July 31 PM

Since Yahoo email was giving me guff for sending out so many email updates on Denise, I just started up a blog for her instead. Computer geek that I am, I can't believe I didn't think of this first. Make use of the comment feature to contribute your knowledge and encouragement.

She's still in critical condition, but steps in the right direction came later in the afternoon.

Denise's blood pressure was high enough that they stopped the blood pressure medication. They have to watch her, but we hope that she can maintain adequate blood pressure.
They turned her oxygen concentration from 80% this morning down to 65% by the time I left. Hopefully, her body will tolerate that. My understanding is that too rich an oxygen mixture can be bad.

On the down side, her platelet count was 18 so they couldn't do the lumbar puncture to see if there are some nasty bugs in the spinal fluid (hope there's no menengitis). They also couldn't do the D&C to clean her up from the labor. Both procedures run the risk of bleeding.
Also, she has a lot of swelling. They have been giving her a drug that helps her kidneys get rid of fluid in the bloodstream. But today they started her on Albumin, which I think is supposed to help get fluid out of cells so the swelling can go down. And her blood sugar was lower than what they wanted to see.

One of our friends told me that Denise is treating this healing process like a dance (she LOVES to dance). There are pauses here & there, back's to the audience sometimes, bursts of movement all of a sudden... That was a nice way to think of things today. Also, Denise's dad read day 25 of the Purpose Driven Life book. That chapter was about trouble, and it was perfect for today. I read it to Denise. Then when done, I put the iPod on her so she could listen to some Ella Fitzgerald music for a while. One of the nurses came in from another part of the hospital to say that everyone's thoughts & prayers are with Denise... very encouraging to hear that so many people care.

Thanks for the visits today! Our friend Kristen bought a journal for Denise and left it in her room. If you swing by the hospital, be sure to jot your name down there, and anything else you like!

Denise Update July 31 AM

Greetings!
We're sort of in a holding pattern, and they had me
sign a consent for a lumbar puncture (spinal tap, as
far as I'm concerned). Denise is still in critical
condition and most things are stable. We're a little
discouraged that her blood pressure dropped slightly
and they had to bring her oxygen concentration up from
60% to 80% (still better than the 100% she needed).
And we're still in the waiting game to find out for
sure what the cause of all this is.

However, several nurses and friends that have been in
my position encouraged me by stating that sometimes
Denise will make 2 or 3 steps ahead (and she DID with
those lungs the other day!) and then she'll pause or
go 1 or 2 steps backward. Looks like that's happening
now.

Since they've allowed people other than family to
visit, she's been flooded with well-wishers. In fact,
we'd like to keep a list for you to sign! One of the
nurses commented that Denise is definitely among the
most-visited and most frequently prayed-over patients
they've had. Thank you. I'm supposed to get the word
out that if you feel remotely ill, please refrain from
visiting until you are well for a few days (don't
worry... she'll probably still be there). Please wash
your hands before touching her, and ask the nurse if
it's OK to touch her, just to be sure. They've been
really generous with the number of visitors and length
of visit. But the nurse yesterday commented that it's
possible that too many visits could overstimulate
Denise & rob her of rest. So if your visit is cut
short or if you are asked to wait, please don't be
offended or alarmed.

As far as all the offers for practical support, I am
going to start contacting some of you soon. As the
adrenaline is wearing off, I'm faced with having to
plow through regular life in the midst of the crisis.
I am grateful that I have so many of you to rely upon
for the practical stuff. I'm glad I rub elbows with so
many teachers that are off for the summer and, oddly,
still want to be around my kids.

I'm going to the hospital in a while, so I may send
off another email this afternoon. Speaking of email,
Yahoo informed me that I now have a cap on how many
emails I'm supposed send. So I'm recruiting point
people that frequently check email so I can send just
to them, and then they can forward the updates to the
rest of a group. Maryly is taking care of Pasadena
Christian School staff, and I'd like a volunteer for
the parents (past and present... I'll provide a list
of email addresses). Kristen will be forwarding
for the Westmont College crowd. Cindy will be
taking care of Denise's dad's side of the family.
Melanie has been nominated to be the contact
for the East Whittier Friends Church crew (which also
encompasses most of the Quaker Meadow buddies... what
do you think, Melanie?). Has Jim been the guy
for Duarte Fellowship Church? I think once I get those
major groups taken care of, we'll be sitting pretty.

Thanks again for your support!

