Nurses’ Health Study Research Results

December, 2017

Nearly 30 years ago I decided to join the Nurses’ Health Study and complete a 30 minute questionnaire about my habits and life style every two years. In the beginning, I colored in the little circles in black pencil on a computerized answer sheet and mailed it back to them, but now I do it online. They have kept up with me through my many moves so I haven’t been lost in the shuffle. I am in the second cohort of thousands of nurses called NHS2. They now have a third group of younger nurses born on or after January 1, 1965. If you are a RN, LPN, or nursing student born then and would like to participate, please do your part to continue this wonderful ground breaking research and sign up at www.nhs3.org . They are especially recruiting male nurses. They have also recruited and followed the children of NHS2 nurses to see the maternal influence on their children as they age. They like to recruit nurses because we are reliable and honest in reporting our life style. All our years of charting about our patients is definitely a benefit to this research!

Physical Activity and Heart Disease in Women

Middle-aged and older women who are more physically active have significantly lower rates of coronary heart disease (CHD). Women who walked briskly for at least 2.5 hours per week saw a 35% lower risk of developing CHD.

Get your walking in!

NSAIDS and acetaminophen may increase risk of hearing loss in women

Two-thirds of women in their sixties suffer from hearing loss. Among 55,850 women in a subgroup, using NSAID (Ibuprofen, Motrin, Aleve are common over the counter names) for over 6 years was associated with a 10% increased risk of hearing loss. Use of acetaminophen (Tylenol is common brand name) for over 6 years showed a 9% increased risk of hearing loss. There was a 7% higher risk of hearing loss in women who used either of these more than two days per week. However, duration of use of aspirin was not associated with hearing loss. They are doing more research in this area.

Diet Quality and Physical Functioning

It is important to maintain physical function as we age. They compared those with the healthiest diets with less healthy diets and found the group with better diets were 13% less likely to develop physical impairment. Higher intake of fruits and vegetables, and lower intake of sugar-sweetened beverages, trans-fats, and sodium were associated significantly with less physical impairment as they aged. The strongest positive relations were found with increased intake of oranges, orange juice, apples, pears, romaine or leaf lettuce, and walnuts.

Gluten Free (GF) Diets

GF diets have increased in popularity due to concerns about celiac disease and gluten allergies. However, little research has been done to explore how GF diets impact people without celiac disease. NHS found that eating foods high in gluten from whole grains can be beneficial to health. Men and women with the highest levels of gluten intake had 20% lower risk of developing diabetes, and 15% less risk of developing coronary heart disease. Gluten intake did not lead to weight gain in people under age 65.

Maintaining a Healthy Weight

They examined which specific foods and eating patterns led to less weight gain and more weight gain as we age.

These foods were associated with less weight gain: tofu, soy, plain or artificially sweetened yogurt, seafood, fruit (especially blueberries, prunes, apples, pears strawberries, grapefruit, and avocados). Chicken without skin, replacing 1 serving daily of sugar sweetened beverage with coffee or water, vegetables (especially cauliflower, summer squash, string beans, broccoli, and green leafy vegetables), replacing 1 serving daily of fruit juice with coffee or water, eating nuts (especially peanut butter, peanuts, and walnuts).

Eat your fruits and veggies for your health!

These foods were associated with more weight gain: corn, processed meats, peas, chicken with skin, sugar-sweetened beverages, baked, boiled, or mashed potatoes, fruit juice, regular full-fat cheese.

The American Journal of Public Health published a special edition in September 2016 to celebrate the 40th anniversary of the Nurse’s Health Study which is still available.

I hope you will incorporate these findings into your own life style and instruct your patients so everyone can be healthier!

But even more important than physical health is spiritual health. I thank Jesus Christ that He has satisfied the deepest hunger of my heart. “And Jesus said unto them, I am the bread of life; he that comes to Me shall never hunger, and he that believes on Me shall never thirst.” John 6:35

Jesus is the spiritual bread of life.

