Here we go again...

First it was Christopher’s brain injury in April of 2010 and then seven months later, my multiple massive Pulmonary Emboli. Now it’s Nick’s turn.

He traveled to Antigua, Guatemala four weeks ago for a seven-week work assignment and we were fortunate to spend a week with him there for a family vacation! He noticed fairly soon after arriving in Guatemala that his breathing was quite labored while running but he assumed it was due to the high altitude. He’s used to running at sea level in Los Angeles and Antigua is at 5,000 feet. As the weeks progressed, he found it difficult to simply walk a block and by yesterday, walking from one room to another was enough for him to become out-of-breath. So he saw a doctor at a local clinic who said it sounded like he possibly had a Pulmonary Embolism but he sent him home with several syringes of Lovenox, an anticoagulant.

By the time Nick called us yesterday afternoon to talk about what was going on, he had contacted his medical insurance company and informed them of what was happening. Paul called Vivienne Newman, Christopher’s ICU doctor who put us in touch with a Pulmonologist at Stanford Medical Center. Our thoughts were that we wanted to get Nick out of Guatemala and to the States as quickly as possible so that he could receive proper medical attention. But both Nick’s insurance company and the Stanford Pulmonologist gave the same instruction to Nick… “Get to the hospital immediately!”

So Nick’s house father, Carlos drove him to the nearest hospital in Guatemala City and he arrived around 6:00 pm last night. They admitted him and began the process of running tests. They did and EKG, a contrast CT scan and a full blood panel. Within an hour and a half he had a definite diagnosis of Multiple Pulmonary Emboli. He has a large clot in his right lung and several small clots in his left lung. They gave him another injection of Lovenox, started him on Coumadin and moved him to the ICU where he is on complete bed rest. He will be in the ICU for at least 48 hours and then in the hospital until he is at a therapeutic level on the Coumadin.

Paul arrived in Guatemala at 6:00 this morning and I know both he and Nick were glad to see each other! After speaking with the Doctor, Paul said he feels comfortable having Nick at this hospital. It sounds as though he is receiving great care and there is no need to get him to the States at this point.

An ultrasound was done on Nick’s legs this morning that showed 2 blood clots. There is a small superficial clot which is inconsequential but the doctor also found a massive 2 ½” to 3” diameter deep vein thrombosis in his right calf. Not only is the size of concern, but also it seems to be moving very slowly with the flow of blood to his heart so they need to watch this one very carefully. He will continue to be on complete bed rest in the ICU until the clots begin to dissolve which will be monitored via CT scans. If the clot continues to move and becomes a threat, they will need to do surgery to insert a screen to keep the clot from breaking loose and reaching the heart and lungs. Surgery is unlikely at this point, though and the hope is that he will soon be at a therapeutic level on his Coumadin and will be released from the hospital by the end of the week.

Thank you for all of your prayers and well wishes! Our God is a great God! He has blessed our family in ways we never imagined possible and we will continue to put our trust in Him. Please continue to pray for Nick’s recovery and for safe travels for Paul and Nick when they return to the States. 

I Can Only Imagine

For those of you who know me well, you know that I rarely speak of my faith on my blog. I never set out to do (or not) that; it’s simply the way things have played out. But today is different for I feel compelled to write. And the words that are flowing from my fingertips speak of my faith in a God who is so much bigger than me. This God is forgiving… He loved me even when I didn’t believe I was worthy of His love. He is a God who waited patiently for me as I asked my questions; as I struggled to comprehend who He really is and how He can possibly know each and every one of us, down to the number of hairs on our heads. He is a God who placed people into my life... I call them my angels here on earth and I believe they were hand-picked by God to show me His love; to teach me His ways; to set the record straight in my very confused and frustrated mind. But through my struggle to know this God, I discovered that He was always there, that He never let me down, and that His love for me is eternal.

Today an acquaintance of mine passed away. To put it more accurately, Frank passed into the arms of His waiting God. He is no longer in pain and he is finally at peace. Though I only spoke directly with Frank a handful of times, I always knew of him as a prayer warrior. He and his wife, Coralie dedicated their lives to praying for others and I will never forget speaking with Frank shortly after Christopher returned home from the hospital after his accident; hearing him tell me of the hours he spent on his knees in prayer for my child. For that I will always be grateful.