:O) Phil

Denise may have turned the corner :O)

Great news! Be edified that all the prayers, support,
and well-wishing IS WORKING.

Last night (Friday) the doctor told me that "I think we
may have turned the corner." He was encouraged by
Denise's progress. This was a glorious contrast to the
doctor telling us Thursday that we would lose Denise
if her lungs didn't start to improve within a day or
two. The lungs improved overnight! Let me tell you how
well it worked since you've all been pulling for us in
that specific area...

Yesterday afternoon, the doctor showed me Denise's
chest x-rays. He showed the inflammation/fluid getting
worse (appears cloudy) and worse through the x-rays.
Then the image taken Friday morning showed about 2
days worth of improvement! Denise used to need a 100%
oxygen concentration from the ventilator when on her
back, and 80% when on her front (they have this weird
contraption for flipping her on her face, which helped
her breathe better). At the moment, they have her on a
70% concentration while on her back. She's doing well
enough that they're not going to flip her anymore
(good... it was risky). Instead, they brought her a
bed that gently tilts side to side every few minutes.
I won't go into why, but it helps (it's a milder
version of flipping her on her face). They've been
able to tilt her bed up because her blood pressure has
improved enough to pump blood to her brain, and
they've even decreased the blood pressure meds. By
tilting up, it gets more fluid out of her lungs. Also,
her kidney function has been increasing, so she's been
able to get rid of more of the massive amounts of
fluids that they have to pump into her body (and that
makes for less fluid in her lungs). So the lung
situation is going very well. I guess that lots of you
have been putting us on prayer chains, and it looks
like it's working!

Her vital stats continue to remain at acceptable
levels (given her condition) or are ever so slowly
getting better (apparently she will be there for
weeks).

The latest twist is that yesterday morning, the
infectious disease specialist called to say that
Denise probably does NOT have Rocky Mountain spotted
fever after all. I won't go into the technical details
of why it took this long to figure that out. They now
think it is probably Valley Fever, but they'll have to
wait a week to be positive. Again, I won't go into the
technical details, but the coccidioides immitis
(cocci, pronounced KOK-SEE) fungus that is the cause
of Valley Fever looks too close to several other nasty
things to be able to tell just using a microscope. If
you have the time and are interested, you can look up
this stuff on the internet. Or pray for my wife.

Someone pointed out something to me that I can't
believe I didn't see earlier. That ordeal we had with
Gracie a couple years ago at Children's Hospital in
Los Angeles was probably preparation for having the
hope to deal with Denise's situation now. Gracie was
carried through that against incredible odds, with
none of the organ damage that the doctors feared. How
great it would be for Denise to come back home with no
adverse side effects from all this treatment! It CAN
be that great... I've already seen it!

So here are the next points of concern:
- The causes of Denise's problem are elusive and
involve waiting games. We'd like to find out what's
going on so it can be properly treated.

- If it IS cocci, a side-effect of the meds involves
high fever, which Denise has struggled with throughout
this illness. The cure might make the fevers worse. We
don't want damage to brain cells.

- We'd like to see fast improvement, and there's a
LONG way to go. When a doctor smiles, or says "Wow!"
when looking at blood gas results in astonishment, or
describes improvement as "remarkable," those are good
things. We'd like more of them so Denise can come home
& be mommy again.

- All of us are worried about Denise when the time
comes for her to wake up. She'll take the loss of our
baby Daniel pretty hard.

Thanks again for your support in every way. Keep it
up, as while Denise is improving, she's still in very
bad shape. They have started letting non-family
members visit, as long as they're with a family
member. Methodist Hospital's rule is 2 visitors for 10
minutes. But they've let us stretch that a little here
and there.

Thanks again! We're blessed to have you all in our
lives!

:O) Phil

Denise NEEDS Oxygenation within 24-48 Hours URGENT

Denise NEEDS for her lungs to improve (less
inflamation & fluid). This MUST happen soon, within
the next 24-48 hours, or the unthinkable will happen.
She's requiring a huge amount of oxygen and can't keep
on it because too much oxygen can be toxic. Everything
else hinges on this. They're doing everything they
can, and Denise is still having trouble breathing on
her own efficiently.

The doctor stated that if Denise passes away, she
won't feel any pain or know anything. That he said
this is scary.