 

 

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Thanksgiving

Thanksgiving, 2017

“In everything give thanks, for this is the will of God in Christ Jesus concerning you.” I Thessalonians 5:18

Dear Readers,

It seems hard to believe that I began writing this blog four years ago after attending a Christian writer’s conference. My goals in recording what God has taught me during nearly 40 years of nursing is to glorify Him, encourage Christian nurses, and reveal to young people what nursing is all about.  I pray godly Christians will enter the field with realistic expectations.

As many baby boomers like myself retire, we need young men and women to fill the ranks who will give compassionate excellent care to their patients from a heart filled with Christ’s love. Nursing was often a challenging and difficult occupation, but the rewards were great whenever I had the opportunity to point one of my patients to my dear Savior, the Lord Jesus Christ.

I thank the Lord for each of you who come from over 130 countries around the world. When I began to write this blog, I didn’t know if anyone would ever read it, but nearly 7000 people have now discovered it. The main countries where you, my readers, reside are USA, Brazil, Canada, United Kingdom, Philippines, Germany, India, Australia, Italy, and France. Thank you for those of you who have told others about my blog. I’m hoping that I will have time to complete recording my nursing career journey over the next months.

I retired 18 months ago, but have been busy ever since with Spanish language school for seven months, relocating, and several travel trips thrown in there. People warned me that retirement could be busy, and I have found that to be the case! But it has been  enjoyable to make new friends in different corners of the world. I thank God for a good measure of health He has given me.

As we celebrate my favorite holiday here in the USA, Thanksgiving, I thank the Lord for each of you. I pray you will receive the Lord Jesus Christ as your personal Savior if you have not already done so. If I can answer any questions you may have about salvation or pray for you specifically, please email me at pamela.aprn@gmail.com.   For those of you who are fellow believers, may you continue to grow in His grace and keep ” looking unto Jesus, the author and finisher of our faith…” Hebrews 12:2. 

Happy Thanksgiving!

thanksgiving

Prayer for Our Veterans

Nurse Case Manager

I dialed the phone and on the third ring, an elderly man answered in a deep gravelly voice. “Hello?”

“Hi, Mr. G, I am your nurse case manager from the veterans’ clinic and work with your doctor. Your veterans’ clinic home care  nurse said that you came back to your assisted living apartment from the nursing home today, so Welcome Home!”

Mr. G. sadly replied, “I wish I was still in the nursing home. They were so nice to me there. I won’t take any pills until my nurse, Jane, comes here and puts them in my pill box!”

“Mr. G, I’m afraid the nurse from Medicare has to see you for a few weeks first until you are stable, and then Jane will be back.”

“But I don’t like the Medicare nurse! I love Jane. She’s wonderful! I fought in World War II for this country and gave this country the best years of my life. If it weren’t for guys like me, you would be speaking German or Japanese right now! I should be given the nurse I want! Why are you dumping me now???” he shouted into the phone.

I took a deep breath and prayed silently, “Dear Lord, give me the right words for this dear veteran. Help me to explain the rules to him.” “Mr. G, Jane is not allowed to see you twice a week like you need right now. She is only permitted to see you once or twice a month after you are stable for health maintenance visits. Please let the other nurse come to visit you for a few weeks, and then Jane will come back. If you don’t like the Medicare nurse, call me and I will ask the agency to send a different nurse.”

“Well, OK. If that’s how it has to be. I’m so lonely ever since my wife died and went to heaven to be with the Lord. I’ll be glad when I see the Lord Jesus Christ and her again. Thank you for your help, Pam. You’re OK! Could I tell you one more thing? God loves you, and so do I!”

My eyes filled with tears. “I love you too, Mr G.” I slowly hung up the phone and prayed,

Dear Father, Thank you for all our veterans who served our country. Thank You for the freedom I have in the USA. Bless and strengthen and protect our troops right now around the world. I pray that each one would look to you and receive Jesus Christ as their personal Savior. Amen.

Thank You, Lord, for our Veterans!

Thank You, Lord, for our Veterans!