Though I am sad to know that Coralie is now left here on earth to carry on without her beloved partner, I can’t help but think of the joy that Frank is experiencing at this very moment. There is absolutely no doubt in my mind that he is in heaven with God and I can only imagine what that must be like. There is a song by the group Mercy Me that has been playing in my mind all day long and I have always loved the lyric. It expresses so well what always comes to mind when I ponder the day I meet my God in heaven…

I can only imagine what it will be like

When I walk by your side

I can only imagine what my eyes will see

When your face is before me

I can only imagine

Surrounded by your glory

What will my heart feel?

Will I dance for you Jesus,

Or in awe of you be still?

Will I stand in your presence,

Or to my knees will I fall?

Will I sing Hallelujah,

Will I be able to speak at all?

I can only imagine

I can only imagine when that day comes

And I find myself standing in the Son

I can only imagine when all I will do

Is forever, forever worship you

I can only imagine

I can only imagine when all I will do

is forever, forever worship you

I can only imagine

Here's a link to the song if you'd like to give it a listen... 
http://youtu.be/9La_4svq8JI

As much as I am grateful for what God has blessed me with here on this earth, I look forward to the day I will see my God face to face. But for now, I will continue to do my best to honor Him and be a faithful servant. Here’s to you, Frank… you will be dearly missed here on earth but I can only imagine the party that is taking place in heaven.

Letter to Chris from Dr. Newman

Today Christopher received an e-mail from his PICU doctor while he was a patient at Children’s Hospital, Oakland 17 months ago after falling from a tree and sustaining a severe traumatic brain injury. The letter is so beautiful that I want to share it with all of you…

“Dear Chris, I am so proud of your achievements over the past year. Now I hear from your parents that you have passed or rather aced the sailing course and are a fully-fledged, certified SKIPPER. WAY TO GO MAN!!!!!. When I think of the defenseless young boy in the bed, coming out of your coma (as your Dad assured me you would), going on to Rehab and regaining your strength and thoughts almost faster than I could have dared to hope, I am proud to have had the chance to take care of you. We only provided the time for you to gain strength back and you and your family have done all of the hard work. KOL HAKAVOD, which means, "all of the honour" is due to you and your family. I pray that you will all go from strength to strength and that you will have many such successes. Please do keep me informed of ALL of your achievements, no matter how large or small. I look forward to seeing you and your family soon.
Your oh so PROUD Doc., Viv Newman PICU OAKLAND -- I hope that you might remember me a little.”

Knowing Dr. Newman and having the privilege of calling her friend is one of the blessings that came out of this unexpected traumatic experience and we will be forever grateful to her and the entire staff at Children’s Hospital, Oakland. My next (and very soon to come) blog post will be the most recent update on Christopher's miraculous recovery!

I’m writing! I’m writing! I’m writing! I can actually stay focused long enough to write! Oh, happy day!

Skipper Chris!

16 1/2 months ago he was in a coma fighting for his life, but today he passed his sailing test in the San Francisco Bay! Congratulations to my miracle boy, Skipper Chris!

soccer tryouts + christopher = frustration

Christopher’s neurosurgeon thinks he might be able to play soccer next season but since his brain is not yet healed, any physical contact is considered risky and is therefore prohibited. So there he stands on the sidelines, watching enviously while his peers engage in 1 v 1’s, vying for a spot on the team.

A year ago on this day, he had come out of his coma and was high on narcotics. He was sweet and funny, saying things like, “Hey Emily, there are two of you and you have, like 8,000 eyes!” and “Nick, your socks are fantastic and your shoes are sick!”

As much as my heart breaks for Christopher, I can’t help but be grateful to see him standing there, desperately wishing to be in the middle of the action. He has come so far, and this could have ended so differently. He will play soccer again; perhaps not this year, but that day will come. For now, I will count my blessings and give thanks for the life of my miracle boy.

Life As I Once Knew It...

life as i once knew it... there is no such thing. my life will never be as it was. that is not a good thing, nor is it bad. it just is. because of all that has transpired over the past year, i am a different person and i am forever changed. 

Christmas Letter 2010

Where to begin my Christmas letter for the year 2010?  I actually started composing it three weeks ago and this is what I wrote:

“I’m turning 50 on Christmas Eve and believe it or not, I can’t wait! What a year for me to reach this milestone!  2010 has been the mother of all years for me. Do you remember shortly after I returned from Bosnia last year and I wrote on my blog that ‘what used to be so important now seems trivial at best’?  Well, today all I can say is THAT’S AN UNDERSTATEMENT!  I had absolutely no idea what that really meant the day I wrote it. Oh, I felt it all right. I was still reeling from the stories I’d heard from those brave Bosnian women I had met and who were now my inspiration. What I didn’t know then, was that on April 21, 2010, less than seven months later, the meaning of those words, my words, would come screaming back at me in a way I never imagined possible. So today, thirteen months after first speaking them, I want to reiterate that ‘what used to be so important NOW seems trivial at best.’ 

