ROBOJAW 3 REPORT

August 16, 2017 By revheff in Personal Reflection Tags: health update, jaw, surgery 2 Comments

Update on My Most Recent Jaw Reconstruction Procedure

Dr. Marx

Last Thursday, August 10, I underwent the third in a series of surgeries to rebuild my right-side mandible.

Radiation treatment in 2005 eventually undermined the integrity of that bone. I suffered a pathological fracture as a result in late 2015.

Tongue cancer was painful. A broken jaw was excruciating. Worse than that, one can’t chew anything. Something had to be done.

Fortunately Dr. Robert Marks, an oral surgeon in Miami, knew just what to do for me. He is one of a kind. I’ve complained about having to travel 500 miles round trip each time I see him. But then I thank God he doesn’t operate out of Seattle.

Robojaw 1 took place in February 2016. They removed half the mandible and replaced it with a titanium plate.

After six months or so of healing, Robojaw 2 occurred the day before Thanksgiving that same year. They wired my jaw shut for three weeks to keep the bone graft to rebuild the mandible fixed in place until it was hard enough for me to safely chew again.

Another six months gone by brings things to the present with step three. Dr. Marx removed four additional teeth in the lower front of my mouth. They would have eventually died from radiation treatment as well.

He also placed four implants below the jaw line. All this acts as a prelude to getting some teeth back in my mouth so I can chew food on that side, speak better, and prevent the upper right teeth from growing down and falling out since they have nothing to bite down on.

The surgery went well. It lasted about two hours. They were so pleased with the ease that they discharged me that very day. There was no need for an overnight stay for observation. I’m sure that made the insurance company happy.

Next Tuesday I will make yet another Miami trip for my two-week post-op check up. At that point I hope to confirm the timing for Robowjaw 4, six months from now and what it will involve.

By next February the implants should have become integrated with the bone. They will affix posts to the implants. These will set above the jaw line.

After three weeks of wearing some sort of mouth guard to keep them in place, the climax will happen. I will get eight teeth where now there are none.

I’ve already got a celebration plan mapped out. We’re sitting on a wedding gift card to Ruth’s Chris. I’ve never been. Might as well take those new teeth out for a ribeye spin and see just what they will be able to do.

Thanks for all for your prayers and support!

A PERSONAL UPDATE

March 31, 2016 By revheff in Personal Reflection Tags: cancer, health, jaw 11 Comments

A dear self-professed atheist friend of mine follows my blog. This both humbles and encourages me. But he did recently complain about the content. “Too much religion. Not enough about you.” Just like my buddy. This post he will like, I think.

Sick Leave

I had to shut down the blog for a couple of weeks recently due to ongoing treatment during my current medical absence. Following jaw surgery six weeks ago my surgeon ordered ten hyperbaric dives to aid in my recovery. They completely wiped me out. Productivity of any kind flew out the window from day one. Fortunately I’ve left those in the rear view mirror. I am actually starting to feel human again.

010

Before I write anything more about me, let me update on the Queen of the Manor, Miss Nancy. Honestly, we don’t have a great deal to report about her cancer battle. She continues diligent treatment with her latest alternative protocol.

She remains optimistic in every way. She has no pain or symptoms. Still no word on the results of her lymph node pathology. We may wait as many as two more weeks for those. Sigh.

Needless to say we pray a lot through this journey. Thanks to so many of you who join us in petitioning the Father in Jesus’ name for her complete healing.

robojaw

Now back to the less interesting part of this post. How do you like my new look? Yep, allow me to introduce you up close and personal to “robojaw.” This most recent scan shows my titanium implant.

Note the span. It runs from the socket by my ear all the way past the midline point of my chin. Just above the “chain” shows my remaining live bone in the mandible. Noticeable by their absence? All my teeth in that quadrant. Needless to say the left side does all the chewing work these days. I’m wondering if my dental hygienist will discount me 25% now at teeth cleaning time.