Be encouraged that your prayers HAVE worked, and we
need more prayer NOW! Today, Denise definitely
squeezed my hand 2 times (weak, but they were
squeezes). Since my last email, I heard that her
kidneys were working well. Acidosis is getting better.
Urine flow is going well. Her hemodynamics did better
(she's more efficiently pumping blood through her
body). I heard that she stopped deteriorating, and all
the numbers that they wanted to get better DID get
slightly better (except the lung issues). She got her
oxygen requirements down to 80% when they flip her on
her front side (but she goes back to needing more
oxygen when flipped on her back, and she can't stay on
her front). She's taken the meds well. She's turned
for the better. But if she can't start breathing
better on her own and has diminished ability to get
oxygen into her bloodstream, then none of the other
improvements will matter.

Pour it on, everyone! God's been using her mightily to
bless everyone around her for the whole time I've
known her. I can't imagine that His To-Do list for her
on earth is done.

Thanks for the support!
:O) Phil

Denise Update Thursday July 28

Sadly, we lost the baby yesterday. When a nurse asked
my dad & I to leave so she could clean Denise, she
found the baby was crowning. The baby was born quickly
but the little guy was only about 6 months along and
they couldn't get his heart & breathing going. The
ObGyn said nobody suffered; Denise didn't feel a thing
and the baby passed away peacefully. He's in a better
place than we are now, and quite well taken care of.
As bad as this is, I still saw God working in the
situation. My dad & I were going to leave the
hospital, and a neighbor happened to be in the lobby
visiting her husband. The few minutes that we were
unexpectly detained talking allowed us to hear the
"code blue to CCU" over the hospital-wide intercom and
allowed us to get back up there. Otherwise I would've
been most of the way home. Bittersweet, but I was able
to hold Daniel Williams while he was still warm. And
for that I'm thankful. He was a perfectly formed
little guy, 14 inches long, 2 pounds, 3 ounces, and
beautiful (fortunately, all the kids get ther good
looks from Denise's side of the family   :O). I'm
simply not prepared for the decisions I must make
today and tomorrow regarding mortuary, cremation,
casket, funeral, memorial, etc.

Densie started recovering from the birth-related
issues remarkably well. But the other issues are still
quite dire. They had to start blood transfusions, her
lungs have increased in inflammation & fluid. Her
blood sugar went low, acid too high. She could take in
oxygen well, but couldn't get rid of the carbon
dioxide fast enough. Kidney and liver function got
slightly worse.

Last night they tried a couple procedures to help
correct the acid & carbon dioxide problems. The
acidosis has gotten slightly lower. While still very
bad, her blood pressure, blood sugar, and heart rate
numbers improved slightly. That's a good sign that
she's able to improve.

While typing this, the doctor called and said that her
urine output has increased dramatically from what it
was yesterday afternoon (though it's lower than when
she first went into ICU), and that's a good sign. She
has no uterine bleeding, which is a good sign.

He said the most crucial items (read: prayer points)
are oxyenation (lung fluid & swelling) and kidney
function.

Even though the doctors & nurses say Denise is
completely sedated & probably can't hear anything, I
still talk to her. I thought it was sappy when I saw
that in movies & TV shows. But now that I'm in this
situation, it seems to be the perfect thing to do. I
figure maybe she is hearing something, and it's good
therapy for me. I'm joking around (my way to cope) and
telling her about all kinds of mundane things, along
with plenty of encouragement and prayer whispered into
her ear. Her dad & sister were singing to her all
night long. I thought I'd bring an iPod to let her
listen to so she can hear all the music she likes to
dance to. That's infinitely better than me trying to
sing.   :O)

I've spoken and read email from many of you that said
you've been praying fervently for Denise & wisdom for
the doctors & nurses. The fact that there's been some
improvement is encouraging, and I'd like you all to
know that. But she's still in very bad shape, so keep
lifting her up! Losing our baby boy yesterday
constituted the worst day of my life. The possibility
of having to bury my son and my 32-year-old wife at
this time is an unbearable thought. The kids (Gracie,
3 1/2 and Jacob, 15 months) are asking about mommy
more and more as the days go by. Truly, I'm having
"Job" phase in my life. About the only thing that's
propping me up right now is my faith in Christ and the
resulting confidence we have in where we're going when
God's done using us for His purpurse here on earth. I
say this because some of you stated that you admired
my strength through this. Trust me, it ain't *my*
strength. Not one bit.

Thanks for pulling for us. Please pour it on right
now!
:O) Phil

Denise in Very Bad Condition

Here's what's changed since Denise went into ICU
yesterday. Things are getting worse, and she's in very
bad condition.
She's been sedated, breathing tube inserted, feeding
tube inserted, catheters for measuring blood pressure
inserted, lung cam inserted to look around.
Lower white cell count and more lung fluid than
yesterday.