Nothing, absolutely nothing can prepare you for the experience of seeing your child at death’s door. All I will say is that it’s a good thing I wasn’t still ‘living my safe little life in my tiny little world’ the day Christopher fell out of that tree. That’s not to say I wouldn’t have been able to handle and cope with all that lay ahead of me had I still been living in that tiny little world. However, I truly believe that experiencing all that I did in the months preceding his accident prepared me for the journey I suddenly found myself on late that night, when he was diagnosed with a severe traumatic brain injury.”

As I read those words today, Tuesday, December 21st, they are once again begging to be written here on this page, only now, their meaning has even more significance. Eighteen days ago, I made a late-night trip to the emergency room that led to a diagnosis of multiple massive pulmonary emboli, landing me in the hospital for eight days, five of which were spent in the intensive care unit. Yes, today, WHAT USED TO BE SO IMPORTANT NOW SEEMS TRIVIAL AT BEST!

Christopher in the ICU on April 22, 2010

Standing by Christopher’s bedside while he was in a coma, watching those numbers on the monitor day after day, night after night will forever be embedded in my mind. The thought of losing him was heart wrenching. I spent the weeks and months after Christopher’s miraculous recovery and release from the hospital in a daze. 


Has anyone ever told you that often, after living through a traumatic event, everything falls apart? That YOU fall apart? I was appropriately warned of it, but I didn’t believe it could actually happen to ME. I was fine. I had handled the month Christopher was in the hospital like a champ. I was strong, resilient and optimistic. I was the rock everyone had come to know and I had every reason to be on top of the world. After all, my miracle boy was alive!  But alas, it all came crashing down as the reality of what had transpired settled in and I found myself struggling with what I initially called ‘the blues’ but eventually accepted as depression. I recently read a book and this sentence jumped out at me, “The fogginess lasted a long time… I didn’t live the time after the accident so much as I watched it unfold.” That perfectly describes what life was like for me during those months after we came home from the hospital.

Christopher – June 2010 – Yosemite Nat’l Park

I was a bystander… life happened all around me, but I had a difficult time engaging.  As weeks passed, I accomplished only what was essential.  Of course, I beat myself up on a daily basis for my behavior, but I was unable to change it.  

Ironically, it was on the morning of Friday, December 3^rd, the day of my trip to the ER and pulmonary emboli diagnosis that I said to Paul in a text message, “I’m gradually getting stuff done.  I feel like I’m coming back… a little more energy… a little more positive.”  It was also that morning that I found myself finally breaking down a wall that I had built between God and I.  My heart was softened and I felt a sense of peace.

Emily – Sept. 2010-Sacramento

Who would have thought that that night I would have my very own brush with death?  The timing of my pulmonary emboli and subsequent hospitalization is perplexing to me.  I truly felt that I had struggled enough this year.  I was looking forward to putting everything behind me and moving into the Christmas season feeling refreshed, strong, and once again light-hearted.  But evidently, that was not the plan.  I have learned so much during this difficult year, and one thing that is crystal clear to me is that I have very little control over my destiny.

Nick – July 2010 – Mexico City

I am not being dramatic when I say the Ackerman’s came closer than imaginable to celebrating Christmas this year as a family of three. I don’t understand why Christopher and I both escaped death.  Perhaps it is not for me to understand, but I am so very thankful for the prayers of hundreds of people and for God’s hand on our lives. We have been blessed beyond comprehension and for that I am grateful.  I will never be able to adequately thank all of my wonderful friends and family for the love and support you have shown us this year.  Your phone calls, text messages, e-mails, cards, gifts and letters, meals, flowers and visits are what have carried us through these challenging times.  One particularly difficult morning during my stay in the hospital, I received an e-mail from my friend Gloria who seems to have an almost eerie knack for appearing in my life when I most need to be encouraged.  Here are the beautiful words she wrote to me:

Paul – 10/10/10 – Chicago Marathon

“The Lord is with you, around you, behind and before you, knowing all of the most intimate of anxieties and fears you hold… I pray that His peace, His grace will lighten your heart as you let time and medicine heal you.  Be well slowly, gradually and patiently, hidden in the shadow of His wing…”

October 2010

My daily encouragement and challenge is to listen to Gloria’s words and embrace them. I will continue to count my blessings every day and treasure all that I hold dear in my life.  I pray that your Christmas is filled with joy and peace and that you remember the reason we celebrate; that Christ came to earth to give us the gift of life abundant… peace and contentment that cannot be explained… this new life is abundance, and this is true life.

