Friday, August 22, 2008
(Debbie) Karis was released from the hospital late this afternoon, once the docs were satisfied that she was stable enough to come home.  She's very happy to be free again!

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Thursday, August 21, 2008
(Debbie) Karis has been sleeping all morning, still exhausted from obstructive episode.  A doc just came by saying they need to keep her in the hospital a little longer.  She's still not fully rehydrated from all the fluids she lost, and her EBV has continued to climb--now 25,000, despite IV meds.  The docs are debating whether to let her try to eat something.  Her scope & biopsies yesterday (checking for rejection) were perfect, so they may try lowering her immunosuppression one more notch to give her body increased ability to help fight the EBV.  Her platelets and potassium are in normal range at the moment so they're easing off on those meds.

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Wednesday, August 20, 2008
(Debbie) Karis did well while we were traveling. A few hours after Rachel, Valerie, and I landed in DC from Guatemala this morning, however, we received a call from a friend saying Karis had been hospitalized with a bowel obstruction. We drove from DC to Pittsburgh this afternoon after Dave's flight arrived from South Africa (via London) and are with Karis now. She's doing better. The obstruction resolved spontaneously this afternoon and she's receiving IV's to compensate for the dehydration that usually accompanies these painful events. They're giving her IV Gancyclovir also, to try to bring her high EBV level down. Otherwise things have been going well, and Karis has been working hard on her thesis (63 pages written so far). We're happy that she stayed well while we were gone!

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Thursday, August 7, 2008
(Dave) Karis just had a check-up with the transplant team.  She's doing well overall, with more energy and ability to focus.  Until this weekend she had trouble reading more than a paragraph, but that seems to be improving as she works to recapture temporarily lost ground.  She's working hard in PT, walking now faster and with better balance.  She's still battling high platelet, EBV, and potassium levels, but these things are not making her feel sick.

The rest of our family will be leaving Pittsburgh tomorrow, returning Aug. 20 from Guatemala (Deb, Rachel, Valerie, Dan) and South Africa (Dave).  Karis will have friends staying with her while we're gone.  If there are no updates during that period, please know that things are going well.

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Wednesday, July 30, 2008 ~ Happy Birthday to our son Dan!!
(Debbie) Two steps forward, one step back.  As long as we are moving forward, we shouldn't get discouraged about the persistence of challenges along the way.  I just talked with Karis's transplant nurse (the wonderful gal who keeps track of all the details and helps us implement what the doctors order).  Karis's EBV had gone down to 5,800 (goal: under 200), but this last blood test shows it back up to 16,000.  She can't take a higher dose of the antiviral medication, so if the EBV persists high they're going to try to wean back her immunosuppressant (Prograf) so that her body can better help fight the virus.  This is a delicate process since we don't know exactly where the line is that will put her into rejection.  However, a lower Prograf level will be easier on her kidneys.  Karis's potassium is higher again also, so she's on a restricted diet, which accomodates the diet restrictions required by Coumadin, which she is being switched to off of twice-daily injections (nice to be getting rid of those!!) for anticoagulant therapy. 

GOOD NEWS: her platelet level is now in the normal range!  For the time being she's off the platelet-killer medicine.  We're working with two medications to try to pull out of the depression, hoping that soon she'll be capable of getting back to work on her thesis and conquering that last requirement for her "true" graduation from ND!  One step at a time . . .

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Friday, July 25, 2008
(Debbie) Yesterdays blood tests were encouraging:  Karis's platelets are down to 424,000!!  Hurrah!  The docs allowed her to cut back on one of the three meds they're using in relation to this.  She felt better after receiving IV fluids yesterday.  Needs to return for blood tests again tomorrow and clinic again on Monday (we seem to be on a yo-yo between home and Montefiore!).

We're so grateful for God's protection during the days that Karis was so vulnerable to forming blood clots, which could have gone to her heart, lungs, or brain.  It's good to breathe a sigh of relief that she's no longer in the serious danger zone.  Thank you for your prayers.

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Thursday, July 24, 2008
(Debbie) People have been asking whether Karis's numbers have continued to improve.  Yes, though there's still a ways to go.  Last tests showed platelets down to 750,000 (from over a million; goal: under 400,000), EBV down to 7,500 (from 23,000; goal: 100), hemoglobin up to 10.4 (from 7.6; goal: 11 or higher), potassium down to 5.0 (from 5.2; goal: around 4).  She'll have blood tests again today.  We're having to work to keep her hydrated, perhaps a side effect from some of the meds.  Karis is putting her limited energy into physical therapy.  She has more freedom of movement and has stopped taking regular pain medication.

We're very much looking forward to getting her off of some of the strong medications she's taking.  One side effect is depression, a purely chemical reaction that has hit her sideways and has made things extra challenging at the moment.  Karis has not been up to answering her cell phone or taking initiative toward anyone.  She just needs a little time to get her body chemistry sorted out. This will pass.  We know you'll understand and until it does, not take her withdrawal personally.  If you really need to communicate with her, please for the moment use my cell:  574 339-3350.

34 family members –including me– will be gathering in Guatemala in August to celebrate completion of the Nebaj Ixil-Maya New Testament, my dad's life work!  I'll be gone from Pittsburgh Aug. 8-20 unless there's an emergency situation.  Please be praying that the medicines will be effective, that Karis will soon be free from them, and that no other complications arise. 
Thanks! See www.IxilFund.org/IF

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Sunday, July 20, 2008 ~ 9:30 a.m.
(Debbie) I just heard from Dave that Karis is indeed coming home today; her platelet count is down to 840,000.  Hurrah!

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Sunday, July 20, 2008
(Debbie) Dave has gone early to the hospital hoping to be there when the doctors make morning rounds.  We hoped Karis would be able to come home yesterday, but despite high doses of medications, her platelets were a little higher yesterday than the day before (tho less than a million, which seems to be the "worry number").  Not having a spleen complicates the situation, because the spleen normally removes old platelets from the blood.  (Her spleen was removed during the multivisceral transplant.)  If today's numbers show a trend downward, they'll probably let her out.  Tests showed NO clots formed or forming in her legs, which was a big relief.

Everything else is going well.  Karis has been walking around and around the unit on her crutches.  16 times around makes a mile; I don't know how many miles Karis has walked (other patients have started saying "there she comes again").  She's moving much more easily and the pain has eased enough that she has started refusing her pain medication.  She's anxious to get back to physical therapy and to the activities she was beginning to feel well enough to resume, excited to be walking better than she has since before her first transplant (August of 2004).  Her physical therapist has said she'll need three months of work to strengthen her muscles and correct the foot drop (dragging of her foot) that she still retains from her past neuropathy.  She wants to conquer this even faster.  Anyone need a wheelchair, cane, and crutches?!

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Thursday, July 17, 2008
(Dave) Karis is being hospitalized.  Her platelets indicate blood density or likelihood of clotting.  High is 400,000.  The doctors were worried on Monday when it was 958,000.  Today it’s above a million.  She’s being admitted in order to deal with that and with the possibility of a blood clot (embolism) coming loose.

As regards her hip, Karis is better every day.  She had her first session with a new physical therapist yesterday.  He is the best she’s ever had.  Praise God for that!

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Monday, July 14, 2008
(Debbie) It's a beautiful summer evening and we just got back from an outing to a park.  Part of the time Karis walked with her crutches and part of the time Val or I pushed her in the wheelchair.  It was more fun than our outing earlier in the day, to Montefiore for clinic (we were there from 6:30 a.m. until almost 2:00 p.m.).  We won't know for a couple of days the current status of the EBV, but the docs are worried about the possibility of blood clots because Karis's platelet level is very high.  So they've added a second daily injection and another oral pill to her ever-increasing number of daily meds, and they want her up and active as much as possible.  This would be easier if she weren't so tired.  A few other issues were addressed at clinic as well and she's to go back to clinic on Thursday, with a visit to another doc and PT sessions in between.  Dave gets back tomorrow from Brazil.  If we don't update for awhile, please assume everything is OK.  We're trying to make life happen that doesn't revolve around medical issues.

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Saturday, July 12, 2008
(Debbie) They decided not to give Karis the problematic drug this morning.  Instead, gave her an IV version of the one she's already taking, and will repeat tomorrow.  Karis is fighting a bad cold — one more annoyance!  But her surgery pain is better, and she's walking more easily with her crutches.

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Friday, July 11, 2008
(Debbie) I spoke too soon yesterday about a quiet day.  A physical therapist came for a workout, then several visitors, whom Karis enjoyed, but she's pretty tired today.  We just received a phone call saying her EBV, rather than continuing to go down, has shot back up to 20,000.  We had hoped to discontinue the drug.  Instead they doubled the dose, and she has to go to the hospital tomorrow for an IV treatment which in the past has resulted in very painful side effects (these drugs are in the class of chemotherapy).  So I guess it's too soon to stop praying!  Thanks!

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Thursday, July 10, 2008
(Debbie) I think we've turned a corner.  Last night was Karis's best night since surgery.  This morning she got out of bed by herself for the first time.  We shared breakfast and devotions and now she's out again.  Praise God, no clinics or doctors or home care nurses scheduled for today, so she can just rest.

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Wednesday, July 9, 2008
(Debbie) It's been great to be home but it's been a bit challenging too, figuring out how to make Karis comfortable without the luxury of the fancy bed and nice recliner she had in the hospital.  Her pain medicine was cut significantly when we came home, and pain kept her from sleeping last night.  We spent this morning at Montefiore, where the transplant team addressed a number of issues including her pain coverage, and their way seems to be working better.  We are encouraged.  They pulled her PICC so we no longer have to worry about infection from that source.