Reflection

Mr G. died the next year at the age of 93. I thank the Lord for him and our other veterans that I might enjoy the freedom I have here in the USA. As a nurse case manager working for the federal government, it was sometimes very challenging to explain the complex rules and insurance regulations of the various programs available to veterans. As we honor our veterans here in the USA on November 11, I pray God would bless and strengthen them.

I hope you watch the following video about a dear World War 2 veteran, Harry Walmer, who gave much for his country. I have had the pleasure of meeting him and thanking him for his service. Despite his 100% disability from the war, he continues to rejoice in the Lord Jesus Christ and looks forward to that day when he will go to heaven to be with his Savior.

Harry Walmer story

I also pray that we would all be good soldiers of the cross for the Lord Jesus Christ as we are in a spiritual warfare daily. May we be able to echo with the Apostle Paul, “I have fought a good fight, I have finished my course, I have kept the faith; Henceforth there is laid up for me a crown of righteousness, which the Lord, the righteous judge, shall give me at that day; and not to me only, but unto all them also that love His appearing.” 2 Timothy 4:7-8

Knee Rehabilitation

November 16, 2004

I thank the Lord for the progress I’m making here in the rehabilitation center after my knee replacement on November 8. I now only need Percocet for the pain every three hours which my stomach can tolerate right after I eat a snack. It was great to sleep 7 hours last night! I did better in Physical Therapy (PT) today as they walked me on a straight cane rather than the walker, but I am still a little wobbly. The Occupational Therapist (OT) taught me how to put on my support hose with a sock aide so now I can shower and dress myself totally independently. They even had me marching and raising my knees high! I met the recreational therapist and enjoyed doing an oil painting which distracted me from the pain for awhile. She said my church choir could come here to sing for the residents any time they like. I so appreciate the visitors from church and their sweet encouragement to me. I never realized before how much visitors help.

The oil painting I enjoyed doing in rehab which helped distract me from my knee pain.

November 21, 2004 – Sunday

I’m awake for now so I want to record snap shots from the past few days. I am now able to go 5-6 hours between percocet pills for the pain. At my request, they added magnesium and calcium to my medications. An hour after I took them, the deep burning pain went away and I could walk much more easily! I missed church so much this morning, so I turned on the TV and watched a couple church services. My nursing assistant, Angela, walked in and said she enjoyed hearing these men preach and that she had received Jesus Christ as her personal Savior.

I asked her if she knew of any other patient who would like to sing, pray, and read the Bible with me? She said she would think about it. Thirty minutes later she brought Teresa to my room and the three of us had such a precious time together. We sang “How Great Thou Art”, “Rejoice in the Lord” and then I read Romans 5 from the Bible. Teresa had some questions about eternal security, so I tried to help her with that. Then we sang “Turn Your Eyes Upon Jesus” and “It Is Well With My Soul” and Angela closed us in prayer. Teresa has cancer and will meet with her doctor and family tomorrow. She asked me to come to her room tomorrow and sing hymns again with her.

November 24, 2004 – Thanksgiving Eve

Home sweet home!! Mary brought me home yesterday afternoon. We enjoyed the most wonderful dinner together that she brought me. I slept fairly well last night, but it’s a little tough to get out of bed. Today PT comes. A friend will take me to the Thanksgiving service at church tonight and another friend has invited me to her house for Thanksgiving dinner. Thanksgiving is my favorite holiday of the year! Two other families invited me for Thanksgiving dinner, so I asked them to bring their left overs on Friday and Saturday nights so I have three Thanksgiving dinners in a row and fellowship with my friends. Dear Lord, You are so wonderful. Thank You so much for saving my soul, for Your loving kindness, and for all the help from my brothers and sisters in Christ. Amen.

December 8, 2004

I had a good post operative visit with Dr. R. He was pleased with my progress of being able to bend my knee to 100 degrees now, do straight leg raises, and climb steps with 50% of my weight on the hand rails.  He said I could go to aqua therapy since my incision is well healed. I can also drive again even though I’m still taking Percocet for the pain.  He wants me to take the entire 12 weeks off from work so I heal well. If I go back earlier, I’ll be stiff, sore and swollen and may have a setback. My home PT showed me how to do all the water exercises at the local indoor pool, so that will save me money. I only pay $33 per month at the pool compared to $20 each PT session three times a week.