Merry Christmas! 

With love, Laura 

“These things I have spoken to you, so that in Me you may have peace.  In the world you have tribulation, but take courage; I have overcome the world.”  John 16.33

Very often, the first warning is the last one...

Wednesday, December 8, 2010, 8:30 pm

So when you’re the patient, your time is not your own, you find it more difficult to advocate for yourself (you feel whiny, needy, etc…), and rather than being the visitor or the supportive family member, you’re actually the person who is sick.  And being sick means that you don’t feel like doing much of anything. I’ve been in the hospital now for one hundred twenty hours.  That’s five days now... to the hour.  The first twelve hours were spent in the ER and the rest of my time has been here in the ICU.  It has nearly killed me to not write.  Oh, the hours I’ve spent lying here in my bed, composing in my mind.  But as much as I was dying to get my thoughts written down, I just didn’t have the energy needed for the effort necessary to put my prolific fingers into action.  I would have had to reach over and pull my laptop out of my backpack. That was perhaps my biggest obstacle!  It’s amazing how much we rely on the oxygen level in our blood to be hovering around 98 – 100%.  But when that level plummets down to the upper 80’s/lower 90’s, everything becomes a chore.  So I allowed myself to do just what the doctor ordered… stay in bed and rest.

For the first 24 hours in the ICU, I was on complete bed rest, but after that period of time, I was allowed to walk 5 feet to use the restroom.  Just getting there was quite an ordeal with all the wires that are hooked up to my body and then attached to a monitor on the wall.  They are constantly measuring my Heart Rate (HR), Respiratory Rate (RR), Blood Pressure (BP) and Oxygen Saturation Level (SAT), numbers on a monitor… While lying in bed, my heart rate would settle in as low as 68, my respiratory rate would be about 15 and my oxygen level was around 97%, but during the 4 minutes it would take to walk that 5 feet to the restroom and back, those numbers typically moved to an HR as high as 133, an RR of 35 and SATS of 87%.  I would climb back in bed and lay there, huffing and puffing, my heart beating so fast I thought it was going to jump right out of my chest.  My body’s response to that insignificant level of exertion was the biggest indicator of the fact that it had not yet begun breaking down the 3 massive (yes, that’s now what they’re calling them) blood clots in my pulmonary artery.  The clot they’ve been most concerned with is one they call a saddle clot.  It is lying in the center of the pulmonary artery where it branches off into each lung.  If another small clot was thrown and landed there, it could have caused a full obstruction. 

As soon as the blood clots were detected on Friday night during a CT Scan, they began giving me injections of Lovenox, which is an anticoagulant (blood thinner) that prevents the formation of new clots.  The assumption that there were more clots in one of my legs was confirmed when an ultrasound showed several behind my left knee.  After several days, the Lovenox forms a web-like coating around any blood clots in the veins of the body.  This web attaches itself to the wall of the vein, prohibiting movement of the clot.  The body then either breaks down and dissolves the clot naturally or re-routs the blood to another vein close by, but the risk of the clot breaking free and being thrown disappears.  Now the clots in the pulmonary artery are not subject to the same effect from Lovenox as clots in veins because the blood in this artery is oxygenated, therefore, immune to the ‘web-effect’.  These clots will just dissolve over time. 

They began giving me Coumadin, which is another anticoagulant by mouth on Saturday night.  It will be several weeks before I am what they call “therapeutic” on it, meaning that the level of Coumadin in my body is appropriately preventing the formation of blood clots while at the same time, not thinning my blood so much that it won’t clot when necessary.  My doctor has put me on Coumadin for the rest of my life.  I have been given an INR (international normalized ratio) that was arrived at based on a blood test that showed how quickly blood clots in my body.  The challenge is to keep that INR level consistent.  Too little and I run the risk of forming blood clots, too much and I could bleed to death.  The thing that makes it complicated is that there are many factors that can affect INR, such as foods, alcohol, other medications, illnesses, or changes in activity and travel.  Foods rich in vitamin K pose a particular risk because vitamin K acts the opposite of Coumadin in that it helps blood to clot.  It’s not that I can’t eat them.  I just need to be consistent in the amount I consume on a daily basis.  Some examples of these foods are leafy green vegetables; anything green such as lettuces, spinach, broccoli, asparagus, etc… Cranberry products increase the effects of Coumadin and can lead to bleeding problems. 

