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”.

Spring is a coming in!

Tomorrow is the first day of Spring and daffodils are opening to drink in the light rainfall. Although he is not yet springing around, David is regaining some walking power and strength this week.

Accomplishments in the last 24 hours include eating some of those little Hunt's puddings by mouth (Dave is still on the stomach tube for the canned formula, however). I think we will stir up some Cerelyte ORS for him to sip during the day. And he is getting a few visitors as well as therapists. Paul and the kids came for supper on Tuesday when Gwendolyn was at Symphony practice for a concert on Saturday. Gabriel and Miriam didn't seem too worried about David's appearance sitting up in the TV study room with his stomach tube hooked up to his supper. This morning he practiced getting down the stairs with the Physiotherapist to use the walker down there on our ground floor. If it hadn't been raining, she said they would have practiced getting outside and sitting in the sun. Enshallah, we will go outside this weekend to inspect our blooming bulb flowers and bushes.

Right now it is still chilly enough for that gift Vermont Sweatshirt to feel good on him. Last night David watched a crazy basketball movie on cable TV with a good friend while Lydia and I went to Weds night chorale practice. “Bridge over Troubled Water” takes on a new meaning for us at this time. Today a couple from our church stopped by to discuss their summer drive across the USA to the West Coast where David and I were raised; so that was fun.

David has been tuning into several telephone conferences regarding the vaccine trials this week but can’t speak too clearly yet. Too many visitors would still be exhausting, I’m afraid. We do appreciate your cards and e-mails, although I probably am depending on this blog to respond to your prayerful concerns. One DC colleague has been regularly sending Bangladesh postcards with hilarious little ditties written on them – we have all 8 in plain view of David’s perch near his computer in the “recovery room.”

Next Tuesday we go back to the GBMC/Hopkins doctors and speech therapist for appointments so I’ll do the next posting then.

Home sweet home

We are home. It seemed like ages of the gradual weaning from the tubes in the hospital last week but now we are down to just the PEG tube feedings and wound care, liquid pain and anticoagulants for medicines. Despite the great nursing care and careful attentions of physicians, I think we are glad to be back in our own rather calm house. Supplies seem to fit in an empty dresser and under the bed so I feel "resettled." Paul Sack helped us get the office room set up for home health care and a visiting nurse came by this Saturday afternoon before David settled in to watch basketball - the Maryland defeat by Duke. David, in his usual scientific rigor, devised a daily medications schedule so we can keep accurate track of when and what to give.

Today another flurry of cards arrived in the mail as well as those copies of insurance billings for lab work and initial hospital days. We have no idea yet how much the intricate surgery, anesthesia, and hospital ICU cost. We are thankful for Hopkins Blue Cross and Blue Shield insurance which will cover 100% of the home health care, (I’m unpaid) supplies, and a visiting nurse to draw bloods several times a week. We pay a small deductible on all prescriptions. Unlike many Americans, we will not need to declare bankruptcy from this medical calamity because David’s employer (with matching deductions from his paycheck) has a paid-for plan. We are hopeful that President Obama’s team can work with politicians to restructure health care in America. Big insurance companies like Blue Cross negotiate costs with hospitals for their clients but uninsured people (like our daughter Rebecca’s family) pay the highest possible prices for care and medicines. Good health is costly but of high value for individuals needing help.

Ironically, David has been listening to Barack Obama’s “Dreams of My Father” on audio CDs, narrated by our current President. This man grew up, like most of you readers, with tremendous changes and many moves around the world. He knows that making transitions calls for careful planning, whether it is coordinating a move from a hospital to a home or a for country used to neglecting it’s poor to a nation which cares about equal access to educational opportunities, jobs and health! Many of President Obama’s closest relatives have had calamities in health care. I’ve been writing to our elected congressmen at federal and state levels about many of those issues these past days of Dave’s recovery. We definitely need to give voice to our hopes for improvement as well as work in every way to help our struggling neighbors and overseas friends!