I still have some swelling. My surgeon, whom I saw recently in Miami, refers to these weeks as “the accommodation” phase of my healing. But everything looks good. I can eat anything I find tolerable. Some speech and swallowing therapy lies ahead as soon as we can arrange it, but things overall improve daily.

office

Thankfully, this week I’ve returned to the office for a good part of each day. Prime time pulpit work will have to wait a bit longer, but writing and administration–no problem. Seems I can manage the occasional appointment as well. Sure beats breathing 100% O2 at a simulated 45 feet below sea level in a claustrophobic chamber.

Our elders huddle up in a couple of weeks. At that meeting I expect we will discuss my progress and what steps might lie ahead for a more complete pastoral reentry. In the meantime, I praise God for His kindness in sustaining me through this marathon journey. Go ahead and say it “L.” “There you go again with that religious talk.”

I just can’t help myself.

VALENTINE’S DAY IN MIAMI

January 7, 2016 By revheff in Personal Reflection Tags: health, jaw, surgery 10 Comments

Can’t say I don’t know how to show my bride a good time. Yes sir, I’m pulling out all the stops this year. I’m taking Nancy to the Magic City on February 14. Unfortunately we won’t be having a romantic dinner for two on South Beach, unless you count Smoothie King a five star establishment. No, we will head that way on the 14th so I can report for jaw replacement surgery first thing in the morning on the 15th.

MarxScanAgain2

After visiting on Monday of this week with Team Marx associated with Jackson South Community Hospital, we had no doubt the Lord had led us to just the right resource to deal with my fractured mandible. The image above shows the results of a CT scan they did in the office that day. If you look closely at the largest of the pictures head on at the top, you can see to the left (my right side) the break in the bone. Apparently there are some splinters of the jaw floating around in there adding to my misery. To use one of the doctors words after they examined the area treated with radiation in 2005–“You got fried.” And so I did and these are some of the unfortunate consequences.

titanium jaw implant.jpg

The procedure takes anywhere from seven to nine hours. It begins with removing all the dead bone on that side of jaw. I will lose the next two teeth in line as well since they are sitting on top of dead bone. Fortunately the titanium plate (pictured above) then implanted will not, in my case, pass the mid-line, as in this stock picture I grabbed from the web. While the oral surgeon does his thing up above, a micro-vascular surgeon will work below on my right thigh to start something called a “free flap” transplant. When the jaw is finished, then the second surgeon will attach the vein he pulls from my leg to a good blood supply on the left side of my neck and run it across to the right side. This will insure adequate blood supply for the needed tissue growth and healing of the jaw.

jacksonville2

After the surgery I will spend two nights in ICU to monitor the free flap part of the process carefully. Assuming all goes well with that, then it’s off to the main floor of the hospital for another four or five days. The docs are very optimistic about how quickly I can heal and get back to work, but some of that depends on how many HBO2 dives I am likely to need after surgery to aid in the healing process. I’m still waiting for more info in that regard.

Honestly I had hoped for a sooner surgery date than February 15, but supply and demand being what it is in this highly specialized kind of procedure, I am grateful I don’t have to wait even longer.

One last tidbit. When one of the doctors who will work on the free flap procedure heard I was a pastor, he smiled and shared with me that he takes online courses at Southern Seminary in his free time! He went out of his way as a brother in Christ to give me his contact info and even friended me on Facebook. The Lord is so kind to add those touches of providence to our circumstances when we are asking for His clear leading.

While I wait for “Operation Robojaw” to take place, I hope to make as much progress as I can on my manuscript for Baker Books. Fortunately it doesn’t hurt when I write, only when I preach!

Mandible Misery My Mentor

December 9, 2015 By revheff in Personal Reflection Tags: jaw, mentoring, pain, suffering 2 Comments

I know. I don’t look very miserable in this picture. That was a good day coming forth from hyperbaric O2 therapy number whatever for deep wound treatment to my radiation-decimated jaw. I managed to prevail on the nurses’ good graces that day to get some pics from the bowels of the compression chamber so others could have some idea of what my new normal looks like these days.

Here’s another.

I’m not hooked up here, of course. There is no O2 flowing. But this gives an idea of the rig I have to wear as a delivery system of 100% O2 for three thirty-minute periods, five times a day at Florida Hospital South. All sorts of fun.

So far I’ve navigated twenty-one of these. Nineteen to go. The adjustment hasn’t gone all that rough. I read a good bit of the time now. Apart from the occasional nausea bout, things go pretty smoothly.