When I got in the warm whirlpool, it felt so delightful that I almost cried tears of joy. I am exactly one month out today from my surgery. We had an ice storm yesterday, so I had to cancel my endocrinology appointment. I don’t dare walk on the ice or snow yet because I certainly don’t want to slip and fall.

December 18, 2004

It has been a rough week. I’m having so much pain at night that I can’t sleep. I decided to go to outpatient PT to see if she can help me with the pain. Kimberly, PT evaluated me and said I still have swelling, I’m doing too many exercises, and I need to rest more. She instructed me to only do 2 sets of 10 repetitions of each exercise just once daily in the pool or on land. She reminded me that a knee replacement is extremely painful and takes time to heal. I’m thankful that tomorrow I complete my twice daily Lovenox shots in my abdomen to prevent blood clots. My stomach is all bruised and tender from the shots. Dr. S. mailed me two fun books for Christmas. It was so kind of him to remember me.

Reflection

And so ended 2004. It was a year of stretching with two surgeries, an international trip to China, and adrenal collapse. But through it all, I could see how much God stretched me and caused me to know Him better through these trials. Truly He filters everything through His loving hands for His glory and our good.

“My brethren, count it all joy when you fall into various trials, knowing this, that the testing of your faith works patience. But let patience have her perfect work, that you may be perfect  (mature) and entire, lacking nothing.” James 1:2-4

 

 

Total Knee Replacement

October 9, 2004

“For I reckon that the sufferings of this present time are not worthy to be compared with the glory which shall be revealed in us.” Romans 8:18 “What man is he that fears the Lord? Him shall He teach in the way that He shall choose.” Psalm 26:12

If the Lord tarries, my total knee replacement surgery will be on Monday, November 8. I visited three rehabilitation (rehab) facilities and chose the nicest one with a private room and private bath. I have to pay $20 extra per day for a private room, but it is worth it since I am such a light sleeper. I don’t want to end up with a roommate who screams all night. This facility specializes in joint rehab and has an excellent reputation. My sister, Marsha, is flying here on November 6 and will be with me through the 15th. I am so thankful she can be with me during this time. My dad offered to give me money every month while I am out of work, so I thank God for my dad’s help also.

I thank God for all the valuable lessons He will teach me in this school of knee surgery that He has chosen for me. Here are the classes: Surgery 101, Inpatient Rehab 102, Home Rehab 103, Outpatient Rehab 104, Out of Work 3 months 105. I know He will throw in some surprise classes and pop quizzes. God encouraged me today with 2 Corinthians 1:5, For as the sufferings of Christ abound in us, so our consolation also abounds by Christ. God will not test me above what I can bear. Thank You, dear Lord, that You have it all perfectly planned out.

October 16, 2004

I went to an interesting class at the hospital to prepare me for surgery. They gave me a folder and had me watch a video by a TV actor who had both his knees replaced at the same time. He is now able to ride a horse, so maybe I can cross country ski a little next winter. Dr. S. told me not to give away my skis!

Yesterday I attended a conference for orthopedic nurses and many of the hospital nurses who will be taking care of me also attended. I learned much, but I’m not sure if it was good for me to hear about all the possible complications of knee replacement surgery. I am so thankful my two nurse friends from church will both be working the week of my surgery. It’s always nice to see familiar faces at the hospital.

October 30, 2004

I tried to donate blood to store for myself, but my veins collapsed. Two friends at church who have my blood type volunteered to donate on my behalf, so that was very generous of them. The Nurse Practitioner who was my first preceptor in graduate school now works for my primary care doctor, and she gave me my preoperative physical. It was great to see her again! I only have six days of work left. I am so ready to move onward and forward and have this surgery behind me.

