Dear Friends and Family:
I appreciate your prayers very much. I want to update you first on my recovery from the stroke on Dec. 22, 2011. Laura has given birth to her first son who is also on our prayer list at this time. Please click on the link to read the entire message….
God has blessed me richly in many ways. As mentioned three weeks ago, I returned to work with no obvious deficits that would interfere with my work in surgery or at the hospital. The medical staff did not place me on night call to allow me to get extra rest which turned out to be a wise decision. I became progressively fatigued over the first two weeks of January with very little energy during the day.
I required a lot of extra rest, but also found that I was short of breath when climbing the hill to which I was acclimated after 4 months here. I checked my pulse and found it was around 100. I had a nurse check my blood pressure and found it was only 105\66; my normal BP has been 130\85 under normal circumstances.
It made sense to me that the small dose of blood pressure medicine was causing more than a 20 point drop making me somewhat hypotensive. I stopped the medication the next morning and found I was up 10 points. By the next morning, I was back to normal, and so was my energy. The doctors here agreed with holding the medicine until I visit the prescribing doctor in Nairobi on Feb. 2 this week for my scheduled appointment.
I still find that I need a full night’s sleep to have normal energy. This past Monday, I hadn’t slept so much on Saturday night and was very tired after the clinic day. When I came home at the end of the day, a new visitor came by and almost whispered to me for thirty minutes wanting to tell her life story and why she needed some money for school fees. I knew I needed a nap and was able to send her away with a promise to pray about her situation and make a decision soon.
I told Rachel I was going to lie down for a nap before dinner and then slept hard for an hour. She “called the cops” on me when she was worried. She had two surgeons and a family practice doctor come by to see me that evening. I was able to convince them I really was okay but had needed a nap; Mike Chupp could tell that I was not in the same situation as a month ago and let me pass. I had to show Rachel my pulse rate daily for the next five days before she really believed me.
I think the reason I lost sleep Sunday morning waking up at 4 am was probably related to the second anniversary of Marty’s passing that day. I knew all of us were thinking of Marty that day. I decided to write our children which I will share with you at this time.
Dear Children:
It will come as no surprise to any of you that today marks the second anniversary of your precious mother’s graduation to Heaven. I expect a wide range of emotions is represented throughout our family and perhaps within each individual as well. Playing the Chris Tomlin song, I Will Rise, no doubt will start the water works for most of us.
However, I didn’t play that song yet, nor did they ambush me by playing it at church today as occasionally happens. I woke up early this morning with thoughts about Marty; thankfulness dominates all other feelings today.
I could make a long list of things for which I am thankful, but I will only mention a few. Marty led me to the Lord – lovingly with perseverance. Without her preaching God’s Word with her words and life where would I be? Maybe I would be still lost, stumbling around in sin – only God knows. My salvation should be at the top of the list of eternal things.
You children and grandchildren have eternal life because of Jesus Christ, but Marty’s willingness to be His handmaiden and allow Him with thankfulness and without reluctance to put you in her womb must be acknowledged with great gratitude. How many men at this stage of his life can say he has this many descendants not just living but walking with the Lord with the help of the godly woman God gave him?
How many would willingly leave parent, home, and children to go with her husband to the end of the earth and lead people of another culture to her Savior? I am thankful that she spent so much time in prayer to hear God’s voice that orphan children needed parental love and help.
Yet I must not end the list without her example of her love for Jesus and His Word which she instilled in each of your lives as well as her encouragement to me to learn more and more of Him each day. I can’t begrudge our Lord having taken her to sit at the feet of His throne where she was prepared to be. I can only praise Him with thankfulness for the time I was given with Marty. We were all prepared by her to walk on our own feet alongside our loving Lord Jesus.
Love to each of you, Dad
Two days prior to this, Laura gave birth by Cesarean to Yoshiki James Noguchi in Japan. His name, Yoshiki, when written in Kanji, means “Joy in Christ.” He has a special challenge in his young life, a cleft palate and lip, which will require surgeries beginning in three to five months.
Laura and Keisuke are coping very well with the adjustments recognizing that this has been no surprise to God and that He intends for them to be a witness throughout the process. A special encouragement has been that the government insurance covers everything including dental treatments in the future.
Our orphan ministry continues to go very well. God has blessed us with sufficient funds for the existing enrolled students as well as the four beginning freshmen students at Umoja and four at Kenduiwo. Thank you, Lord. Please pray that throughout the coming months, He will provide an equal amount of support divided equally in April and August. We had asked for guidance on how many we could start; we interpreted His provision of the needed amount for all eight students. God is good, all the time.
I am excited to report that we have started a cervical cancer screening clinic this month at Tenwek and some of the outlying clinics. Each Friday, I have been called to examine patients identified by a trained nurse who sees potential pre-cancerous conditions. Instead of seeing patients who have inoperable cancer, for the first time, I am seeing either immediately pre-cancerous or early stage conditions which can be treated effectively.