I may make one more posting next week and then close this blog. We are assuming that Easter will mark his next transition back to work. Thank you for your caring for David during this month of miracles!

Preparing for departure from Hospital

We celebrated ten days post surgery today with the news that David should be able to transfer to our home for the rest of this month-long recovery! His expectation is to be discharged on Saturday. The trach tube came out this morning, so now it is just the PEG and the IV and soon, the IV will come out. David says that he is feeling much better, though the slightest effort still makes him very tired. Getting the trach tube out was very little effort, but he was exhausted so he took a nap while I got some exercise nearby. Our house should be much quieter and I know David may want to spend some time on the computer communicating with some of you once back in Fallston. The pathology report from Dr. Califano today was very good in terms of removing the culprit squalmous cell cancer with no apparent spread.

This afternoon, David "test drove" the cadallac walker loaned by the family of our now-in-heaven 97 year old church member. His speech is almost intelligible now, despite some swelling in the donor tissue area inside his mouth. Tomorrow he will practice getting up stairs without putting too much weight on that right donor leg. Also on Friday I'll learn how to change dressings and use the PEG g-tube for liquid breakfast, lunch, dinner and snacks. Our son Paul will be the expeditor for this move. We have some lovely flowers to take home this weekend (THANKS) and some music from a singing friend. Also, we are listening to President Obama reading his "Dreams of My Father" on CD. These next few weeks we will be house hermits but be keeping as mentally active and physically engaged as possible as David regains strength.

However, I doubt if David will have very much energy for visitors or phone calls until later this month. We are certainly enjoying your witty cards, heart-felt emails and even some calls via my cell phone. Today a big box arrived from New England colleagues with maple syrup, a St. Patrick's hat, and several mystery packages that I must wait to have the patient open once home. Fun to anticipate these unnecessary surprises!

A very valuable surprise is the followup that is offered by the GBMC Dance Cancer Center therapists and the Hopkins Home Health group. Thank goodness for these services paid for by our Hopkins Blue Cross insurance! A visiting nurse will come by our home several times to advise us on wound healing, feeding, and to draw bloods for monitoring the blood thinners. Apparently the physical therapist and trach nurse will also make a home visit, as well as the speech therapist expert on swallowing as we try to transition to swallowing soups and other shakes by mouth later this month. We are certainly thankful that we had so many delicious meals with friends prior to these surgical interventions - the cans of high calorie nutritious beverage going into the stomach tube are not a shareable experience. But all this will bring David back to a healthy future, God willing!

Two tubes out and one in

I'm finding that progress for post-surgical recovery is marked by how many tubes are running in and out of the patient. Today the last wound drain was removed as well as the nasal gastric tube. David's face looks almost normal without the swelling but he still can't swallow too well and needs the trach to breathe. A PEG stomach tube was put in late this afternoon so that he can take medicines without an IV and also absorb more food directly, rather than through the narrow NG line. We realize that this painful insertion of a the PEG will make it easier to "eat" once we are back in our home. Discharge is still several days away, however.

Lately David is doing a lot of shoulder shrugging (part of his physical therapy, if you can believe!) to prevent him from becoming too stiff necked. He's always been calm and easy going before... He is also learning to handle a walker with a certain careful grace in the hallway outside the room. .. hard work for a goal oriented scientist! The leg wound looks good, if you like horror story wounds. Sometimes I feel like singing him the "head, shoulders, knees, and toes" song our grandchildren learn - the body parts are all there but needed to be rearranged a bit to work well. Speaking of grandchildren, they now believe that GBMC is the ice cream parlor since I've treated them in the cafeteria each time they have come. They don't even need to peek in his room to "see" this transformed Poppa Dave. Each time we share an ice cream, they feel like they have visited him (and the nurses enjoy these chirpy little blonde kids). They enjoyed the PT room tonight, in fact, with Lydia as their amused supervisor while son Paul and I bid David a sweeter sleep.