November 4, 2004

“Thou hast enlarged me when I was in distress.” Psalm 4:1

I read this verse before I attended our monthly practice meeting yesterday at the hospital. Dr. E., my main boss, asked to meet with me privately after the meeting. He told me they were granting me the medical leave of absence for a maximum of 16 weeks even though they aren’t required to legally because they are such a small practice group. The hospital lost $2.5 million last year and has had to lay off a number of employees. He said he might need to decrease my hours when I return. He wants me to make rounds on all the hospital units to increase the visibility of the rehab unit and to promote the rehab unit as enthusiastically as possible. He said the workload will be difficult for Dr. S. while I am off. They are not paying me any salary while I’m off work, so at least they are saving money that way.

Many changes lie ahead at work in the next three months, but I refuse to worry about it because God isn’t worried! I praise Him for the wonderful peace He is giving me going into surgery.

November 15, 2004 – 2:40 a.m.

I had my surgery one week ago, and I’m now at the rehab facility in my pleasant private room. Marsha flew back to her home today. She was my advocate while I was in the hospital when I could not think straight from the pain and anesthesia. I am so thankful for help from her and the nurses from church. I thought I would lose my mind from the pain right after surgery. I fainted several times in the hospital from low blood pressure caused by the pain medicine, so the doctor changed to another one. They put my leg in the continuous passive motion (CPM) machine which made my leg spasm, so I refused it.

My titanium knee xray looks similar to this.

Marsha drove me from the hospital to rehab in my car, but it was agony to bend my swollen knee enough to get it in my car. I think I should have come by ambulance instead. The rehab facility couldn’t obtain my pain medicine from the pharmacy for 12 hours after I arrived, so again the pain was incredible. Mary, my friend from church, visited me and held my hand when my leg spasmed. We sang one hymn after another to try and distract me from the pain. I’m so glad I brought copies of the words of all my favorite hymns with me. Some of the brethren from church came to visit me on Sunday afternoon which was a blessing. They sang “Rejoice in the Lord” and “Isn’t He Wonderful?” I am finding singing to be very therapeutic.

Reflection

And so I began my 10 day stay in the rehab unit. The intensity of the pain after surgery surprised me. I really didn’t know a person could experience that much pain. The experts say that bone pain is the worst kind of pain, especially in the knee joint because the swelling has no where to escape. People who have had both their hip and knee replaced have told me that the knee replacement pain was significantly worse. However, everyone experiences surgical pain differently. A few people only need mild medicine, but I definitely think I was at the opposite end of the spectrum. One probable reason was my age of 49 years and having intact nerves.

More Knee Pain

August 2, 2004

“Beloved, think it not strange concerning the fiery trial which is to test you, as though some strange thing happened unto you.” I Peter 4:12

“In every trial, there are gleams of light and relief, but full deliverance is often delayed by our anxiety to obtain it. God Himself and not the deliverance is to be the satisfaction of His servant. Consequently, the deliverance is often postponed until we are without prospect or expectation of it. Then it may happen in a manner so far beyond our conception that we must see and understand the love and interest which surrounded us during the whole period of our trial.” -None But the Hungry Heart

As I begin my second week of recuperation here at home after my knee surgery (arthroscopy), I am so thankful for this encouragement from the Lord. Dr. E., my big boss, was so kind when I talked with him this week. He said to take all the time I need to recover. He knows I’m not hanging out in the Bahamas:) He asked if I have osteoarthritis, chondromalacia (rough knee cap), or torn meniscus (cartilage). I told him that I have all three which shocked him. He said he was at a loss for words to say something to make me feel better, but God is my comfort and strength.

I spoke with one of the nurses at church who had her knee replaced. She encouraged me to have it done as soon as possible so I don’t ruin the other one. She was able to drive ten days after surgery, but said the pain is intense the first few weeks.

August 9, 2004

I tried to return to work last Thursday for four hours, but it was really difficult because I became so weak. I’m afraid the stress of surgery has made my adrenal glands crash again. It took me three hours to do one admission and see nine patients. I can only stand about 30 seconds, so I went back to work too soon. I am going to write out surgical guidelines for myself for the next surgery to help me remember. I spoke with two nurse friends at church who both work in orthopedics at the community hospital. They both recommended Dr. R. who did my first two knee arthroscopies.