Unfortunately I don’t have much progress to report. Hence my word “misery.” This past weekend my pain spiked. I cut church. If you know me, I never want to give up a preaching opportunity and chance to worship with God’s people (Heb. 10:24-25). Oops. I probably should have put them in the opposite order. Oh well. Sunday is the best day of the week, by far. I am thankful for an extraordinary pastoral intern who stepped in for me at the last minute. You can listen to his message here.

With the pain spike came a fever on Sunday night. OK, now I’m getting nervous. Long story short, after consulting my dentist, infectious disease doctor, and oral surgeon since then, we have a unanimous verdict. Off to the hospital I go. It’s time to circle the wagons and call in some big gun consultants to play what-do-we-do-with-what’s-left-of-this-preacher’s jaw. The idea is to get my pain under control. I’m all for that. Then to get me hydrated and built up nutritionally. Not only can’t I eat; I am also having difficulty swallowing. It hurts that much. Then, Lord willing, next week they will operate again to remove more dead bone and hopefully save the jaw. I’m not kidding on that one. If my mandible gets a pathological fracture, I’m looking at some sort of radical replacement surgery I DON’T EVEN WANT TO THINK ABOUT! Has my sense of urgency come across the page? Please pray for mercy for me in this regard. I have read about this procedure. I would really rather avoid it, if at all possible.

But if I do, my mandible mentoring, miserable as it might be, will continue with sovereign efficacy. God wastes nothing in our suffering, whatever its nature. In hard providences like these, I remember verses like Psalm 119:71.

It is good for me that I was afflicted, that I might learn your statutes.

This slow learner apparently needs an extra dose of afflictions that he might learn all the more the treasure of treasures, the law of the Lord. Mentor me, oh my Master (and I don’t mean my mandible, but my mandible-maker), but please, I beg of you, go easy on what’s left of this poor man’s miserable jaw. Amen.

Jaw Journey Update

November 16, 2015 By revheff in Personal Reflection Tags: health, infection, jaw, wound care Leave a comment

I gave this report in our church’s e-news this past week:

Thanks a ton for all your prayers as I continue to travel the healing road with the wound/infection in my jaw. I am now essentially under the care of infectious disease doctors for my osteomyelitis. They have put in play every strategy known to help my particular problem. It’s a two-fold approach. First, I have an at-home, every six hour, 24/7 antibiotic infusion—for four to six weeks. The hardest thing about that is the disruption of my sleep patterns. Pastor needs his sleep!

Second, the infamous hyperbaric oxygen dives. The toughest thing there is the time involved and somewhat the discomfort. I arrive at the hospital every morning, Monday through Friday, at 6:30 AM. They load the dive chamber somewhere around 7:30. It takes about fifteen minutes to pressurize the cabin to the equivalent of 45 feet below sea level. My sinuses tend to object strenuously on the way down. Think ice pick thrusts above the eye and you will get the idea. Once at depth, they install a clear plastic hood over my head. I breathe 100% O₂for 30 minutes, 5 minute break, another 30 of breathing, take five once more, a final half-hour of oxygen, and then 10 or 15 minutes or so back to the “surface.” I’m home in Altamonte usually by 10 AM. Fun, huh?

Needless to say, this treatment regimen has cut in significantly to my morning study time. As a result I feel I need to suspend the Genesis series until finished with this stewardship. I’m planning something less strenuous for Advent from the gospels. That will give me some breathing room as I keep on the healing path. My apologies for the disappointment this causes anybody. I just can’t bring myself to cheat study time on arguably the most challenging book of the Bible I have ever preached.

Most of my work hours for now will occur in the afternoon, evenings, and weekends, as energy allows. I appreciate the patience and grace I’ve received as I try to navigate the schedule with wisdom and grace.

Jaw Wars

October 21, 2015 By revheff in Personal Reflection Tags: grace, health update, infection, jaw, pain, strength Leave a comment

The Star Wars saga has nothing on me. I’ve got more episodes in my journey than the popular movie series will ever produce.