They're administering Xigris, a new drug that's not
been tested on pregnant women yet. The focus has gone
from doing what's best for Denise and the baby to
simply doing what's best for Denise.
As more procedures & drugs are administered, the
chances of damage to the baby have increased. The
ObGyn said we might need to prepare ourselves to have
the baby delivered early, and there would be poor
chance of survival for the baby.
In the latest phone call, the doctor stated that
there's a 53% mortality rate among patients in
Denise's condition. The good news I've heard is that
Denise's heart is as strong as ever, and that's going
to be a great asset in the fight.

Please forward/call the requests to other friends.
I've had some address book problems, and I know that
some of our common friends & family have been left out
of the loop. Sorry to those of you that didn't get all
the updates from the start. Oh, no visitors are
allowed except family in the ICU. Thanks for the
offers to visit, though. I'm driving over right after
I send this off.

Pray and pray some more, friends!
Thanks for all the verses! They're a great comfort to
me right now. Particularly, I liked this bit from a
song by the Newsboys...

"Lord, I don't know where all this is going
Or how it all works out
Lead me to peace that is past understanding
A peace beyond all doubt"

Glory to God, no matter what!

:O) Phil

Denise Moved to ICU

Just a fast update (and some of you are newly added to
the list and may not have known what was going on).

Denise was moved to ICU at noon today.

Her breathing is becoming very inefficient (they are
considering putting in a breathing tube, which would
mean sedation and lack of ability to speak).

The meds for the Rocky Mountain spotted fever don't
seem to be working well. So a new antibiotic will be
started that is risky during pregnancy. Doxycycline
can cause bone problems. However, the doctor said that
Denise is far enough along (over 25 weeks) that this
may not be much of an issue. This is the first
antibiotic that would be used for this disease, but
they were holding off because of the pregnancy.

Her fevers are still a concern.

And they found an oddball fungal presence in one of
the blood cultures. Since it didn't show up in any of
the others, they think it was just contaminated
somehow (lab guy has athlete's foot? Who knows). At
any rate, the doctors would like to treat one thing
and not two. So we hope the fungal thing is a fluke.

On a lighter note, somebody postulated that since
Denise has Rocky Mountain spotted fever, and is
getting so many drugs for treatment, it could be said
that she'll get a Rocky Mountain High.
Good thing she's a John Denver fan.

Thanks for pulling for us! Keep it up, everybody!

:O) Phil

Rocky Mountain Spotted Fever is the problem

Here's some information that we just learned tonight.

The good news: They figured out that Denise has Rocky
Mountain spotted fever, not contagious, and no spinal
tap will be necessary. Most likely from a trip we took
to Big Bear or Tennessee (less likely due to the time
frame). Antibiotics should take care of the problem.
AND Denise is one of only about 800 Americans per year
that get this... they could set up a pretty exclusive
club at that rate.

The bad news: She will need to stay in the hospital
for a while because the fever can persist. And the
fever is what they are concerned about with the baby.
Of course, we're hoping for a short stay with minimal
discomfort from fever & chills. She feels rotton most
of the time & is having trouble getting quality sleep.

Thanks for all the well-wishing and offers of practical
support! We're blessed to have you in our lives!

:O) Phil

Denise In Hospital

Hello!
We'd appreciate your prayers. Denise has been sick
since July 13. On Monday July 18, her ObGyn admitted
her to the Methodist Hospital in Arcadia. Denise has
had high fever, chills, weird rash, cough, all on top
of being gestationally diabetic. Our baby boy is due
November 4th. Fortunately, the baby (a boy, they say)
is doing great. But thus far, the doctors haven't been
able to figure out what's wrong with Denise. They've
already tested all the usual fluids, and all bacterial
& viral cultures have come back negative. They're
assigning an infectious disease specialist to her and
there's talk of a spinal tap being the next step. So
what we thought would probably clear up with a day or
two in the hospital is starting to get scary.

Thanks to those of you that got early word of this for
your offers of help. My folks have been a tremendous
help (my dad is currently on a chemo break, and has
indicated he'd rather not start up again when it's
time, for those of you that have been asking... not
enough time for all the details here), and Denise's
folks are here helping with Gracie & Jacob (who really
miss mommy) for a few days.

:O) Phil