I tried to go to church yesterday, but became so weak after driving two blocks that I had to turn around and come home. So I laid on my couch and listened to a good Bible message on thinking right. I keep asking God to help me to see this exercise in my life from His point of view and to help me not to wrestle, but just nestle in His loving arms today.

August 14, 2004

I saw Dr. R. for a second opinion on my knee. He needs the operative report and and photos from Dr. M. He’s not too eager to do a total knee replacement on me because it only lasts 8-10 years on someone my age. If I can wait 11 more years until I turn 60, the knee replacement will last 15-20 years. He ordered water therapy in the pool which I did yesterday and today. I am still getting weak and dizzy once or twice a day, so I’m not sure when I will be strong enough to return to work. I’m off work without pay now since I used up all my sick and vacation time. I know the Lord will provide.

Dear Lord, Carry me this day. I give it to You in all my weakness. Thank You, that this path of affliction is for Your glory and my good. Help me to trust and rest in You. In Christ’s Name, Amen

August 26, 2004

“The Lord will give strength unto His people; the Lord will bless His people with peace.” Psalm 29:11

God is so gracious in carrying me along this week. The endocrinologist and naturopath both agreed that my adrenals are my main problem causing the weakness and dizziness and have restarted the cortisone and other supplements. I am getting custom inserts for my walking shoes to try and align my knees better since my knee caps point out instead of straight ahead.

Dr. E. called me again to say hello and see how I was doing. When he worked in internal medicine, he had a patient with adrenal insufficiency and said he knew what a difficult problem it is to have and treat. He assured me that they will not replace me and not to worry about my job or come back too early. If I need to come back just 3 or 4 hours daily, that can be arranged. It was so nice of him to call and reassure me.

I thank God so much for the compassion of Dr. E. and Dr. S. and allowing me to work with these two men. They are so refreshing compared to my two previous nurse managers at the LPN school and the insurance company. But I realize that none of this will matter 100 years from now, so I’m just trying to keep the big picture. I now qualify for disability since I have been out of work for over a month. I thank God so much for His encouragement today.

September 30, 2004

“And after you have suffered for a little while the God of all grace, who called you to His eternal glory in Christ, will Himself perfect, confirm, strengthen, and establish you. ” I Peter 5:10

After taking the cortisone for 9 days, I was finally able to return to work a couple weeks ago, but the knee pain is intense. Dr. S., my boss, ordered forearm crutches for me to walk with as these give the most relief from knee pain. My patients are so sympathetic as I make rounds on them and we joke about our mutual aches and pains. I’m connecting with my rehab patients on a new level.

My knee pain was so bad that I needed to walk with forearm crutches at work.

I saw Dr. R. yesterday about my continuing knee pain. He reviewed the surgical report and photos and said I need a total knee replacement if I don’t want to end up in a wheelchair. I don’t qualify for a partial knee replacement because my bones are soft and I have triple compartment arthritis. I will need about 10 days in a rehab facility after the hospital stay since I live alone. He recommended two facilities and said I should visit both before surgery to see which one I preferred. I will need to be off work for three months after surgery. He is very comfortable dealing with people with adrenal problems, so they will give me a huge steroid dose the day of surgery to prevent my adrenals from crashing again hopefully. He is going to order the newest and most expensive titanium knee for me that is supposed to last 30 years. It costs $30,000! I sure hope it lasts until the Lord takes me home.

Dear Lord, Help me to relax with the pain right now and rest in Your everlasting arms. I just want to line up with Your plan and not my own. You plan this surgery and use it for Your glory and honor. In Christ’s Name, Amen

Reflection

And so God prepared me one step at a time for a very difficult surgery. Many days it seemed like I would never be pain free again in my life. I realized even more what a blessing health is, but many times He teaches me the most when I am so very weak and can do nothing but lean on Him. This very difficult time in my life gave me much greater compassion for the health problems of my patients.

Pain, Pain – Go Away!

