An Important Request for Help - for a missionary friend of ours in Honduras

I received this request for help from a friend of ours, a doctor at a missionary hospital in Balfate Honduras. Although we live far from them now, when we lived on the island of Guanaja we often traveled (by boat, then by plane, and finally by road) to visit the hospital, to receive excellent medical care for our family. Dr Jeff McKinney is an extremely dedicated missionary doctor. We have known him and his family, and his ministry, for about 5 years.

Loma de Luz Hospital, Balfate Honduras

The letter is long, and occasionally technical (with medical information), but I'm posting it in the hope that someone might see this, and be able to help out.

Here is the letter I received:

Dear Ones

I rarely send out emails addressed to a broad audience like this. But we are in a pretty urgent need to get the word out for help with nursing care for Bob Lillard down here at Hosp. Loma de Luz. Many of you already are aware of the situation... although you may have not been updated in the past couple of days. Some of you may not have heard yet. I'll give a brief synopsis of the situation to all as if you had not heard yet.

Bob Lillard is an 81 year old man. (His birthday was 4 days ago). Bob & his wife Zina were church planting missionaries in Italy for 35 years. (They are also my wife Rosanne's parents). Since retiring from Italy, they have been very much involved in the development of the Cornerstone Foundation... serving as some of the first board members, then in the past several years have become more and more involved here at Loma de Luz. They currently are serving here as missionaries back on the field again, 6 months here, 6 months back in the states. Bob was in generally good health until about 3 weeks ago, when he became acutely ill with a non-perforated duodenal ulcer, and acute colonic diverticulitis. His recovery from this was a little rocky with an on again, off again ileus due to his diverticulitis. But by the end of about a weeks hospitalization he was just beginning to turn the corner when on the morning of the 4th of January, he had an unexpected cardiopulmonary arrest on the ward. The etiology of this is not known for certain, but most likely was due to a pulmonary embolus.... perhaps exacerbated by an underlying hypokalemia.

The arrest was witnessed or discovered very quickly, and CPR was begun within probably close to 5 minutes, then a full code begun immediately. By the grace of God, Bob responded to the resus.. By about 15 minutes into the code he regained a functional cardiac rhythm, and shortly thereafter began to breath spontaneously (intubated). He was, as you would expect an immediate unstable critical care patient for the next 3 to 5 days... In a mission hospital on the edge of the jungle. The entire missionary & hospital staff rallied around Bob and we quickly developed an ICU. Bob has gradually recovered to a status where he is still critically ill, but stable... and now becoming closer to an intermediate care level patient. With the dedication, expertise, and hard work of several of the missionary medical and nursing staff... the earnest and effectual prayers of many of you, and again by the grace of God, Bob continues to recover a little bit each day.

Currently Bob is breathing on his own (via a tracheostomy), with pulse Ox in the high 90's on 5 liters via O2 concentrator. He is clearing a right lower lobe pneumonia.... has 3 or 4 broken ribs from the CPR, but no flail segment and seems to be improving pulmonary wise each day. From a cardiac standpoint he is now in a stable sinus rhythm... pressure and pulse normal for age. From a GI standpoint, he is tolerating tube feedings via NG... though he still has a central line, all meds have now been changed over to enteral. I plan to put in a G-tube tomorrow... and hope to shortly after that, get the central line out. Renal function is good.

The primary, on-going issue, of course, is neurological. Due to the arrest/code and ensuing hypoxia, Bob suffered a non-focal (global) ischemic brain injury. He is not vegetative, but "semi-comatose... breathing on his own, with normal cough & gag reflex & response to noxious stimuli. On the seventh day post event... (2 ½ days ago now), Bob began to occasionally open his eyes, occasionally with an apparent fixed / conjugate gaze. In the past couple of days, he has been blinking a lot more, has moved his lower extremities spontaneously, and now his right arm spontaneously. Tonight he opened his eyes , fixed gaze, and seemed to respond to a request to blink.

So, an otherwise relatively healthy 81 year old man, stabilizing rapidly 9 days after a successful code, slowly but steadily improving neurologically... but still basically a total care patient. ... and also a missionary on the field... and also my Father-in law... and also, for the time being will stay put out here at this mission hospital. He is getting excellent care. But he is getting care at a hospital that has not been previously set up to provide this level of care on a protracted basis... particularly from a nursing staffing standpoint.

We are very grateful that the Lord is bringing about this gradual recovery. Believe me, we are praying that it will continue. I know that many, probably all of you have been too. But, short of a Lazarus level miracle, we anticipate many months of nursing care... gradually lessening in intensity, but currently one on one. We plan to utilize our Honduran staff more. We plan to augment our Honduran nursing and "Aide" staff. But in the next month to two months at least... we could really, really benefit from a US nurse coming down to help with the shifts for Bob's care. They do not need to be ICU nurses. Any US trained nurse with medsurg experience would be great. For the next month or two, we could really use an additional 4.2 nurses at any given time.

I'm sorry to be asking for help in this way. I wish things were different and we didn't have this need. But we do... and after the Lord, it is our friends we turn to when we are in need.

Thank you for being there.

God's Blessings,

Dr Jeff McKenney

If you can offer any help, contact me, and I'll help you get in touch with the hospital. Thanks so very much!