Your many cards, some beautiful flowers, such kind e-mails and those sincere prayers are the best "visitors" for David at this point. We are enjoying catching up via my e-mail with some overseas friends during this ordeal. Several of you have shared parables of healing with us, including the vision quest scene of a young Indian boy who is left alone all night, blindfolded, in a dark and scary woods - he was told not to leave that place and be brave until the sun rose when he could remove the tight eye cover. Frightening animal noises and imagined dangers haunted him in those lonely hours but he stayed firm until dawn. When he took off the blindfold, there was his own father sitting close by, watching all night to protect his stalwart but terrified son from any real dangers. So it is with illness and our imagined worse fears - our God is watching over us even though we are unable to see.

Although David has had to drop out of the Deer Creek Chorale, the Director has chosen several appropriate songs for our choir concert April 26: The Storm is Passing Over and A Bridge over Troubled Water. Tonight on the way home from the hospital, the full moon was shining through the gathering rain clouds. Life offers so many parables for us in difficult times.

Sunday Morning - International Women's Day 8 March

I simply need to report that David has the love and respect of the wonderful nurses (only one is male) at Greater Baltimore Medical Center. These multinational health providers have been caring for the wounds, keeping the nutrition and medicine tubes flowing, and encouraging Dr. Sack to communicate any problems. BRAVO for the women who chose nursing as their service careers. Please call and thank any female friends who are nurses or physicians on this day of celebration of women!

Healing is always slower than the "patient" desires after major surgery but his doctors are still very happy with Dr. Sack's progress. Rebecca wrote from Burundi that she was especially praying that the redness and swelling in Dave's leg would disappear. Sure enough...Today a wound drain was removed from his leg and a new dressing put on (the saran wrap post surgical dressing did well to prevent cross infection). You just have to believe in the power of prayer, dear friends! Dave will try to be sitting up more but don't expect lots of energy in e-mails yet. Dave is experimenting with talking through the trachea but mostlyhas the exhausting work of writing on a dry erase board to communicate.

Visitors are discouraged although Stan Becker is stopping by before flying to Dhaka so those of you in Bangladesh can get the first person report from him next week. I have a bag full of beautiful sentimental cards to take to David from so many of our friends. Thanks - these will be a big boost.

I stopped by our Fallston house after church today (very interesting peace sermon about the children of Abraham needing to live together without fighting from a former World Vision friend who has lived in Bangladesh, Cyprus, Germany, South America, etc.) and discovered the most magnificent box of orchids I've ever had in my house - better than those in Thai or Singapore airports. Thanks to Hopkins folks who must know that these flowers will outlast any others for David's homecoming (we hope late next week)! I'll be staying nights at home with our borrowed 13 year old daughter so I'm enjoying them (and taking 4 sprays to the hospital room as soon as I post this).

Day 5 Post Surgery - Weekend Strengthening

We must be getting better because we found a few kinks to complain about yesterday - and, by the end of the day, they were made better! I call them our "small wonders." Because of blockage from too many oral medicines, David's narrow guage NG tube needed to be removed and replaced. Also the trach was switched several times and a pressure drain clogged up on his leg and was eventually fixed. I wonder about all this "plumbing" but you need mostly to know: David is feeling better and major recovery is happening.

Some progress notes: Instead of only communicating via inscrutible writing on a dry erase board, our friend Alain brought by the smallest computer we have ever tried to use with a speaker notepad software and amplifier. Dave could type an inquiry to a nurse and hit the full stop and a deep voice read the line! However, the trach nurse and speech therapist prefer that he use his energy by inhaling deeply (nice therapy!) and voicing through larynx. Both methods make him a deep, deep bass now but he's gotten used to the write/erase board mostly and makes his needs known. I caught him "talking" about the various vaccine trials to a Brazilian ENT resident yesterday morning...

Despite the disconnection wonders, his swelling is going down and the bone graft is really doing well in his jaw. He's looking almost normal although I overheard him say that he had requested a Paul Newman face from the Ghana plastic surgeon. He's still the same old Dave (probably feeling advanced in age this week but grateful for survival).