April 22, 2004

I had my painful left knee injected with cortisone yesterday because I could barely walk. I have been trying to climb more flights of stairs at work to get in shape for ascending the Great Wall in China, but it has only made my knee worse. I do wish I never would have tried to learn how to downhill ski nine years ago. A bad fall is what started all the arthritis in my knee. It’s difficult to make my walking rounds at work in the hospital because of the pain.

April 24, 2004

“He (God) gives power to the faint; and to those who have no might He increases strength. Even the youths shall faint and be weary, and the young men shall utterly fall. But they that wait upon the Lord shall renew their strength; they shall mount up with wings like eagles; they shall run, and not be weary; and they shall walk, and not faint.” Isaiah 40:29-31

 I saw the Physical Therapist (PT) yesterday and he thinks I have floating pieces of cartilage in my knee again because of the catching and buckling when I walk. The orthopedic Physician’s Assistant (PA) read me the surgeon’s operative report from 1996 who said I have a major defect beneath my patella (knee cap) and exposed bone. My xrays this week showed arthritis behind the patella and a narrowing of the space, so I’m probably looking at a total knee replacement in the near future. The Lord knows. The PT gave me an electrical stimulation machine to use for the pain four times daily over the weekend. I apply electrodes on either side of my knee and then the small machine sends low dose electrical signals through my knee to block the pain.

May 3, 2004

“I will go before you and make the rough places smooth… and I will give you treasures of darkness, and hidden wealth of secret places in order that you may know that it is I, the Lord God of Israel, who calls you by your name.” Isaiah 45:2-3

So much has happened in the past week. SARS (severe acute respiratory syndrome) has reoccurred in Beijing leading to one person’s death, eight confirmed cases, and 1000 people exposed. I am scheduled to visit friends in Beijing on May 19. I have committed the situation to the Lord and have asked Him to open or close the door for me to go. It is so wonderful to be still and know that God is in control.

June 5, 2004

I had an interesting trip to China and enjoyed seeing the Forbidden City, Summer Palace, and climbing an unrestored part of the Great Wall with my friends. I thank the Lord for the health He gave me and for protecting me from SARS, but all the walking took a toll on my knee.

I just fit in the Circle Door at the Summer palace

I had fun dressing up as Empress Pam at the Summer Palace.

Staying cool Chinese style as I toured the massive Forbidden City.

July 2, 2004

My left knee started catching and buckling again last week, so my boss, Dr. S., was able to call the orthopedic surgeon and get me an appointment this week. Dr. M., the surgeon, is a friendly personable guy. He said, “I really like you, but I hate your knee.” He looked at my xrays and photos from my last arthroscopy two years ago and said I was already down to the bone in several places with severe arthritis. He informed me that a knee replacement lasts 17-20 years under the best conditions and doesn’t work well if I would need a second knee replacement on the same knee. I’m only 49 years old, so I sure hope the Lord comes soon! I also am very high risk for synovitis (painful inflammation of the joint). I will have my third arthroscopy on July 23 to clean out my knee.

August 1, 2004

I have had a rough recovery from my arthroscopy with weakness and dizziness. I saw Dr. M. for followup and he said my knee looks like one from a 90 year old woman and that it is not happy. He suggested that I need to think about getting a desk job, take another week off from work, and then return only four hours per day. The next step is a total knee replacement, but he can’t predict if or how long the arthroscopy will give me any pain relief. This news shocked me, but I’m thankful that my soul is happy in Jesus even though my knee isn’t.

“Although the fig tree shall not blossom, neither shall fruit be in the vines; the labor of the olive shall fail, and the fields shall yield no food; the flock shall be cut off from the fold, and there shall be no herd in the stalls; Yet will I rejoice in the Lord, I will joy in the God of my salvation. The Lord God is my strength, and He will make my feet like hinds’ feet, and He will make me walk upon mine high places. Habakkuk 3:17-19

God uses change so we can use our spiritual muscles that we have never used before.

Reflection

And so God gave me lessons once more in the school of pain. Little did I know that I would remain in this classroom for many more months. God is so kind to hide the future from us so that we may learn to abide in Him and trust Him just for today. Next post I will continue telling you about my painful journey.