Please continue to pray for protection from infection in her surgery site and from blood clots, for resolution of her anemia, lowering of her EBV count, for pain management, progress in PT, getting rid of 13 pounds of retained fluid in her body, and the ability to rest and sleep.  (In the last month her EBV level has come down from 23,000 to 4,600, but she was told today that they want to see it close to 100 before she stops taking the drug, which has some unhappy side effects.  We were told that EBV is the one single most dangerous bug for transplant patients.)

Each day should get better!

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Tuesday, July 8, 2008
(Debbie) Karis is still in the hospital, but she expects to go home this morning.  They wanted to make sure her hemoglobin level had improved sufficiently following her blood transfusion.

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Monday, July 7, 2008 ~ 2
(Debbie) Karis has been pretty shaky today and it turns out that her hemoglobin is low and she'll need a blood transfusion before she can go home.  We're also still trying to figure out insurance and home care details.  They're still saying they're trying to get her out today, but it won't be until later, probably this evening.

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Monday, July 7, 2008
(Debbie) Karis has been cleared for going home this afternoon!!  Just need to work out the details of home care.  She's learning to walk short distances on crutches.  She'll be doing outpatient physical therapy right here at Shadyside Hospital, which is very convenient for us!  Hallelujah!

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Saturday, July 5, 2008
(Debbie) Karis is off walking down the hall with her physical therapist, moving more freely today than yesterday.  This afternoon they'll take her down to the gym to practice getting in and out of a car and climbing two or three steps.  Exciting!  She continues making good progress in all areas, taking less pain medication now so she's not as dopey.

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Friday, July 4, 2008
(Debbie) Happy 4th, everyone!  Karis is doing well.  She just walked about 50 yards down the hall with a walker and one therapist.  This morning a drain was pulled out of her leg and they're going to pull the nerve block line today, since she's doing well with other pain medication.  She's steadily becoming a free woman!  She's sitting up in a recliner now, waiting for her brother and sister to wake up and come visit.

If all continues to go well, she'll go home from the hospital Monday or Tuesday.  We've been told we need to get a bed for her at home first — she won't yet be allowed to do the bending that a mattress on the floor requires.  If anyone in Pittsburgh has a bed you're not using that we could borrow for a few weeks, we would really appreciate it! Bed provided, PTL !

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Thursday, July 3, 2008
(Dave) Ted and Claudia Limpic, OC collegues formerly in Brazil and now in Spain, came from Spain for Karis's graduation.  I thought you might like to see their loving report of participating in that weekend with us.
PDF Limpic

Karis is doing wonderfully well after the surgery.  A small fever came and went this morning.  She has walked around her bed with a walker and the support of two people from physical therapy.  The pain that got up to level nine this morning (on a scale of ten) is now down to five with good pain treatment.  She's more asleep than awake cause of being dopey from the pain medications, but she's doing really well!  They've removed three tubes or lines which gives her more freedom, including the push-botton for pain since it's been replaced by oral pain meds.  Four tubes or lines to go! 

Our son Dan arrives tonight for three days.  YEA!

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Thursday, July 3, 2008
(Debbie) When I left Karis last night she was still very sleepy and saying funny things, so I expect she had a quiet night.  Dave stayed overnight with her and I'm heading over now.  Within a couple of days they should be able to start pulling some of the drains and tubes hooked up to her now.  Dan will be coming up from DC tonight.

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Wednesday, July 2, 2008
(David) Karis came through the surgery with flying colors.  She's resting well.  No fever or complications thus far.  She really looks good with no tubes coming out of her mouth, nose or neck!  YEA!

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Tuesday, July 1, 2008
(Debbie) Karis's surgery tomorrow is scheduled for 9:00 a.m.  She needs to be at the hospital at 6:00 a.m. to receive IV antibiotics before the surgery.  (The hospital is just a block away from our apartment!)  I asked her what she would like prayer for in particular:
1. That she not wake up during the surgery (as happened during her transplant surgery).  She has low blood pressure, so they can't give her deep anesthesia.
2. That no infection will enter her body.  (The EBV and the UTI seem to be conquered, thank God.) 3. That she not have trouble with blood clots.
4. That God will give Dr. Crossett and his team wisdom and skill.
5. That she not have any complications and can be out of the hospital in 4-5 days.

The postponement to July 2 allowed Karis and Valerie the deep delight of attending the wedding of precious friends in St. Paul, MN last weekend.  They got home yesterday evening.  The July 2 date also allows Dave to be here for the surgery, before he travels Sunday to Manaus, in the Amazon region of Brazil, for a long-planned conference.

Thank you.  A friend here has prayed that we would be "ridiculously confident" in God re. this surgery!

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Tuesday, June 17, 2008
(Debbie) We just received a phone call saying Karis's surgery has been rescheduled for July 2nd.  Two more weeks . . .

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Monday, June 16, 2008 (evening)
(Debbie) We're home from the hospital, feeling rather deflated.  (No pun intended, Karis!  Karis had several liters of retained fluid pulled from her body during last night and today. :-))  She's to report in to clinic on Wed. and if they're satisfied with her progress, we'll be able to contact the orthopedist to see about re-scheduling her hip replacement.  Certainly God is in control, and we do trust him for the next steps.

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Monday, June 16, 2008
(Debbie) Today's surgery has been cancelled — Karis has a urinary tract infection.  It will be rescheduled once this is treated.

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Saturday, June 14, 2008
(Debbie) Karis spent nine hours yesterday at the hospital doing pre-op testing, and the conclusion is that her Monday surgery is a go, 1:00 p.m. at Shadyside Hospital.  She's still working on her thesis!

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Friday, May 30, 2008
(Debbie) Karis was just informed that her hip replacement surgery has been scheduled for June 16. Please pray that the docs will help her manage her pain so that she'll be able to complete her remaining school projects before then! Thanks.

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Wednesday, May 28, 2008
(Debbie) Thanks to friends who took pictures (principally my 11-year-old nephew Noah), we can share some of the fun of Karis's graduation weekend!
      [click here to see photo page]

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Thursday, May 22, 2008
(Debbie) We joyfully celebrated Karis's graduation from Notre Dame, with the lovely presence of friends and family members.  We'll have a second celebration once Karis is able to finish her last assignments.  ND graciously gave her an extension.  She spent several days of her last week of the semester in the hospital but hopes to get back to work soon.

We moved Karis to Pittsburgh the night of May 18 (her graduation day), because docs here wanted to see her on Monday.  This week has involved many hours of in clinics and hospitals.  Bottom line: she'll probably be having her hip replacement surgery next week (or possibly the week after), and is also being treated for a couple of other things that have come up. Thanks for praying her through.  We'll let you know when we can have that second graduation celebration!!

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Sunday, May 18, 2008
Karis graduates from Notre Dame!

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Wednesday, May 7, 2008
(Debbie) Monday evening a group of Karis's friends had a lovely surprise birthday party for her.  We celebrate with joy 25 years of God's faithfulness to her and to our family.

As I write this, Karis is taking her second final exam.  Still to go: a take-home final (translation of a chapter from English into Arabic), a 20-pager still left from last semester, and completion of her honors thesis.  Please keep praying for good sleep that will allow her to focus!

God's faithfulness has been manifest through the provision of an apartment for us in Pittsburgh for the summer (thanks to MANY hours of work by our friend Marilyn!) and an orthopedic surgeon willing to work with Medicaid (feels like a major miracle).  Karis will be moving to Pittsburgh May 20th and has drs. appointments the next two days.  Praise God with us for his faithfulness!

Those of you who have been tracking with us for awhile will remember our little friend Ricardo.  He is in ICU at Children's in Pittsburgh with a large tumor in his liver.  Please pray for him and his mom, Eudiscélia.  We'll be seeing them soon.

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Monday, Apr 21, 2008
(Debbie) Karis continues to work hard on completing her academic work before graduation May 18th.  Her honors thesis is particularly challenging.  She wants to do something truly worthwhile, not just "get through," which leaves some of the rest of us just a little bit crazy!  Prayer requests:
1. Sleep.  Often Karis can't sleep because of pain in her hip (she feels like it collapsed more yesterday), but if she takes pain medicine the narcotics "mess with her head."  Less potent meds don't ease the pain.
2. Focus.  Sleep deprivation makes it hard to concentrate or work efficiently.

Plans: After graduation, we'll be helping Karis move back to Pittsburgh.  Valerie and I will be living with Karis in Pittsburgh this summer, and Dave plans to be there too about half of the time.  Karis will be examined by the orthopedist her transplant team recommends, and we hope he will set a hip replacement surgery date for late May or early June.  While Karis recuperates from surgery, she plans to look for a job.  She would love to find one with insurance that will take her on so that she can be freed from dependence on Medicaid.  We hope that the hip replacement will restore her ability to walk freely and without pain!  The surgery is high risk because of her low immunity (maintained to keep her from rejecting her transplanted organs), but Karis says she can't keep living as she is for much longer.

I'll be traveling to South Bend the end of this week.  I hope to get a head start on packing while Karis finishes her papers and exams, to simplify the move to Pittsburgh.

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Monday, Mar 24, 2008
(Debbie) I've asked my brother (who graciously manages this site) to remove the previous posting, at Karis's request.  She needs to focus on her work, so although she really appreciates everyone's love and concern, she needs freedom from being in the "fish bowl" for the next few weeks.  We'll let you know if something dramatic happens, but otherwise just keep praying that she'll be able to get her work done — and thanks for understanding!  Happy Spring, whenever it reaches you!

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Monday, Mar 10, 2008
(Debbie) Karis had some ups and downs during her spring break week but was able to complete the work for one of her classes from last semester.  Praise God for that!  One big paper to go, and this semester's work, including her honors thesis.