I do believe that’s enough medical speak for now. My brain is exhausted, much like the way it felt back in April when Christopher was hospitalized and we had a crash course in Severe Traumatic Brain Injuries and the intricate workings of that amazing organ.  As I told a friend of mine this week, any confusion I experience in keeping my facts straight I can now chalk up to oxygen deprivation, and I will continue to use that excuse to my full advantage in the future!  I think I’m done learning about the complex workings of the human body, for this year at least. 

There’s more to tell but I’m blitzed.  I am being moved to another unit tonight where I will continue to be monitored around the clock, but I am now out of the severe danger zone.  I walked around the ICU yesterday and again this afternoon (on oxygen) for about 5 minutes, which is something I could never have done without stopping to catch my breath several times only a few days ago.  I am so thankful for the steady improvement I have experienced, and I must say that the nurses and doctors here at Kaiser’s ICU have been absolutely wonderful!  From the fun and laughter shared with Shelagh to the unbelievable kindness and care, including some great conversations with Gerald, I have truly been pampered.  My inspiration came in the form of Wendy, a nurse who was assigned to me on Monday morning (and who was my nurse for 3 additional shifts during my stay).  It turns out that she had almost the exact same experience as me several months ago with massive blood clots in her pulmonary artery, including a saddle clot.  Wendy provided a plethora of information and spent a lot of time educating me.  She is now back at work full time and well on her way to a full recovery.  Every time she walked into the room I thought to myself, ‘that’s going to be me… just be patient.” 

I can’t bring this to a close without saying several things.  First of all, thank you for all of your e-mails, facebook posts and text messages.  They encourage me, lift my spirits and mean more than you will ever know.  I haven’t responded to a single e-mail and it is killing me to not be able to write to each and every one of you like I did when Christopher was in the hospital.  But I’m trying to be gentle with myself, understanding that the circumstances are different this time.  Thank you to those of you who have expressed an interest in coming to see me, but I am going to continue to limit visitors to my family, as having them is very taxing.  Finally, I want to thank all who have stopped by the house, bringing meals, plants and so much more.  It is such a comfort to me knowing that my family is being cared for so lovingly. 

I can’t believe that I have once again found myself in a position of relying on family and friends for so much, but some things are not for us to understand.  I thank God every day that He chose to spare my life last week, as I have been reminded multiple times that with pulmonary embolisms, “very often, the first warning is the last one…”  I’m not really sure what it is that I am meant to learn this year, but one thing I do know is that my time is not up.  While I don’t know what the future holds, I will be open to whatever God brings my way and I look forward with great anticipation to writing all about it!  I love you all…

Watching numbers on a monitor… again?

Sunday, December 5, 2010

Who would have thought that only seven months after Christopher's accident and hospitalization we would once again find ourselves watching numbers on a monitor?  But this time, the numbers are telling the story of what is going on in MY body.  On Friday night, after telling Paul that I needed to be taken to the emergency room because, as I said, "something just doesn't feel right," I was diagnosed with multiple pulmonary emboli.  I have three large blood clots and several smaller ones in my pulmonary artery.  These clots were the cause of my shortness of breath, labored breathing and rapid heartbeat.

So here I lay in a hospital bed in the ICU.  I spent 12 hours in the emergency room and was then transferred to the ICU where I've been for 24 hours and will stay for at least another 24.  I will likely be in the hospital for several days after that.   It’s just so odd to be the patient; the one lying in the bed while my family sits around me, passing the hours.  Better me than one of my children, though.

You know, a couple of weeks ago I began writing my annual Christmas letter and in it, I said that this has been the mother of all years.  At the time, I had no idea what was yet to come and that's probably a good thing.  This is not how I envisioned spending the weeks leading up to Christmas, but I will not complain.  No, instead I will count my blessings.  Oh, how I have been blessed this year!  Christopher survived his brain injury and is thriving, I have family and friends who have been absolutely amazing, showering me with love and support, and today, I am alive and looking forward to celebrating the holidays with family and friends.  THIS Christmas is going to be the best one ever!