Summer is here!

A week following the debulking surgery, capillaries in Dave's transplant tissue leaked and caused much swelling as well as a disappointing appearance. Some adjustment in the blood thinning medicine apparently stopped the trauma and he is better now. In fact, his jaw and outward appearance are looking more normal, finally. The area is still painful and no steak dinners are being ordered yet. Next Tuesday he hopes to get the stomach tube removed by his surgeon at Hopkins (it was left ready in case the bleeding required feeding via tube instead of via mouth). On Saturday he plans to fly to Geneva for an important meeting regarding making cholera vaccines more readily available where epidemics can be controlled (as in Zimbabwe last Dec-Jan). Hopefully the PEG tube incision will heal as quickly as the surgeons say and the changes in air pressure won't cause inordinate pain on the flights to/from this short WHO conference. Here in Baltimore, David has been keeping up the pace at Hopkins and in working with many colleagues around the world via his computer and skype. Jean has also been lobbying in Washington DC for Foreign Aid reform (organized by Bread for the World) and locally to prevent our Fallston branch library from closure due to recession deficits in Harford county. Sightseeing with grandchildren and friends has also been possible in June!

Monthly meetings of a head and neck cancer support group at Greater Baltimore Medical Center have certainly given us perspective on this type of cancer and the courage which so many people must conger up to survive with much more severe deformities than David.

We plan to meet Rebecca and Paul Mosley and our two young grandsons in Nairobi at the end of July for their two week vacation in Kenya. This will be precisely 5 months after Dave's surgery and a great way to celebrate our 43 anniversary the first week of August! Thanks for your continuing good thoughts and prayers for David's successful recovery as we say goodbye to spring and welcome the first day of summer!

Second outpatient surgery went well today

David is back at home today, June 1st, taking it easy after a short operation to reduce the unneeded bulk of tissue on the transplanted gum. Back to some nutrition supplements via the stomach tube but he was able to take the liquid pain killer and antibiotics orally after we drove home from Hopkins. It's beautiful weather for just staying home this week (and watching the berries, cherries, sugar snap peas, spinach, lettuce, and swiss chard ripen in our garden). Two bluebirds hatched in our birdhouse this week. Life seems hopeful. Thanks for your prayers.

Going to work again

Three days of this past week David was working in his Hopkins lab and office (and the other days on his computer at home). He's driving himself (both the car and literally) but it's liberating! On the weekends, I finally decided it was time for us to do some work in the yard and I encouraged David to supervise/assist in the tree planting, grass trimming, and spraying our beautifully flowering fruit trees. It gives us all a mental boost to be outside with the birds, tulips and final daffodils in their full glory. We also managed to remove an entire garbage can of blooming dandelions from the lawn over the past two days. One of our rewards was fresh garden asparagus and rubarb for dinner.

The third week of May will be the next step of his recovery - the reduction of the bulk of the jaw transplant so David can close his lips for easier eating and speaking. I suppose this is considered a small "tidying up" compared to the March 2nd operation. Fortunately, this debulking will occur after a colleague comes from Dhaka, after his brother Bob visits from Oregon, and follows the next vaccine trial conducted by David's staff. We are not sure how much trauma that procedure by the Hopkins surgeon will be. I'm fairly sure that the stomach tube will be put to use again, however.

Slowing down to smell the flowers

David was hit by a stomach/bowel malady this past week. Perhaps caused by a new regime of antibiotics, he thinks he has a mild case of c-difficile and his physicians have prescribed flagyl. Those of you readers who have had to take this huge pill know that it is difficile in itself.

Hopefully he will be out with me this weekend, directing me where to dig the holes for two new plum trees and some new raspberry bushes. We may even be able to harvest asparagus and smell the hyacinths in bloom.

Although several international trips scheduled for this month and next have been cancelled, David has had conference calls almost daily with his colleagues around the world. We also experienced a simple use of telemedicine when Rebecca & Paul used their computer screen (set on a blank Word document page) as a light box for Oren's new arm Xrays. They were in Kigali for meetings with MCC partner organizations and wisely decided to check the healing inside his left arm cast. The radius break had shifted to a 30 degree angle. Orthopedics experts in Baltimore (at Paul Sack's Union Memorial Hospital hand center) and Nairobi (thanks to Embassy friends there) were able to see the new Xrays and urge Mosleys to get Oren's arm reset. The reduction, done after hours of waiting in the Rwanda hospital, was terrifying for our 3.8 year old grandson but we think it was performed safely and well. I believe that Rebecca's family will also need to slow down there in Kigali and find some flowers to smell while Oren recovers enough for the bumpy 6-7 hour drive back across the mountains to Bujumbura.

Dave has been going into Hopkins on Mondays now, with our daughter-in-law Gwendolyn, to meet with his great laboratory staff and administrators. But we have more doctor's appts next week and possibilities of scheduling another type of "reduction" - the bulk of the mouth tissue on the bone transplant is too big for him to thoroughly close his mouth for eating and speech. Stay tuned and enjoy your own Bengali New Years and Springs!

Discovering depths of friendships

If we were to analyze new insights gained from David's need to go through this life-saving surgery, I think the blessings of friendship are right up there with appreciation for the medical interventions. Friends have called from all over the earth, e-mailed from dozens of countries, written cards, and visited from around the Baltimore area during this recuperation month. David would have to take another month off to read the new books you have sent or view all the DVDs on loan. It's amazing, humbling, and inspirational to have such friendships sustaining him.