A friend, Francis, came over with his camera:
Album 166: Questioning Karis

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Sunday, Mar 2, 2008
(Debbie) I have received many inquiries related to turning Worshiping God in the Desert into a book.  That's not as easy to do as you might think!  I have learned, as I've started collecting rejections from publishers, that a thousand manuscripts are turned down for each one that makes it into print.  So I am trying, but I don't know whether it will ever be published in book form.

Along the way, I've done a fairly extensive revision of the chapters as they were originally posted.  Since receiving my last rejection, I've decided to go ahead and post these changes and new chapters here on Karis's site.  If there's a chance that they may encourage someone, I'd rather make them available this way than wait on what may be a vain hope for publication.

Many thanks to each of you who has encouraged me in regard to these memoirs!

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Saturday, Mar 1, 2008
(Debbie) Karis woke up this morning saying "I feel so, so much better!"  Hallelujah!!  The pleurisy pain is gone, and her tummy feels normal again.  She has the week of spring break ahead of her to work on catching up in school.  A new month, a new beginning!

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Friday, Feb 29, 2008
(Debbie) Karis seems to be doing better.  She handled a "soft" supper without major crisis last night.  She's just gone off to class and to make up one of her midterms and a quiz she missed.  We're encouraged!

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Thursday, Feb 28, 2008 ~ 2
(Debbie) The MRI showed that Karis's hip is already starting to collapse.  She will definitely need hip replacement.  Please pray that she can make it until after May graduation.

Our friend Larry in Pittsburgh, whom we have asked prayer for before as he awaits liver and kidney transplants, is once again fighting Hepatitis C with a powerful drug called Interferon.  Until that virus is cleared, he can't have transplant.  We would really appreciate your prayers for him and for his family.

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Thursday, Feb 28, 2008
(Debbie) Karis tells me today that she's not better, but she's also not worse.  It seems that the intense intestinal pain is an obstructive pattern.  When she eats something, shortly thereafter she has serious pain that doesn't relieve until her bowel releases, sometimes 12 or 15 hours later.  But each time the obstruction has resolved on its own, so she hasn't had to go back to the hospital.  The pain medication has been really helpful, not only with tummy pain but also the pleurisy and her hip pain.  I'm a bit concerned that she may get back into dehydration, but so far she seems to be OK.

The biopsy came back negative for rejection, which was not really a surprise (she didn't have the symptoms we've seen with rejection in the past), but it makes everyone feel better to know that.  I haven't yet heard the results of the MRI of her hip.

Karis was going through one of those intense obstructive episodes during the time of her midterms yesterday, so she'll have to make those up as soon as she can, as well as keep working away at everything else she's behind in.  We don't know what it will take for her intestine to start functioning properly again, so would appreciate prayer for that.  Seems to me it needs to heal from the impact of the dehydration.  We learned when Karis was an infant that dehydration is very hard on intestines, and can get into a vicious cycle that results in additional episodes of dehydration.  That's what we're hoping to avoid.

Happy Leap Day, in case I don't write to you tomorrow!

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Wednesday, Feb 27, 2008
(Debbie) Karis was released from the hospital last night, with her blood "numbers" back to normal.  However, she is still experiencing intense pain in her upper abdomen from time to time, for which we as yet have no explanation, and around her lungs, which is probably pleurisy (inflammation of the lining of her lung cavity, left over from her cold).  She was not able to study for her midterms last night until I ventured back out into the snow to fill a prescription for pain medication.  Please pray with us for discernment of what's going on.  Everything else seems to be fine.

During three days in the hospital, besides IVs for her dehydration, Karis had multiple blood and stool tests, a lung treatment, a chest x-ray, a CT scan of her abdomen, an MRI of her right hip (needed to help determine whether she needs hip replacement soon), and ileoscopy with biopsies to make sure she's not in rejection.  She kept the transporters busy!  We don't know the results of all the tests yet, but she'll see the doctor again tomorrow.

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Monday, Feb 25, 2008
(Debbie) Karis was admitted to Memorial Hospital in South Bend Saturday night with dehydration, after a week of diarrhea of unknown cause which she wasn't able to keep up with orally.  Sunday night she developed severe pain in her upper abdomen, so rather than going home from the hospital once the dehydration was resolved, she's still there.  Tests are being run but the cause of the pain is not known yet.  She missed a lot of classes last week because of being sick, and this week is midterms, so please pray that she'll be back on her feet soon.  Thanks!

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Saturday, Feb 2, 2008
(Debbie) Partly due to some confustion about which medications she is supposed to be taking, Karis has had a very tough week.  She hasn't been able to sleep, and is very discouraged about her academic work.  Please pray for her.  Thank you.

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Sunday, Jan 27, 2008
(Debbie) I just returned from a trip and learned the results of Karis's checkups in Pittsburgh and Cleveland last Thursday and Friday.  She has been transferred from the Children's Hospital transplant team to the adult transplant team at Montefiore Hospital next door, so this was her first acquaintance with new doctors, nurses, etc.  It was a very interesting time, with confirmation that her transplanted organs are doing great and new perspectives on ongoing challenges.  Dr. Kareem thinks it IS possible to reconnect her tummy muscles!  She had been told this would be impossible, so is very excited about this prospect, as well as some others that were discussed.  She has embarked on a program of "sleep hygiene" that they expect will help her sleep better at night and thereby be able to enjoy more alertness and ability to concentrate during the day.  This will help her tremendously in doing her schoolwork.

Her orthopedist in Cleveland said the x-rays and the increased level of pain Karis has experienced in her right hip both point to the need for a prosthesis.  Her right hip has developed a second area of necrosis, right in the joint, and the doctor says her hip could fracture at any time.  Good news is that her left hip has NOT gotten worse, so it looks like only the right side will require surgery.  He concurred with the request of the transplant team to transfer her orthopedic care back to Pittsburgh so that everything can be managed in one place.

The present plan, then, is to project surgery in Pittsburgh for May (after her graduation from ND) or early June.  I don't know whether they'll be able to do the muscle closure at the same time as the hip, or whether that will require a separate surgery.  Karis is happy about the prospect of being relieved of the pain she lives with and the inconvenience of not being able to walk freely or lift weights.

Prayer requests:
1. That Karis's hip not fracture in the coming weeks, so that she can complete the semester and graduate in May.

2. That the sleep hygiene will work, giving Karis a better chance of success in a pretty overwhelming amount of academic work to accomplish (including completion of two courses from last semester).

3. That she'll stay well through the winter season of colds and flus.

Thank you!

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Wednesday, Jan 9, 2008
(Debbie) All four of our kids came home to Brazil for Christmas, and we spent a week (Dec. 24-31) visiting two cities in northeast Brazil (Salvador and Natal), a longtime dream of Karis's.  Here are a few pics that Valerie selected (then use your browser's Back Arrow to return here):

www.flickr.com/photos/22656665@N06/sets/72157603671909637/detail/

"You make me glad by your deeds, O Lord; I sing for joy at the works of your hands."  (Ps 92:4)

The US airline lost pieces of Karis's (borrowed!) wheelchair, but our friends found one for us to borrow in Salvador and one to rent in Natal, and we're making do here in São Paulo.  (Still trying to work things out with the airline.)

Since we've been back home, Karis has been working several hours each day to conquer her incompletes from last semester, as well as spending time with friends.  Valerie has gone to Ribeirão Preto for three days to visit her good friends there, since she doesn't know when she'll next be able to come to Brazil.  We've also watched some challenging films: The Constant Gardener, An Inconvenient Truth, Invisible Children . . .

Karis shared briefly at our church service Sunday night, a time of celebration of all that God has done for her, while recognizing some of the challenges she still faces on a daily basis.  Jan. 10-11 marks two years since her 5-organ transplant!  More about that in a day or two . . .

Dan returned Jan. 2nd to work in DC.  Karis and Valerie return to ND Jan. 12th, Karis for her last semester of college!  On the 12th also, Rachel leaves with a group of young people from our church who will join others from São Paulo and Ribeirão Preto for another Promifé outreach, in an interior town of the state of São Paulo.  They will all appreciate your prayers.

We've been remembering what things were like for Karis the last time she was here at home in Brazil, May-June 2005.  At that time,

* Karis had no intestine, so of course she couldn't eat, and was completely dependent on TPN (nutrition through her veins).  We filled a good part of the dining room with her medical supplies.  She was on about 15 medications, most of them IV, some through her G-tube.

* She had so little energy that she spent most of her month at home on our living room couch, where she sometimes felt good enough to visit with friends.

* She had two huge long tubes protruding from her tummy into large drainage bags, that went with her wherever she went.

* She had no control over her right foot, but could walk with a brace.

* She was on high doses of pain meds to cope with chronic pancreatitis.  Her liver was going into failure (two months later she was told she would need liver transplant).

* She was still struggling to re-learn basic skills that she lost while in coma, like reading and writing.

* She refused to let her picture be taken because she hated the way she looked.

Now, though she has some daily challenges especially related to her hips, you can see from the pictures what a transformation there has been! Praise God with us!

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Saturday, Dec 15, 2007
(Debbie) Karis requests that we post the following:

Today we received a special request to make a birthday wish turned Christmas wish come true for a little girl in Alabama . . . her name is Dasia and she is a patient at St Jude's Children's Research Hospital. Dasia is 9 years old and is doing battle with Diffuse Pontine Glioma (tumor in the brainstem).

Last March, when Dasia turned 8, her wish was to receive a birthday card from every state in the United States . . . she only received three . . . but now, the word is out . . . Please join us and help make this Christmas very special for this brave little girl and her family . . . take time and send Dasia a Christmas card today.