Thanks again for all your prayers, a manageable flow of short e-mail encouragements, and our daughter Rebecca's hilarious e-mails about life in Burundi to keep up our spirits. I'm taking in Dave's computer (better keyboard) this morning after breakfast with Mosleys where I sleep at night. But please don't expect David to respond immediately if you write him. He needs those beauty sleeps if he ever is going to audition for Paul Newman's roles!

March 6 - continuing recovery

With the move to a general recovery ward, we anticipate that David will need to become more mobile in order to increase circulation in his legs. The walker stands ready near the door of room 5817 - but energy and resolve are needed. Also, new blood thinners were prescribed to keep pesky little clots away. Visitors need to wait until next week since the trach precludes good conversation (we have only a small white board for Dave to write down his thoughts for doctor's and nurses). We appreciate the fun e-mails from Africa and kind thoughts and prayers from all our friends and family.

Leaving the Surgical IntensiveCare Unit on 5 March

The doctors are well-pleased with David's progress in wound healing, use of the trach, sitting up most of the day. The wonderful nurses have started some nasal-gastric tube feeding. They predict that he can be shifted to a ward room on Thursday. No visitors this week but we do so appreciate your e-mails, prayer power, cards, and concern so please do realize that we feel very much supported by myriads of friends around the world. Paul Sack checks on his Dad every day on his way between hospital and home. Rebecca and Paul Mosley are amazing in keeping in touch via skype and e-mail. I'm getting some intensive nurses' training during the days and good sound sleep at Henry and Bunny Mosley's at night. I suspect David will be hospitalized through the weekend as he begins to walk, gets some physical therapy, and his Hopkins doctors continue their proud observation of their miracle work at Greater Baltimore Medical Center.

David's surgery took 11 hours

What an amazing ordeal and wonderous work was done on this snowstorm Monday at Greater Baltimore Medical Center. David went into the OR at 7:30 and the two teams of surgeons finished their artistry by 6:30. Our dear friend Bunny Mosley stayed with me all day and son Paul came several times. Paul and I visited David in the ICU. David's small spot of gum cancer is gone and he has a new grafted jaw bone (minus a right leg fibula). He would not want you to see him with all those monitors and tubes and drains and IVs and pain medications but the vital signs monitor showed that David was diligently working at recovery tonight. He will be in the ICU for 3 days or so and then shifted to a ward bed where I can spend the night.

I will keep you posted on this blogsite because I will not have the energy/time/emotional stamina to respond to individual e-mails this week.

February 28, 2009

Two weeks ago David met with his Hopkins/GBMC oncology surgeon to determine that the squalmous cell cancer had returned in a small, non-invasive patch on his gum. It has been almost exactly six years since the end of radiation for the first mouth cancer. Although the dreaded second surgery is scheduled for this Monday, March 2, 2009 at the Greater Baltimore Medical Center in Towson, we are hoping for the best outcomes, again. This time the remaining weakened jawbone will need to be replaced by a bone graft from David's fibula so post-op recovery will be longer. We hope to be back home by March 9 or 10th. We anticipate that Easter will be time for David to walk normally and eat more solid foods again.

During these past six years our married children have presented four grandchildren for us to return to and love. Also during this past decade in Bangladesh, the ICDDR,B has thrived and pioneered in important public health discoveries, interventions, and exemplary international scientist's accomplishments (new laboratory tests for infectious diseases, training hundreds of public health students from around the world, publishing important Lancet series and winning newborn health articles, Bangladeshi scientists winning international awards, maintaining funders' confidence, and saving thousands of lives from diarrheal diseases). We have traveled to see dear friends in many countries and do feel that we have lived to the fullest.

We believe that David's work here on earth is not finished by this latest appearance of cancer. We appreciate our friends' and families' prayers from around the world. At our Long Green Valley Church of the Brethren, David was especially blessed by a simple annointing service, joined by deacons, friends, and both children (Rebecca & Paul Mosley were skyped in Burundi).
We have updated wills, finished many projects, asked colleagues to tend to David's Hopkins' projects, and are probably ready for next week's hospital stay at GBMC.