Seeing more cases requiring hysterectomies will add some extra patients on our already full schedule. We are meeting with the surgery department on Tuesday where we hope to agree on another day in the week where we can schedule cases. At this point, we only have one dedicated day in the five major operating rooms; trying to squeeze cases into our own operating room in Maternity is difficult to schedule with all our cesareans and other minor cases with a somewhat unpredictable availability of an anesthetist whom we share with the eye surgeons in their suite. Please pray for a reasonable plan to come from this meeting.
Please pray for a patient I will call Dorcas. She came to us a week ago with a “bad obstetrical history.” Sometimes this means one or no living children out of four or five pregnancies. Dorcas had her first two children born alive and survive, but then she lost the next at 34 weeks. The next 7 were stillborn at 26 weeks – once a year for the past 8 years.
This time she came to the clinic at 30 weeks with the baby still alive. We had an ultrasound performed in November which confirmed the date, but the baby was so tiny inside her womb now. The baby measured more like 25 weeks or a pound with a few ounces – not much growth in nearly 3 months. We used our only working fetal monitor and saw that the baby’s heart rate showed normal variability, a good sign, until a little Braxton-Hicks contraction occurred which immediately sent the heart rate down below 80 for a minute following. Obviously, this baby had no reserve for labor.
We discussed the situation with the pediatrician. He felt that the baby wouldn’t survive for very long in the nursery below 31 weeks; before this age in our set-up, most die from either lung immaturity or bowel death [necrotizing enterocolitis]. If we could watch it closely until the first of next week, the chance might be better with the corticosteroid injections we were giving to the mother. [We had been out for a few days, as the pharmacy hadn’t found a source in the country to restock – first time I had ever seen that medication run out.]
We did daily fetal monitor assessments showing the baby’s condition was unchanged. He was moving regularly. The mother was told she would need a cesarean for the earliest sign of labor or change in her situation; she had to come immediately to the labor room from her bed in the ward. I talked with the nurse in-charge to alert every nurse on duty that a prompt response was absolutely necessary.
Yesterday afternoon, the fetal monitor once again showed the baby’s condition was satisfactory with a “reactive non-stress test.” Four hours later, the mother came to the labor room saying she had a strong contraction. The team was alerted immediately, but the nurse had trouble finding the heartbeat. Dr. Bryan Myers, visiting here for two weeks, came up immediately as they prepared for a cesarean. It seemed like the baby’s heart was only twitching on the ultrasound. The immediate cesarean was fast but not enough to save the baby despite the pediatrician’s best efforts at resuscitation. Bryan said the placenta was only tiny and may have separated at the edge.
Please pray for us and Dorcas as we advise her for the future. We can say with certainty that she has much treasure in Heaven, but her body does not seem to have the ability to nourish a baby large enough to reach maturity or even given a chance under the best circumstances available here.
Please pray for my doctor’s visit on Thursday, Feb 2. I plan to stay overnight in Nairobi, do some grocery shopping, and come back Friday morning. I had hoped that my paperwork would be processed to combine this trip to the government building to get a long-term work permit and a re-entry visa for future trips. But it doesn’t seem it will be ready in time. Does God plan for me to return later in the year or at any time in the future? Please pray for this answer as well.
We have only six weeks before Rachel and I leave Kenya on March 10. There are many questions for our immediate future. Our house has been for sale nearly two years this spring. Is this God’s season for us to sell the house? If not, will we be able to refinance the mortgage which will expire this year? Where would He have us live? Will the volunteer medical clinics in downtown Indianapolis find malpractice coverage for me and other retired doctors? Does God have other medical trips planned for me? These are questions I am praying for answers.
Susanna’s baby is due in the next few weeks; Debbye is due at the end of March. Please pray for safe arrivals for these two grandchildren as well as Yoshiki’s continued growth required for his surgery. Rachel’s ministry has been very effective with her helps ministry. Please pray that we will finish well here at Tenwek over the next six weeks.
I did finish my project of editing the Watchman Nee book, The Normal Christian Life, for my family. Several were encouraged by it. I encourage anyone to read that important book if he hasn’t done so. Nee’s knowledge and radical “big picture” thinking is not sufficiently appreciated in today’s church.
This very helpful book is regarded a Christian classic. Nee To-sheng [Watchman Nee] lived in China from 1903-1972. Much of the independent home church movement in China today has its roots in his teaching and leadership. Arrested on false charges by the communist government in 1952, he remained imprisoned until his death.
This book is based on his lectures in Europe in 1938-39 as recorded in transcriptions and private notebooks. It represents his personal understanding of the Christian life towards the end of the first twenty years of his pastoral ministry service. Although it may seem so, it is not a systematic treatise on Christian doctrine. He did not edit this book or the notes himself. First published in 1957, the edition I have read and reviewed is a revision from 1961 published in paperback by Tyndale in the US in 1977.
Again, thank you for your prayers and support. We give God all praise.
Serving Jesus with you,
Paul and Rachel in Kenya