Her home address is:
     Dasia Atkinson
     1808 Oakado Dr East
     Mobile, AL 36609

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Friday, Dec 7, 2007
(Debbie) Karis says her tummy is better but her hips are worse.  She has negotiated an extension for one of her classes (she'll complete it over Christmas vacation), so that she can concentrate on finishing the others.

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Saturday, Dec 1, 2007 ~ Happy Birthday, Jan!
(Debbie) As we begin Advent we praise God for his Presence in our lives.  Karis just turned in a long-overdue history take-home exam.  She's exhausted and overwhelmed by all that she has to do to finish the semester.  Please help us pray Is. 40:29 [click] for her through these last three weeks, especially that she doesn't get sick.  It's been five years since we were all home in Brazil for Christmas—we're hoping & looking forward to doing it again!

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Sunday, Nov 25, 2007
(Debbie) Karis is doing better since she had a barium swallow (an x-ray exam of barium traveling through the intestine).  She thinks the exam itself, with its required fasting and cleansing of the intestine, helped relieve accumulation in the trapped loop of intestine, which has been causing obstruction.  Otherwise, the intestine is healthy, a wonderful thing to know!  She's working hard in school, with lots to do before Christmas vacation.  We're praying that she'll be well enough to come to Brazil for Christmas!

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Thusday, Nov 1, 2007
(Debbie) November signals for me a renewed opportunity to give thanks to God for his grace in giving Karis's life back to us three years ago, when severe rejection and double pneumonia almost took her life following her first transplant.  We are deepy grateful to all who joined us in that battle (and all of the ensuing ones!) through your love and prayers.

A couple of weeks ago, Karis spent a day in the hospital in South Bend with a bowel obstruction, which though distressing, eventually resolved on its own without the need for surgical intervention.  Since then, Karis has continued to have intestinal distress.  Some tests will be done once they are approved for coverage by insurance.  The suspicion is that loops of bowel become entangled in adhesions, resulting in obstructive symptoms.  Additionally, Karis is battling a nasty cold, and feels exhausted.  Once again, we would appreciate your prayers as she tries to fulfill her responsibilities at ND while not feeling well.  Thanks so much.

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Saturday, September 8, 2007
(Debbie) Karis called yesterday.  Other than a sore throat (pray that it doesn't get worse!), she's doing well, very busy already with a very challenging course schedule that includes a course in the ND law school on defense of human rights.  She finally learned results of her hip x-rays:  her right is apparently just a little worse, but not enough to alter the course of treatment at this point.  The orthopedist wants new x-rays, and maybe some other exams, six months from now.  Meanwhile Karis is continuing with non-weightbearing exercise and riding a scooter all over campus.  It is such a blessing that ND provides that for her (it's blue this semester :-) ). She's very happy that a friend has moved in with her, so she doesn't have to wake up alone or come home to an empty apartment.

Please pray for Luke Murray's family:  a tragic car accident has taken the lives of 10 and 13 yr old cousins.  Thanks.

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Tuesday, August 14, 2007
(Debbie) Karis finished her Arabic immersion last Friday with a one-hour oral presentation in Arabic, along with papers & exams.  She flew to Pittsburgh on Saturday and other than visiting Ascension Sunday morning has mostly been sleeping (& trying to remember how to speak English :-) ).  It's lovely to be able to talk with her again!  She's exhausted but very happy with the successful completion of her Arabic course.

During the next few days in Pittsburgh she needs to work out a number of things regarding insurance for her next school year, a check-up with the transplant team, etc.  She hopes to make a trip to DC to visit her brother next weekend, then back to South Bend the following weekend.  Classes start again at ND on Aug. 28th, Karis's last year!  If all goes continues to go well, she expects to graduate from ND next May.

One answer to prayer is that blood work done in LaCrosse revealed the culprit of her allergic reactions:  egg whites!  She must have inherited this from her donor, because it was never a problem before this transplant.  She should now be able to avoid having more allergic incidents.

Karis is scheduled for a check-up with the orthopedist in Cleveland next Monday (the 20th).  She's optimistic that he will say "stay the course" with conservative therapy, rather than requiring surgery.

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Monday, July 16, 2007
(Debbie) Lukey made it through the night, but they had to increase his ventilator settings to help him breathe.  For a full report, go to www.CarePages.com.  Luke's care page is called lukemurray.  Thanks for your prayers for this precious little boy.

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Sunday, July 15, 2007
(Debbie) Just received this note re. Larry:

"Spoke to Maliya yesterday.   Larry has been sent home . . . His numbers suggest the Enterfurion is NOT effectively combating the  Hep C virus . . . The output of his kidney is fairly minimal  at this time and Maliya expects to begin home dialisis this week.   Doctors’ prognosis for his recovery is sadly, very  diminished. . . He, Maliya and the kids are at a very low point emotionally and spiritually. Larry clearly needs a Miracle.   So please pray."

And this about our little six-year-old buddy Luke, who is in the ICU at Children's with a blood infection and fever over 105:

"Things got really bad for Luke today. I just left the hospital and Luke is now on a ventilator to help him breathe. He does have an infection but forgot the type it is but it is coming from his broviac catheter. He has many other problems tonight. Low blood presures, high sugar readings and a very very low white blood count."

We've known Luke and his family since he was a baby.  Please join us in praying for them.  Thanks so much.

No news from Karis, so that's good news!

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Friday, July 6, 2007
(Debbie) I had a big surprise when I downloaded e-mails today:  an e-mail from Karis!  She said they allowed her to write to let us know that she's doing well.  Praise God!  Three weeks done, five to go.  Here's what she says, "I am learning so much every day I can barely sleep at night, it's all zooming around in my head . . . Pray for me as I delve into the Scriptures daily, rediscovering them in a new language and in this completely different context.  Pray that I might be a witness in this group of people."  The other students are a fascinating mix from various countries and cultures.

I also received an e-mail today about our friend Larry, for whom we have requested prayer before.  He is not doing well.  His transplanted liver is being attacked by the hepatitis C which destroyed his original liver.  The docs have put him on interferon, which is very hard on the kidneys.  Larry and Maliya are very discouraged.  We would appreciate so much your joining us in prayer for them.  Thank you.

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Monday, June 18, 2007
(Debbie) I don't know whether anyone is still checking this website, but just in case . . . !

Yesterday Karis flew from Pittsburgh to La Crosse, Wisconsin to begin 8 weeks of Arabic immersion.  "Immersion" means that as of today, she is not allowed to hear, read, write, or speak any language except Arabic for the duration of the program, except for medical necessity.  She will not have access to e-mail or phone (unless you write or speak Arabic!).

Karis called last night at 11 p.m. La Crosse time to wish her dad a Happy Father's Day (we didn't even realize it was Father's Day in the US!).  By then she had been up for 20 hours, with the early travel from Pittsburgh and then orientation and settling in at La Crosse, after only a couple of hours of sleep the night before, so she was exhausted.  In addition, her hips were hurting a lot (she said 7 on a scale of 1-10).  Her month in Pittsburgh was great as far as seeing people, but it was hard on her hips because she didn't have access to the kind of exercise that works for her (recumbent exercise bike or swimming), and she was not able to avoid stairs.  So in general, her pain level has been in the 3-5 range, some days worse, compared with 2-3 when she had her last checkup with the orthopedist in Cleveland May 15th.

In La Crosse, she will have access to the right kind of exercise, and she will not have to deal with stairs (the building she's in is handicap-friendly).  So please pray that the stress her hips are feeling will be relieved and that she'll return to the comfort level she had a month ago (or better!), and that there will not be further deterioration of the joints.  She's scheduled for another checkup in Cleveland on August 20th, before fall term starts back at ND.  The orthopedist says the pain level is the number one indicator of how her hips are doing, and she's to do her best not to stress her hips to the point of pain.

Please pray too that she'll stay well during these intense weeks, find ways to get the rest she needs, and have the energy to make the most of this program, taking a leap forward in her Arabic skills.

Pennsylvania Medicaid has refused to cover her medical expenses while she's in Wisconsin (blood tests, doctor's visits, Pentamadine treatment).  Karis has appealed that decision, but if she loses the appeal, she'll have to pay her expenses for these weeks out of pocket.  So please pray that whoever is making the decision in Pennsylvania will decide in her favor!  The appeal will be decided within 30 days of filing, which means about three more weeks.  (In August, Karis will have to work out a new arrangement with PA Medicaid for the new school year in Indiana, which last year was pretty complicated and messy.  Praise God she has a wonderful case worker who really goes to bat for her.)

Knowing that God is faithful, and knowing that you're praying, will help us here in faraway São Paulo deal with this period of "radio silence."  No news will, literally, mean good news!   Thanks.

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Tuesday, May 22, 2007 ~ re: Larry
(Debbie) I just checked e-mail after not having access for a few days and received the following from Maliya, our friend Larry's wife.  Can you join us in interceding for Larry?  He's been back in the hospital, in isolation, for several days.  Thanks so much.

20-May-07 Further update . . . from Maliya. [click—>]

We have found out today the Doctors believe the Hep-C is in-fact attacking the liver. This is not good the treatment for Hep-C is interferon a drug that will kill the kidney transplant. Larry's blood count is still very low 25.3 after receiving 2 units of blood and a drug called EPO which takes 2 weeks before any improvement will occur Larry is very sick He continues to be in Isolation due to his immune system being so low he will not be able to fight off anything at this point.  I need all of my family to continue to pray this is very serious and I am very scared at this moment. The medication that they would give for the Hep-C will kill the kidney transplant not to mention  there is only a 43% chance the hep-c will even go away.  Interferon very rarely does anything with the virus. So please let all family and friends know Larry's status and ask them to pray!!! I have to go now I have to get to the Hospital before I have to work tonight. I will keep you informed with any further up-dates love ya.

