opened his laptop and gave me a nickel tour of his Logos Bible Software program.  Logos has an amazing collection of Bible study and commentary resources.  He was showing me the Psalms, and at a click of his mouse button he was able to break them up into genre.  Did you know that of the 150 Psalms in the Old Testament collection, the largest single category is that of lament?

God is apparently at least as interested in teaching his people how to experience emotional distress as he is in protecting them from all distressing experiences.   And again and again in the Psalms he gives Christians a model for how to experience the darker moods of the human soul.   The New Testament offers very clear guidance on this as well.  In the next two posts, I will be discussing how to handle anxiety by considering Paul’s letter to the Philippian church.  I hope you will tune in!

And I cannot thank you enough for your prayers for me and my family.  Well over one thousand people have read my request for “Audacious Prayer” and that is in large case because so many of you have shared that post.  Please let me know how I can be praying for you.

Your Pastor,

Bob Bjerkaas

N.B. The picture is cropped from my fellow Norwegian, Edvard Munch’s famed painting, “The Scream.”

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An Audacious Prayer: Psalm 126:4

As those of you who subscribe to this blog – and others who read it regularly may have noticed, I have not been writing much lately.  As a matter of fact, beyond my basic pastoral duties I have really not gotten much done these last two months at all!  In this blog post I want to explain that absence and enlist your aid in my audacious prayer.

For the past three years I have increasingly struggled with an intermittent neck pain that has slowly but steadily increased in intensity and frequency.  Two months ago I finally received a confirmed diagnosis – glossopharyngeal neuralgia.  It is something of a bummer as the surgical fix for it involves inserting a Teflon sling deep inside my head where the vertebral artery is impacting the glossopharyngeal nerve.   And while I have been called a prude before, I am sure all of you would agree that fooling around in the inner recesses of one’s skull indeed constitutes “inappropriate touching.”  The surgery date is being selected by the good folks at Kaiser Permanente as I type, and my surgeon has informed me that recovery will be two to three months, best case scenario.

So, what is the audacious prayer in which I am enlisting your aid?  First, please join me in thanking God that the cause of the pain has been discovered and that there is a solution for it.  About a year ago I began sensing that the pain was more than TMJ or acid reflux…  I had that disquieting sense that something was very wrong with me, but had no idea what that something might be.  Now I know, and the discovery of even undesirable news enables forward progress not otherwise possible.

Secondly, please pray with me that meds I am currently taking for pain would not take such a toll on my body.  The constant nausea, dizziness, and mild headaches make simple tasks in life and work seem very large.  Thus no blog writing…

Lastly, that the surgery is a resounding success and that the pain goes away entirely.  As a diagnostic test, the nerve cluster back behind the back of my mouth was injected with lidocaine a month ago and for seven blissful hours I felt no nerve pain!  And for you chronic pain suffers, you know what I mean.  My prayer is that this constant background pain and intermittent severe pain be completely gone.

In Psalm 126, we find a pilgrim song in which the Israelites who have returned from the Babylonian captivity find themselves in dire straits.  In verses 1-3 we have the people reflecting on how wondrous their past deliverance was – their God had filled their mouths with laughter, their tongues with joy.  But now things are not going well.  We do not know the cause of the singers’ distress, but we know that it caused them to look back on the festive times of their deliverance with longing.  And we know that it moved them to present God with a truly audacious prayer:

“Restore our fortunes, O LORD, as streams in the Negev.”    Psalm 126:4

The Negev was the southern, desert region of Judah.  It was chiefly navigable by the dry stream-beds that offered the easiest travel through the arid and rough landscape.  Until the rains came anyway.  Then these stream-beds or “wadis” would overflow with a raging torrent of life giving water.  The deserts themselves would bloom.  This is no prayer for a gradual, limited improvement – it is not requesting such a modest trickle of grace.  It is a prayer for a flash flood!

My prayer is similarly audacious.  I desire a complete return to unmitigated functionality as a husband, a dad, a pastor, a coach…  And my prayer is for a flood, not a trickle.  This is my prayer for you as well.  Won’t you join me in being audacious before the throne of grace upon which is seated “he who is able to do immeasurably more than all we ask or imagine.” (Ephesians 3:20).

 

Your Pastor,

Bob Bjerkaas

 

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