This just in. My oral surgeon today said he’s done all he can do surgically. The problem with my escalating pain must be medical. What to do? Two things. One, hyperbaric oxygen therapy. I report for the first of these tomorrow morning, Lord willing, at Florida Hospital. Can’t wait to climb into one of those rigs (see image above).

Two, infectious disease consult. The surgeon removed all the dead bone debris he could find. My pain can no longer stem from that cause. The only thing he can surmise on that score is osteomyelitis–chronic infection of the bone. My oral surgeon referred me back to my medical oncologist/hematologist for this consult, especially because I had multiple infections of the blood during my chemo treatments back in 2005. I am still waiting to hear back from his office about an appointment. My understanding at this point is that treatment protocol for this involves inserting a central line for six weeks of IV antibiotics. Something to look forward to. But I am trying not to get ahead of myself.

Pain remains high. Still pushing the drugs to cope. Lots of rest required. The saga goes on.

I’ve hauled out a familiar friend from ’05, the promise of God in 2 Cor. 12:9, to sustain me along the way.

But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me.

Oswald Chambers says this about one of my all time favorite verses of the Bible:

God does not give us overcoming life: He gives us life as we overcome. The strain is the strength. If there is no strain, there is no strength. Are you asking God to give you life and liberty and joy? He cannot, unless you will accept the strain. Immediately you face the strain, you will get the strength. Overcome your own timidity and take the step, and God will give you to eat of the tree of life and you will get nourishment. If you spend yourself out physically, you become exhausted; but spend yourself spiritually, and you get more strength. God never gives strength for to-morrow, or for the next hour, but only for the strain of the minute. The temptation is to face difficulties from a common-sense standpoint. The saint is hilarious when he is crushed with difficulties because the thing is so ludicrously impossible to anyone but God.

Not sure about the hilarious part, but definitely striving for strength in the strain of each minute. Appreciate all the prayers of the faithful on FB.

More importantly, regarding Nancy, there is not much to report. She continues to work her therapy program therapy. Thank you for your faithful prayers on her behalf as well.

Jaw Joy

September 23, 2015 By revheff in Personal Reflection Tags: gospel, grace, jaw, surgery Leave a comment

I won’t make this a long post. But post I must.

Jaw pain on my right side has plagued me since a root canal tooth failed in May. This morning I underwent oral surgery to remove dead bone on the right side of my jaw. The procedure exceeded my expectations. My surgeon cleaned out a bunch of junk. He did a superior job. That I can work on a blog post the same day testifies to that effect.

I got to thinking about one’s jaw. I admit it. I take mine, both sides, for granted. I shouldn’t. My right side got hammered ten years ago with radiation treatment for head and neck cancer. Gotta love cancer treatment, conventional style. While cancer cells get killed, so also do healthy cells. Hey, I’m not complaining. I’m still preaching ten years later. My complications have been minimal. Couldn’t be more grateful.

Still, there is this jaw thing. Preacher’s tend to make connections from the experiential to the spiritual. Here’s mine, with the help of Puritan Matthew Henry, from Hosea 11:1-7.

He eased them of the burdens they had been long groaning under: I was to them as those that take off the yoke on their jaws, alluding to the care of the good husbandman, who is merciful to his beast, and will not tire him with hard and constant labour. Probably, in those times, the yoke on the neck of the oxen was fastened with some bridle, or headstall, over the jaws, which muzzled the mouth of the ox. Israel in Egypt were thus restrained from the enjoyments of their comforts and constrained to hard labour; but God eased them, removed their shoulder from the burden, Ps. 81:6. Note, Liberty is a great mercy, especially out of bondage (emphasis mine).

Do you see that phrase, I was to them as those that take off the yoke on their jaws? At this point in my spiritual journey, no other verse may matter more to me in the strengthening of my faith to finish strong. Do I long for the pain in my jaw to abate? Absolutely.

Would I trade that for the confidence that Jesus, by His gracious death on the cross and victorious resurrection from the dead, has TAKEN OFF THE JAW OF WORKS and given this unworthy ox the mercy of laboring under gospel grace?

Not in a million years.

Thank you, my great Savior, for using my frail jaw for reminding me once again of your great grace.

This jaw, what’s left of it, praises You.