 Maliya

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Tuesday, May 15, 2007
(Karis) Last weekend we celebrated my sister Rachel's graduation from Wheaton College.  She has been such a sweet presence in my life since the day she was born.  I love her with all my heart and I'm so pumped she is on her way back to Brasil (home!) for the next year or two.  I have watched her grow in humility, love, independence and wisdom since she left for college four years ago.  And I am not the only one who has noted how much more beautiful she has become.  I have loved being relatively close to her during this last year at Notre Dame, visiting her apartment in Chicago and enjoying learning from her passion for the city, as well as cherishing times at her church, Resurrection.
 
Just a warning: within the next few weeks us Kornfield girls are all hoping to be getting our drivers' licenses.  Stay off the sidewalks!  =)
 
It was such a weekend for celebrations--my birthday, May 5, and Rachel's graduation, May 6.  How very appropriate, my younger sister celebrating her acheivements and me my survival.
 
Thank God for his sustenance!  Ebenezer: thus far the Lord has helped us.  I made it through an entire schoolyear, finishing my Spring semester without incompletes (and with a 4.00 GPA).  I have been officially accepted to the Arabic Immersion Program at La Crosse, WI for the summer.  Pray that I will be able to find a competent and willing doctor to take me on for the eight weeks I will be there, and that God will grant me the endurance to make it through the very demanding schedule they have set out for me.  Then I will have only one year to go, before graduating at long last in May '08.
 
Thank God for incredible support from family, friends and His people worldwide who have held me up in prayer, given me rides, done my laundry, let me cry on their shoulders, workshopped my poems, helped me move, made me meals, visited me in the hospital...  The list of those to whom I owe a debt greater than I could ever begin to fill is endless.
 
Thanks be to God for His renewed presence with me.  Immanuel.  The dry season is over, the harsh Sun has abated for a time.  I have been inundated with God's presence in such a sweet way.  This is in my mind the truest miracle in my life.  It is incredible to put my hand on my abdomen and feel my intestines move within me, to savor food and sunlight again, to have the strength to raise my voice enough to be heard; but more incredible is His grace.  The part of me I felt was crushed forever has been slowly phoenixing:  my ability to rest in God's presence, to cry, to worship wholeheartedly.  A Voices of Faith Gospel Choir Concert that I was a part of about a month ago was my chance to thank Him with my whole body, with the voice that He has restored...  I am incapable of really communicating how in love with Him and with life I am, though.
 
Not only that, we had a good report yesterday from Dr. Stulberg in Cleveland:  x-rays showed no further deterioration in my hip bones.  The doctor was more optimistic than I could have dared to hope, saying there was more than a 50% probability that I would regain my ability to walk without pain, without having to resort to hip replacement or other invasive surgery...  I still walk with a cane, and only short distances, but I can walk!  Praise the Lord.
 
This Sunday was Mothers' Day.
 
There are no words to express what Mama has been to me throughout the last months and years.  She will be leaving for Brasil soon.  Thursday morning will, Godwilling, be the last time we will see each other before Christmas.  Today will likewise be the last posting on this website, until (or rather, unless) something big happens...
 
God bless you all, and thanks for your continuing prayers.
 
Ebenezer,
Karis Joy

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Tuesday, May 1, 2007
(Debbie) Our friend Gary is back in the hospital with a high fever. His mom had just been rejoicing that his weight was up to 79 pounds! This situation is just really difficult and we ache for them. Please pray for Gary and for his whole family. Thanks.

Karis has continued to improve, alternating rest with hard work on her remaining papers and projects. She still hopes to finish the semester on time and not have to take any incompletes, but this last week out being sick was tough. The sun is shining and that helps so much!

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Sunday, April 29, 2007
(Debbie) It's a beautiful day here in South Bend, made even lovelier for us by the fact that Karis gets to go home from the hospital! No bacteria grew in the cultures, so the conclusion is that her pneumonia is viral. She's doing well and anxious to get back to work on finishing the semester. Thank you for your prayers!

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Saturday, April 28, 2007
(Debbie) Karis had a bronchoscopy late afternoon yesterday and came through it well. It will take another day or two to get results of the cultures and biopsies. If the organism is treatable orally, Karis will be released from the hospital. If it requires IV antibiotics, she'll have to stay in. We should know by tomorrow. Meanwhile she's in good spirits, particularly because she's found a way to access internet at the hospital and can now proceed with research for the papers she's writing.

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Friday, April 27, 2007
(Debbie via Daniel) The doctors still have not been able to identify the offending organism and an x-ray showed that Karis's lungs are getting worse. They are not entirely sure what to do but are frustrated that they could not identify the organism within 24 hours of admitting her, which was their goal.

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Thursday, April 26, 2007
(Debbie) No progress today in identifying the organism responsible for Karis's pneumonia. However, she's feeling MUCH better, which we believe is due to the antibiotics finally clearing up her sinus infection. She's been able to do some schoolwork and has enjoyed several visitors. The doctors have asked for prayer for wisdom to know how to proceed, since Karis has not been successful in coughing up a sample from her lungs that can be cultured. So far they are hesitant to do something as invasive as a bronchoscopy.

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Wednesday, April 25, 2007 ~ evening
(Debbie) CT scan shows an "atypical" pneumonia, not staph or strep or any of the usual ones. Please pray that the docs will be able to identify quickly which organism is causing this so that they'll know how to treat it. Thank you!

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Wednesday, April 25, 2007
(Debbie) Karis has just been admitted to the hospital with pneumonia. Appreciate your prayers.

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Tuesday, April 24, 2007
(Debbie) Karis has been quite miserable the last few days with all of the symptoms of a bad cold, including fever. She's being treated with antibiotics for a sinus infection. Please pray with us that this not turn into pneumonia, and that Karis can continue to complete her work as the semester draws to a close. Thanks so much!

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Saturday, April 21, 2007
(Dave) I just talked with Karis on her cell phone as she travels to Alan Komm's wedding in Pittsburgh this weekend.  She's really encouraged.  She's gotten A's in all her classwork this semester and doesn't feel under pressure as she comes into the last three weeks of the semester.  She's even more encouraged because the pain level in her hips has moved from the 5-7 range on a 0 to 10 scale, down to a 2-4 range.  She doesn't know if it's because she's been extra careful about resting and not standing or walking or if it's the medication or a combination thereof.  Either way, her quality of life has improved dramatically!

She's applied to two intensive Arabic programs for the summer and hopes to hear by the end of next week as to whether she's been accepted.  Both are in Wisconsin.  If she gets in the program of her choice, in LaCrosse, she'll be there from June 10th to August 10th — assuming she can work out the insurance issues with Medicaid in Pennsylvania.  And assuming that the May 14th consultation with the orthopedist in Cleveland is positive and doesn't indicate that she need surgery soon.

As regards the people we've been concerned about, Larry [click—>] has been released from the hospital but has a long recuperation ahead of him.  Izzy continues to really need our prayers as does Gary.

I'll be heading to the States on May 2nd for a small family reunion focused on Rachel's graduation from Wheaton College along with my two nieces, Claire and Sarah Kornfield.  Should be wonderful!  I'll be coming from a week of ministry in Bolivia and head back after a little less than a week in the US to our annual missions'  pastors' conference with about 1400 participants.

Thanks for keeping us in your prayers!  :)

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Saturday, April 14, 2007
(Debbie) SOS—please pray!! Our friend Larry (for whom you prayed several months ago [click—>] re: his long wait on the liver transplant list) finally had his transplant last week, but he's not doing well. He is seriously rejecting his new liver. He and his family (two teenage kids) are having a very hard time. Will you join in prayer for them?

Also, a sweet little 9-year-old named Isabelle, and her family, need our prayers. Izzy had kidney transplant several months ago and is in kidney failure now, probably because of the adverse effects of the immuno-suppressant medication that she takes to prevent rejection of her earlier intestinal transplant. Her kidney is in worse shape now than when she had the kidney transplant. Izzy also struggles with several other distressing complications. We met Izzy and her family when they first went to Pittsburgh for evaluation, and they are dear to our hearts. Thank you for your prayers.

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Tuesday, April 10, 2007 ~ Happy Birthday, Jessica!
(Debbie) Karis and Valerie spent a delightful Easter weekend in Wheaton with Rachel. Strong & willing cousins and friends helped carry Karis where she needed to go when the circumstances were not wheelchair-friendly. It's been a month since Karis started the medications recommended by the orthopedist in Cleveland. She's still having a LOT of pain in her hips, and referred pain to her knees, when she exercises, even the approved swimming and recumbent cycling. It's probably too soon to know whether the meds are helping. She'll have another appointment in Cleveland on May 14th.

Please pray for successful completion of the semester, and definition of details for the summer. Karis is hoping to do an immersion Arabic study program in Wisconsin.

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Monday, March 19, 2007
(Debbie) I just talked with Karis by phone.  She's back at school, working on another big paper, after a delightful spring break in Pittsburgh (following her Cleveland appointment).  She spent one day of her break at the hospital with a weird allergic reaction (no success in identifying the allergen) and dehydration, but got fixed up with IV Benadryl and 2 liters of fluids.  It was such a treat for her to see her Pittsburgh friends.