Friends at church welcomed David back to worship last Sunday and assured him of continued prayer power. On the first Friday of this month we went with close friends to hear Mahler's 9th Symphony played poignantly by the Baltimore Symphony. Like many other 9ths, this profound orchestral vision was Mahler's last completed work and captures the sunlight and darkness of his life = appropriate for Lent and this Holy Week. In playful contrast, we took friends and Paul's family to the Orioles opening baseball game on April 6th where Vice President Biden threw out the first pitch and the New York Yankees were defeated 10-5. David took advantage of a wheelchair loaned by friends and all 10 of us had great leg-room seats in his "assisted" section of the ballpark = the benefits of a disability. Finally we have had friends/family over for dinners this month and shared food and memories. Henry Mosley had just returned from his visit with our Burundi family and showed amazing photos of Rebecca & Paul's work and friends there.

We appreciate this week's confluence of important religious events - Passover and Easter. We realize that life is a journey directed by God and shared with family and friends until death parts us. Getting well from an illness is like a type of doorpost marker or symbol of salvation to remind us of the power of the divine.

Obviously David's surgery and recovery are not unique - many of our friends and family have been through similar ordeals and thankfully survived to continue life's purposes. The 98 year old Oregon mother of our artistic sister-in-law, Corinna, sent David this wonderful lyric:

Thanks for the memory
Of skimpy gowns to wear
To cover up your bare=,
Of tubes and things and needle stings
And hurts from heels to hair-
How lovely it was-

Thanks for the memory
Of pokes that do not please-
Like tracheotomies,
Of catheters when one incurs
Such gross indignities,
How lovely it was-

The orderlies always on call,
For that fast gurney ride down the hall,
You might be enjoying it all,
But it's not far to the O. R.
Thanks for the memory

You guess you've walked the walk,
From doctor's double talk,
You're cut and stabbed and sliced and jabbed
And left with wounds to calk-
We thank you so much !

Thanks for the memory
We're starting in apace
At sculpturing your face
A human or a Newman
Says the surgeon on your case
How lovely it was-

Thanks for the memory
Of all those pounds you've shed,
While, awkwardly, you've fed
From IV stands
And nurses hands
On your proactive bed
How lovely it was-

The ambulance sirens at night-
Rapid footsteps you hear out of sight,
Don't help any sufferer's plight,
Hold tough, old sock-
find wood to knock...

Thanks for the memory
Their praise of doctor's skill
From Brad and Bob and Bill
And better yet- do not forget
To sign a living will.
We thank you so much !

VP Campbell 3.27.09

As David eschews the stomach tube formula, his Hopkins Lab team sent in another artistic tribute for him to consume: An edible fruit arrangement which Lydia and I also are enjoying. The vagaries of Spring sunshine, rain, hail, rainbows, and budding trees areencouraging revitalization inside and outside of our Fallston home on this Sunday.

Doctors declare David's progress successful

Already three weeks out of surgery and David has gotten good reports from the surgeons and therapists we visited at Hopkins and GBMC yesterday. He used the walker to traverse some long hallways at the JHU Outpatient Center and was grateful for the fold-down seat during the prolonged delays in a crowded waiting area. According to the surgeon who transplanted the fibula to jaw, the stabilizing “boot” for his right leg won’t be necessary unless Dave goes on further long walks. That leg incision looks better and the trach opening is nearly healed over. The GBMC swallowing expert/speech therapist is working with David to get his swallowing and jaw opening functioning better, despite the swollen tissue inside his mouth. Hopefully that replacement will lose bulk naturally and David will find that eating and speaking are coming back rapidly. The physiotherapist has a routine of exercises for his shoulders, neck and legs. This is definitely an amazing team of specialists working with David for complete recovery ahead. Our next oncology surgeon’s appointment is in late April, after Easter.

We also met with the nutritionist yesterday. Dave’s stomach PEG tube stays in for a few more weeks for the highly nutritious supplements and medicines. There are entire cookbooks for cancer recovery but I’m mostly just adapting our normal diet for this wounded researcher. For Dave’s supper, I blended up some of the chicken curry and dal I cooked – a la Bangladesh! Today he consumed scrambled eggs for breakfast and put crackers in his lunchtime cream of broccoli soup to practice near normal swallowing. Dave thoughtfully slurped and “tasted” a chocolate/peanut butter milkshake this afternoon and anticipates the chewing exercise of meatloaf and mashed potatoes with asparagus for supper! Who knows, he may gain back that 12 pounds that he shed earlier this month. Interesting that culinary enjoyment is so much a part of our social life. So, we will look forward dinner guests next week, but I won’t offer to grind up their meals, I promise.

In the hallway of GBMC is a little saying: “Life is not about waiting for the storm to pass but rather learning to dance in the rain.” One aspect of David that you all will agree is that he maintains a positive attitude and is always willing to learn something new or even to be the subject of an experiment. An associate at Hopkins has an uncle who invented that facial jaw replacement with the fibula, in children, about 25 years ago. I’m glad that it works in adults as well. David definitely is still low on energy but I’m working out in the garden whenever I can before that rain comes. Our grandson, who was playing after the rain in Rwanda, fell against an iron gate and broke his left arm. You can bet that I will definitely hang on to David on rainy days!

Speaking of Hopkins, each day David is spending hours on his computer and is trying out a new lab software for analyzing the tests necessary for antibody titers. Next Monday we will go back into the SPH for a meeting with his vaccine testing lab staff who have successfully done two trials during his absence. Hopefully David can begin to do the drafting of an NIH grant proposal, using work from Dhaka. If President Obama is serious about opening up more funding for scientific research, especially in health breakthroughs, why not participate? Perhaps this enforced rest and time away from his office can be productive? Thanks again for your many communications, books, and prayer power on this “dance”.