You will shortly see the posting of the last chapters of Worshiping God in the Desert.  I'm bringing it to a close so that I can invest in other projects. :-)

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Monday, March 12, 2007
(Debbie) Karis had her appointment with the orthopedist in Cleveland today. Good news! Recent developments in successful treatment of AVN in Japan point toward trying a conservative approach first, using a blood thinner to improve circulation and another medication to stimulate production of new bone cells. Karis is going to try this for two months, and then have another check-up in Cleveland in May after she finishes the semester at ND. So for now, no surgery!!!! Karis is VERY happy about that.

X-rays taken in Cleveland this morning show that the necrosis in her left femur is more interior, while on the right side the deterioration is more on the surface. This is why she has so much more pain on the right side. She is to keep a daily pain journal as a way of tracking what is happening with the AVN.

Karis was very excited that this doctor says she may swim, and she may pedal a recumbent stationary bicycle. She has been very frustrated by not getting any exercise. However, she is to avoid weightbearing, which includes standing and walking, because it is still possible for her hip to collapse. She has just moved to a ground-floor apartment, which makes her daily life much easier. Many thanks to all who helped with this move.

Karis flew to Cleveland in a small private plane, thanks to the generosity of Angel Wings. Our friend Alan from Pittsburgh drove up to meet her there and is driving her back to Pittsburgh where she will have a check-up with the transplant folks and visit friends during this week of her spring break. Angel Wings will fly her back to South Bend on Sunday.

Praise God from whom all blessings flow!!

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Thursday, March 1, 2007
(Debbie) We so often tell you difficult news that I have to grab the chance to share good news. Here's what Karis wrote when she received an e-mail from her prof saying she had gotten an A on her research paper from last semester: "I spun around in my chair and clapped, and still haven't stopped grinning."
Hurrah!! Hallelujah!!!

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Wednesday, February 28, 2007
(Debbie) Well, we have a new development. The insurance company has decided to send Karis to see an othopedist in Cleveland (not Duke, nor Philadelphia, nor Pittsburgh) who has given her an appointment for March 12th, during Karis's spring break. I researched him a bit on the net and he sounds like a very competent doctor, so we'll see what he recommends. Karis expects to move this week to a first-floor apartment. She has been advised to keep physical activity to a minimum to slow deterioration of the femurs. It hurts her too much to stand anyway. We're praying for God's direction about what can be done to help her.

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Friday, February 23, 2007 ~ Happy Birthday, Marsha ! !
(Debbie) People have been asking for updates on Karis but I haven't quite known what to say. We've pursued the option of her going to Duke but that isn't working out for insurance reasons. Then there was the possibility of her going to see a specialist in Philadelphia. Yesterday we learned from Dr. Urbaniak's office at Duke that there's an orthopedic surgeon trained by him right in Pittsburgh! So now we're going after trying to work with him. The earliest appointment we could get for Karis so far is March 26th, but we're worried that if we wait that long, it may be too late for any useful intervention. Karis's pain has increased so we don't think we have a lot of time to play with. Appreciate your prayers for things to work together in a way that can really make a difference for Karis.

Oh--I'm just seeing that the last notice we posted said that surgery would not be an option. At the encouragement of ortho surgeons in both South Bend and Pittsburgh, we're going after a second opinion on that question.

Duke has a site with a great patient's manual that can tell you everything you want to know about the surgical approach to AVN that's been recommended:
www.DukeHealth.org/Services/Orthopaedic/Programs/SpecificToBody/Hip/index

It takes a little while to access the patient manual (at least on my computer!), but it's worth it if you want to understand the details a little better. The link for the manual is at the bottom center of the page.

Last Friday (the deadline) Karis turned in her research paper that was left over from last semester. Hurrah!!

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Thursday, February 15, 2007 - Happy Birthday, Barbara Blechl ! !
(Debbie) No information to give you about Karis, except that orthopedists in both South Bend and Pittsburgh have recommended that she have an evaluation with experts at Duke.  We're still waiting for things to sort themselves out, like whether PA Medicaid will pay for an appointment in North Carolina.  Meanwhile, Karis is working hard to catch up in school and is preparing to move to a ground-floor apartment so that she won't have stairs to deal with.

Some people have asked, especially here in Brazil, how we can afford all that Karis has been through medically, with three girls in college, on a missionary salary.  (Perhaps we have a private fortune tucked away somewhere??!)  Maybe it's past time to address this question openly.

The answer, of course, is that we can't even begin to touch it.  The amount it has all cost is too big to fit into my head, yet God has provided over and over again in big ways and small ways.  Karis's medical expenses have been covered by Pennsylvania Medicaid since December of 2005, when she reached the lifetime limit with the insurance we have through our mission.  PA Medicaid doesn't like spending money outside of PA, but even there people have gone to bat for us to make it possible for Karis to study at Notre Dame.  The girls' colleges have been generous with financial aid.  And many people have helped us to cover everything else:  flights back and forth from Brazil (either through $$ or miles), living expenses in Pittsburgh and South Bend (including a car), thousands of dollars of medical expenses that "fell through the cracks" in the transition to Medicaid and her transition to living in Indiana . . . 

We're very aware that we live in a privileged time and privileged society, and have been surrounded by amazingly generous people.  None of this situation really makes sense, when we look at the condition of the world around us, with so many struggling just to have food to eat every day.  Karis has often wished she could have access to the money that has been spent on her behalf:  she thinks she could wipe out third world hunger single-handedly!  All that we can do is try to be good stewards of what God does put into our hands.

May God meet each of your needs.

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Friday, February 9, 2007
(Debbie) Well, we've made progress in understanding things, thanks to considerable time & effort invested by several doctors:

1. Surgery (such as a bone graft) to try to avoid collapse of the joint is not considered an option for transplant patients. There's a lot of relief for us in that Karis won't have to deal with surgery and a long recuperation at this point.

2. There has been some success with slowing deterioration in the cases of three transplant patients on the adult side, by stopping steroids and doing physical therapy to strengthen the muscles around the joints for better support. One of the three had a worse MRI than Karis's. Karis is making plans to go to Pittsburgh during her spring break in March to learn what she can from physical therapists there who have experience with this, and to see an orthopedist experienced with transplant patients. Karis is already being weaned off of Prednisone (whose function has been to help protect her from rejection).

3. Still under discussion: How "radical" to be in terms of walking, weightbearing, stairs, summer plans, etc.

It's been a challenging week for all of us and we SO appreciate your support and prayers!!

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Wednesday, February 7, 2007
(Debbie) "This is the day that the Lord has made. We will rejoice and be glad in it." It's the only day we have!

No answers yet--there will be a meeting in Pittsburgh tomorrow between transplant docs and orthopedic specialists. Thanks so much for your support and prayers.

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Monday, February 5, 2007
(Debbie) As Dave and I listened to Pastor Vandeir's sermon last night, we thought of many people whom we wished were there to hear it.  We never dreamed we would so need it ourselves today.  The sermon was based on Exodus 14:13-14.  When the sea is in front of you and the army at your back:
1. Do not be afraid.
2. Stand firm.
3. See the deliverance the Lord will bring you.
4. The Lord will fight for you.
5. You need only to be still.

We've mentioned that Karis has been feeling increasing pain in her right hip, especially when she walks but recently even when she's resting.  Remember the MRI she had in Pittsburgh on Jan. 5 (exactly a month ago)?  We had never heard the results of that test.  Karis was simply told that she should follow up with an orthopedist.  She was not able to get an appointment in Pittsburgh until Jan. 30th, so she went on back to Notre Dame to start the semester and finally had her ortho appointment in South Bend today.

The orthopedist, Dr. C, basically just read to her the results of the MRI:  Karis has avascular necrosis in BOTH hips, though the right side is worse.  Avascular means blood supply is cut off, causing death (necrosis) to the tissues.  This is a side effect that some people have from steroids and it is progressive.  About one fifth of the tissue in the ball of the femur has been affected.  (Where the thigh bone joins the pelvis there is a ball-and-socket joint).  It is soft and could collapse, so Karis is to avoid weightbearing.  She is going to check into what housing options are available at ND with a bedroom on the ground floor.

The usual treatment for something like this would be hip replacement.  However, there are some experimental surgeries being done with bone grafting, which might postpone the need for hip replacement.  In Karis's situation, any kind of surgery is very high risk.  Tomorrow, her South Bend doctors will be communicating with the transplant docs in Pittsburgh, who will partner with ortho specialists in Pittsburgh to figure out what to recommend.  Right now we have a million questions and not many answers.

Meanwhile, Karis slept most of the weekend, still trying to recover from her bronchitis, that has set her back in all of her classes.  The deadline for turning in her remaining research project from last semester is a week from now.  Please pray for energy, concentration, efficiency, peace, and everything else God brings to mind.

Thank you.  We need you.

Last night at church we sang a lovely song.
It's in Portuguese, of course, but here's the gist:

"God of Promises"
I know that your eyes
Attentively watch me
And your ears
Are sensitive to my cry
I may even weep . . .
But joy comes in the morning
You are the God who is near, not far away
You never change.  You are faithful.

Covenant God, God of promises
You are not a man that you should lie
Everything can crumble and change
But your word will be fulfilled.

I can face what comes.
I know who fights for me.
Your plans can not be frustrated.
My hope is in the great I Am
My eyes will see
The impossible accomplished.

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Saturday, February 3, 2007
Click on photos for larger image. See more photos on menu at left.

Karis & Carissa

Kornfields & Hastons
Deb, Dave, & Karis with
Carissa, Wayne, & Sharon

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Friday, February 2, 2007
(Debbie) Praise God, Karis is feeling better today than yesterday! Her lungs are clearer and she's not coughing up so much junk. She's had nearly two full days of antibiotics now. She had another episode of "dumping" last evening (even though she had eaten very little), but got through it without having to go to the hospital. Pray that she will continue to improve through the weekend!

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Thursday, February 1, 2007
(Debbie) Karis is pretty sick with bronchitis. Pray with us that it doesn't turn into pneumonia, and that she doesn't get too discouraged in regard to school. Also, her hip is hurting a LOT when she walks. She has an appointment with an orthopedist next Monday. Thanks!

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Wednesday, January 31, 2007
(Debbie)  We have recently learned about Nick Vaccuji, and have so appreciated the following videos from www.LifeWithoutLimbs.org:

	Nick Vaccuji		at Cornerstone

They are well worth taking a few minutes to watch!! 
We put them on the menu to the left so you can have easy access if you want to find them later.

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Saturday, January 27, 2007
(Debbie) The docs have determined that Karis has been suffering from "dumping syndrome," in which the stomach empties too rapidly, which sets off a series of distressing physical events, including a large shift of fluid into the bowel, which leads to nausea, dehydration, low blood pressure, and fainting. Apparently this is a fairly common consequence of gastric surgery. We hope that adjusting her diet and eating pattern will help. Good to know what's been going on!

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Thursday, January 25, 2007
(Debbie) Karis passed out again last night and was taken to the ER. This happened while we were in Wheaton as well. Please pray that the doctors will figure out what's going on, and that it won't happen when she's alone in her apartment or in any way that causes injury.

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Tuesday, January 23, 2007
(Debbie) Karis didn't finish her paper because she slept almost all weekend. She feels like she's turned a corner though in fighting this virus; she's feeling much better.

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Saturday, January 20, 2007
(Debbie) I'm in the South Bend airport waiting for my flight to New Jersey and then back to Brazil. David has already left (we weren't able to get on the same flight). We leave with hearts full of gratitude for the month we have spent with our kids, and for all that God continues to do in each of our lives. We're also profoundly grateful for the kindness and generosity that have been poured out on us by loving people in the ten cities we've visited. I think we're the most pampered people on the planet!

Karis has completed her first week of the new semester and is excited about her courses. At first she wanted to try doing five classes, which would be a "normal" full load, but after attending the first week she has sensibly dropped down to four. This weekend she is determined to finish her incomplete research paper from last semester. She worked very hard on it while we were in Wheaton, but lost two full days of work due to a computer malfunction, coupled with a few sick days that took her into the beginning of the new semester without finishing the paper. Please pray that she'll be able to conquer it this weekend so that she can devote her energy to her new classes!

Karis had an encouraging return to physical therapy yesterday, and though she continues to fight some kind of virus that keeps her a bit less than full energy, she's coming into this semester much stronger than she did the last one, more confident and optimistic. (They're lowering her dose of immunosuppressant, which should help her deal with the virus.) The scooter assigned to Karis this semester is blue instead of bright red, so her presence on campus will be a bit more subdued. Last night she hosted an impromptu dinner party for ten in her apartment, which was a great way to celebrate the friendships and all of the gifts God has given to her in response to your prayers.

A few comments on the documentary about multivisceral transplant on the Discovery Channel last evening, in case you watched it. It was kind of a surreal experience to be taken back into that world, even through an impersonal medium like TV. How amazing to live in a time and place that such things are possible.
1. The show called Gretchen's transplant a six-organ transplant because her spleen was removed (as was Karis's) in addition to her small bowel, duodenum, stomach, pancreas, and liver. But like Karis, she received only the last five organs (the spleen was not transplanted), so it was really a five-organ transplant, same as Karis and Carissa.
2. It was fascinating to watch part of the surgery, and see a bit of what happens during those long hours when we as family were confined to the waiting room. Gretchen's surgery took 16 hours, as compared with 13 for Karis, but in Karis's case you'll remember that her intestine had already been removed 14 months earlier.
3. Karis commented that they didn't give much attention to the challenges of recuperation from the surgery--can't do everything in a one-hour program! Gretchen was out of the hospital 8 weeks post-op, and allowed to go home at 12 weeks. From our experience with many other transplant families, that is unusually fast. Most patients are kept in Pittsburgh for at least six months following transplant. You may remember that Karis was in ICU for seven weeks after her Jan. 10-11 surgery and on the transplant floor for eight more, before she was transferred to the rehab hospital for three months. She was released from the rehab hospital on July 27th and started at Notre Dame on Aug. 17th!
4. It was fun to see the surgeons we had met in connection with Carissa (Dr. Kareem & Dr. Costa), and one of Karis's surgeons, Dr. Bond, in action in the OR. The show highlighted how demanding transplant surgery is, and the high personal cost these surgeons pay. Let's keep praying for them and for the other transplant surgeons we know: Dr. Mazariegos, Dr. Sindhi, Dr. Soltys, and their families.
5. Like Gretchen and her mom, we have a hard time expressing how grateful we are to the whole transplant team for their knowledge and expertise, their compassion, their commitment to excellence and to what will be the very best for each of their patients. Not just the surgeons, but the nurses, lab techs, and everybody else who does the bulk of nitty-gritty care both pre- and post-surgery. And we're profoundly grateful to Karis's donor family, and think about them a lot.

It's been a long road, and so good to be at this end of it. Thank you for walking with us.

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Wednesday, January 10, 2007
(Debbie) One year ago tonight--yes, a whole year!!--Karis went into the operating room at Children's Hospital of Pittsburgh for her 5-organ transplant. As we celebrate today the precious gift of Karis's restored life, we're thinking of our donor's family and friends, who today remember their very great loss. Please join us today in gratitude for all that God has done for Karis, and pray for God's special care for our donor's family.

We celebrate also the amazing love and generosity of each one of you, who have walked this journey with us. We thank you with all of our hearts.

Hey, guess what just happened--Karis ran, for the first time since the summer of 2004!  What a great way to celebrate this one-year anniversary!!!!!  She's all smiles . . .

If you are interested in knowing more about what Karis has been through, here's a special opportunity: next week Discovery Channel will be showing a documentary on multivisceral transplant. Friends who have already seen it were very impressed. It's the story of a transplant done next door to Children's, on the adult side. One of the surgeons you'll see in the documentary, Dr. Bond, assisted with Karis's transplant.

Here's the info: Discovery Channel, Friday Jan. 19, 9:00 p.m. (and Sat. Jan 20th 1:00 a.m.).

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Saturday, December 30, 2006
(Debbie)  I hope your Christmas was as lovely as ours!  After Karis was released from the hospital in Pittsburgh on Thursday Dec. 21st, Friday we drove to Harrisburg to have lunch with Carissa and her family (pictures will be forthcoming), and were delighted to see Carissa doing well--she's gained 50 pounds since her transplant (from 62 to 112)!  She looks terrific!! 

We then drove to DC to pick up our son Dan, and from there drove 19 hours straight to arrive in Sebring, FL Saturday afternoon.  It was great to see David's parents and spend several days with them.  Dave and Dan are still in Sebring, while Karis and I are visiting my two sisters who live in Florida (Rachel and Val are attending the Urbana missions conference in St. Louis).  Next week we'll drive back to Pittsburgh for a few days for Karis to have a couple more tests done, and then head back west to Wheaton and South Bend for the girls to start their new semesters.

We didn't have internet access while in Sebring so Karis and I are trying to catch up with e-mail a bit today, thanks to a cafe where her cousin Katherine works.  What with being sick while we were in Pittsburgh and the busy-ness of all that we've done while in Florida, Karis hasn't been able to work yet on the research paper she still needs to finish for her incomplete class from fall semester.  But I have to brag on her a bit, since you all have prayed so much for her transition back to college:  in her other three classes, she got two A's and one A-!!!!  We would have been impressed if she had just managed to pass, with all of the huge adjustments she had to make last semester!!  Praise God from whom all blessings flow!!!  Karis wants to try taking a regular full load next semester, of five classes.  We'll see . . .

The docs in Pittsburgh still have no real clues as to what caused this second bowel obstruction, just like the one she had in September.  That leaves us a bit insecure about whether it might happen again.  But we'll at least know to get medical support sooner next time, so that she doesn't again end up passed out on the floor from dehydration. She always hopes to avoid doing the hospital thing, but sometimes it's just necessary, and it certainly was a lot simpler that it happened when we were already there in Pittsburgh.

Happy New Year to all!

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Thursday, December 21, 2006
Karis is out of the hospital ! Details to follow . . .

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Wednesday, December 20, 2006
(David) Karis was admitted to Children’s Hospital in Pittsburgh today for dehydration.  She had serious intestinal obstruction early Tuesday morning, fainting in the bathroom.  Everything’s under control and she should be released from the hospital tomorrow after routine tests.  Pray that we would indeed be able to leave Pittsburgh Friday morning to continue our trip which includes lunch with Carissa and her family en route to Washington DC where we’ll connect with Dan, visit his new apartment and then continue our 18 hour trip to spend Christmas with my folks in Sebring, Florida (a little south of Orlando). 

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Sunday, December 17, 2006
(Debbie) We're in Pittsburgh, and I just found some quiet moments to check e-mail, which I hadn't done for several days. Some people have been asking about Karis. We consider that she made a spectacular achievement this semester: she was able to finish all but one 25-page paper, so left ND with one incomplete, which she hopes to deal with this week so that she'll be "free" for the rest of her vacation time. We are so thankful to God, to all of the people who have helped support Karis (especially Jim and Barb), and proud of Karis's hard work and determination.

When we think about what things were like for Karis as we approached Christmas a year ago, we are awed by all that God has done for her and for us. Thank YOU for your amazing faithfulness to us in love and prayer.

Karis will be having check-ups in a number of areas this week. We're hoping for some "fine-tuning" in a few areas, like the severe pain in her hip when she walks very much. We also suspect that she has periodic partial bowel obstructions--probably loops of bowel get temporarily caught in adhesions, and then work their way free. At least, that's what the symptoms seem to indicate. There's nothing to do about that, except to pray that the situation will not get severe enough to require surgery. Today Karis has a sore throat and another one of those trapped bowel situations (we think), along with the exhaustion that one would expect at the end of a semester of college. (All three girls were well ready to crash today!) But she was able to enjoy going to Church of the Ascension this morning and seeing many dear friends.

Summary: overall she's doing GREAT, with just enough little problems to keep us all dependent on God and not too cocky!

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Sunday, December 10, 2006
(Debbie) Just had a chat with Karis. She's very tired, has a high white count & tummy ache, and has 3 papers to write and 3 exams this week. Can you pray with us that God will keep her well and give her the energy she needs to complete the semester? Thanks so much.

Please pray also for our niece Cherilyn, a student at Taylor University. She had a fairly serious concussion and has been hospitalized for several days. She'll be having to take incompletes in her classes. Really appreciate your prayer for her complete recuperation. Thank you!

David and I leave Brazil on Tuesday night to fly to the US. We'll see Karis on Wednesday evening, if all the flights go well. The air traffic controllers have been on strike here in Brazil but we're expecting to fly out as scheduled. We'll be picking up the girls in South Bend and driving to Pittsburgh for a week, where Karis will have a check-up with the transplant team. Then we'll be going to Florida for Christmas with David's parents before returning to Pittsburgh. At least that's the plan!!

In case we don't post again before then, Merry Christmas!!

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Tuesday, November 31, 2006
(Debbie) Our hearts are full of praise to God for all that he has done for Karis.  While people all around her are sick with colds and flus, she has stayed strong.  The only explanation she can think of is the protection of prayer.  Thank you for continuing to pray for her.

Karis says she is entering this Thanksgiving holiday with an immense feeling of freedom:  she's caught up in all of her classes!!!!  This is amazing!  Our four kids and two of their cousins will be spending Thanksgiving together in Chicago.

And there's more good news:  in physical therapy this fall, the range of motion of her right foot has increased from 40 degrees to 47 degrees!  There's been quite a bit of pain involved, but this is SO encouraging!

Please thank God with us also for my mother's 80th birthday, on Thanksgiving Day.

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Wednesday, November 8, 2006
(Debbie) Karis is doing well at ND without me. I thank God every day for the wonderful people He has placed around her, and for the wonderful progress she continues to make. I'm loving being back home with David in Brazil.

I'm writing today to request special prayer for friends of mine in Pittsburgh, Maliya and Larry. Larry contracted a rare type of hepatitis when he had a kidney transplant. The hepatitis has destroyed his liver, so he's now waiting for a liver transplant. Yesterday, five liters of fluid was removed from his abdomen so that he can breathe better. Every time this happens there is high risk of infection. Please pray that his transplant call will come SOON. The strain is very tough for him and for his whole family. Thanks so much. I asked Maliya whether I could post this request because I know that the people who track Karis's website are people who really pray.

Other patients whom we are particularly concerned about right now are Luke, Izzy, and Hannah, and their families. Please pray too for Lisa, whose son Justin died just before Karis and I moved from Pittsburgh. THANK YOU, dear friends!

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Tuesday, October 31, 2006
(Debbie) It's 1:14 a.m. Eastern Standard Time and 4:14 a.m. in Sao Paulo.  I'm flying right now over the Caribbean, a bit east of San Juan, according to the map on the screen.  I haven't been able to get to sleep, thinking about what I have left behind in the U.S. and what awaits me back in Brazil.

Yesterday I happened to see some pictures of Karis from before her transplant.  What a vivid reminder of God's faithfulness to her and to us!  She has come such a long way since those difficult days in 2005, and since the transplant.  Some things still seem tough, so it's good to remind ourselves of how far God has brought us--to the point that I can feel confident in returning to Brazil.  The amazing kindness and generosity of friends in South Bend and the university support system that we "tested" when Karis had the bowel obstruction a few weeks ago contribute enormously to my feeling that now is the time to take this step toward celebrating Karis's ability to live more independently.

Praise God with us and as you think of Karis, pray for God's continued protection from rejection and infection, and for the stamina she needs to give all that she can to her classes, along with enough sleep and rest and fun along the way.  Thank you!

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Monday, October 30, 2006
(David) This weekend Karis went on an Iron Sharpens Iron spiritual retreat with about 70-75 other Notre Dame students (similar to Intervarsity or CCC).  She (and Valerie) came back real tired, but had a wonderful time of spiritual refreshment and building friendships.  Coming back from the retreat, she had supper with Debbie at Jim and Barb Blechl’s home, it being the last night Deb would be there before traveling to Brazil today.  Karis rested a good deal today and still feels tired.  Valerie continues 100 miles an hour, loving everything.  Notre Dame is paying for a woman to help Karis five hours a week with washing and ironing clothes and cleaning the apartment.  This is a tremendous gift from God, picking up some of what Debbie had been doing. 

Karis asks prayer for:
1. Friendship – friends that she can feel free to call up on the spur of the moment to do things or eat together.  She has plenty of friends, but none that are close.  She’ll really feel Deb’s absence in that regard. 

2. Energy and ability to keep up with her studies.  She’s working on a French project that was initially due two weeks ago and is very challenging.

3. Pray too for Deb’s transition to Brazil, that it might flow in a very natural way.  Pray that Karis wouldn’t have any major crises these next six weeks.  Deb and I expect to return to the States on Dec 13th for 5 weeks with our kids and with some supporting churches.

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Saturday, October 21, 2006 9:00 a.m.
(Debbie) I talked with Karis last night and she sounded good, even after a long day. Perhaps on the day she was so draggy she was just--tired! Happens to all of us from time to time . . .

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Wednesday, October 18, 2006 10:30 a.m.
(Debbie) I just received an e-mail from David requesting that I post an update on Karis. I've been waiting a bit to see which way things are going, but it is a good idea to ask for prayer. Karis is on fall break, with two papers to write that were due last week, and just hasn't had the energy to tackle them. She's super draggy. We did learn that her blood tests a week ago show her EBV count is up, so her immunosuppression was adjusted a bit to help her fight that. She had been told she didn't need to have blood tests this week while she's on break, but we're waiting for a call back from the transplant office re. whether they want to have her EBV re-tested sooner than next week. (Oh--I'm just being asked what EBV is. Epstein-Barr Virus is best known as the virus that is responsible for mono. It can also cause some other ills. Immunosuppression, of course, makes Karis more vulnerable than the rest of us.)

I'll post more when we know more. Appreciate your prayers!

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Wednesday, October 4, 2006 10:30 p.m.
(Debbie) Our trip back to South Bend from Pittsburgh yesterday was pleasant. (MANY thanks for your generous help, Shawn and Anna!) All of the medical tests that were done came out perfectly normal! We're very grateful, even though we don't know what caused the obstruction. Best guess is that a loop of intestine got caught in some adhesions and then worked itself loose, or that there was an intussusception that popped itself free. Is it likely to happen again? No one can say, so we'll trust God with what is outside of our control. We're so happy that God spared us from a potentially life-threatening situation. And that we had the pleasure of seeing some of our dearly-loved Pittsburgh friends and our son Dan.

I talked with Karis by phone a few minutes ago. She's had a good day, feeling well, but rather overwhelmed with all the work she has to do for her classes tomorrow.

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Tuesday, October 3, 2006, 12:40 ET
(Steve) Just got a call from Karis! She is out of the hospital! Debbie is driving her in a rental car back to Notre Dame. It's about a 7-hour drive. Debbie is doing well after a good night's sleep. It was a tremendous blessing to have Dan arrive Saturday evening and stay through Monday evening, allowing Debbie more restful nights.  Praise the Lord, and pray for a safe trip. Pray also that Karis will be quickly able to catch up on her studies.

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Sunday, October 1, 2006, 5:30 p.m.
(Debbie) Karis and I were flown by air-ambulance from South Bend to Pittsburgh yesterday afternoon. The doctors in Pittsburgh were very concerned about the severity of the obstruction as shown on the x-rays and CT scan, which they were able to view via internet, so they wanted to get her to Pittsburgh as soon as possible. By the time things started turning around, Karis had been obstructed about 20 hours and the whole length of her intestine was dilated to twice its normal size--a very uncomfortable situation.

Karis is doing well, still having some tummy pain but mostly just tired out. She hasn't had the energy to do anything today other than take a shower. This afternoon her diet was advanced from clear liquids to soft foods. Tomorrow she'll be NPO again for a scope and biopsies followed by upper and lower GI series with follow through. (That means she swallows contrast and then they take pictures as the contrast travels through her system.) They hope to identify what caused the bowel obstruction, in case there's something that can be done to prevent it happening again.

The best guess at this point is that the intestine kinked or telescoped into itself (called intussusception) and that perhaps the pressure of the contrast she swallowed for the CT scan while still in South Bend may have straightened out the intestine so that it opened back up. We are SO grateful that it resolved on its own, so quickly, without the need for surgery! Thank you for your concern and your prayers. It was a bit scary and we're happy to be on the other side of this incident.

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Saturday, September 30, 4:30 p.m. EST

(Rachel) About half an hour ago, Karis turned a corner and started getting a lot better--intestinal activity and a softer stomach, sure signs of no more obstruction!  My mom says that if it had happened half-an-hour earlier they probably would have canceled the flight to Pittsburgh, but as it was, the flight was already booked.  Regardless, we are very grateful that Karis is feeling herself again.  Whatever caused all this, un-caused just as quickly.  Maybe the trip to Pittsburgh will help us find out what happened.