precious son Timothy is a missionary —
a fine son who,
had just returned home on a planned furlough from the mission in
Ghana. Even as he was leaving Ghana, Timothy was starting to
feel sick. He had gotten a malaria test there which came back
saying he was clear of any parasites (malaria=parasites in the
blood). But even as he got onto the plane, he continued to feel
sick. When he returned to the States and to our home, we were
all packing up to attend a family reunion at the Oregon Coast.
After a several hour drive, we arrived safely to the reunion site
down in Lincoln City − a
beautiful home right on the beach. Timothy was not
feeling well, but he was enthusiastic about continuing with our
plans to go on the trip. As the week went by, Timothy was seen
less and less — in the
next days, he continued to worsen significantly; feeling nauseous,
having headaches, extreme fevers, and periods of great sweating
− so much so that we had to
change his sheets and clothing many times daily.
We arrived shortly thereafter and Wes carried Timothy into the Emergency Room. I will never forget that sight. Timothy, so helpless and frail. Without hesitation, the ER team started IV fluids and within a couple hours Timothy had been given over 5 litres of fluids. Only problem was, instead of improving as they had assumed he would, his condition deteriorated dramatically. The internist there did a blood smear and did see clear evidence of the malaria parasites. By this time, Timothy was no longer responding to questions and was moved into ICU. More invasive or serious procedures were undertaken; a 'broad spectrum' antibiotic was begun, an NG tube (nasogastric tube) was inserted, as was a catheter. Timothy's condition worsened and he was no longer responsive. It became readily apparent that he would need more intensive treatment and care far beyond the scope of that hospital.
The ICU doc there felt it to be critical to have Timothy intubated
and immediately transported to Oregon Health & Science University
Hospital. So they chose to 'life flight' him up to the hospital
− but there was a small hitch:
Lincoln City was socked in with fog and the helicopter could not
take off from there, so they transported him by ambulance over the
mountains to the spirit mountain casino where they met the helicopter
which took him the rest of the way north to Portland to the OHSU
We reached the OHSU hospital by 10 pm, and by this time, Timothy was in a deep coma. He was in MICU, on a ventilator and receiving several units of fluids and antibiotics. Testing reconfirmed: malaria. The meds sure took a toll on his well being by raising his heart rate and giving him some bad 'shakes.' He had CT scans to measure the swelling of his brain. IV fluids were continued one after another. We stopped counting at 20 litres. He required numerous IV meds and nutrition, blood supplements, blood transfusions and platelets. Timothy had been receiving medications to reduce his fever - but to no avail. His fever remained high, his pulse was racing – tachycardia, they told us. Apparently, because Timothy is a younger person, he could withstand a longer period of this very high heart rate – surpassing 150 beats per minute for several hours.
He was being "core-cooled" by a machine called: Arctic Sun. The Arctic Sun system pushed freezing cold fluids through hollow pads that were strapped to Timothy's body and a monitor was tracking incremental changes in core temperature. His body seemed as though it could not withstand all that was happening. With fans blowing on him, ice bags under his arms and legs, along with the cooling pads, slowly they were lowering his body temperature - shooting for 37º C. It seemed to take hours to get to that "normal" temperature. We felt helpless watching his body shaking so violently at times – rigors, the doctors called it. All the while, the room was filled with activity – doctors and nurses coming and going – hanging and re-hanging bags of IV fluids, the monitors clicking, the ventilator pushing and pulling air in and out of Timothy's lungs, the blood pressure cuff automatically taking his blood pressure every 15 minutes... the leg compression machine pumping and releasing pressure on Timothy's legs. Signals would sound, alarms would go off; the bags and monitors: drip, drip, drip... click, click, click... the machines would drone on hour after hour.
The head of the MICU told us later Saturday morning that if Timothy "were a 65 year person, I'd give him 100% dead. But since he is a 22 year person I give him 50/50 – and I don't even give him that." Even though Dr. Kahn's bluntness and aloof demeanor was sometimes difficult to take, I knew that God was surely in control and nothing had escaped His gaze. I was continually impressed that this whole matter had sifted first through His loving fingers.
We were told that Timothy needed medication they didn't have at OHSU and that they would have to get them from Seattle. They continued to test to see what strain of malaria they were dealing with. The "experimental" malaria meds were flown down from the Seattle CDC (Center for Disease Control). With this medication now added, they stopped one of the 'tough' antibiotics he'd been receiving. The CT scan showed that Timothy had some brain swelling, and so the docs became more focused on addressing that issue. Then there was concern regarding retinal hemorrhaging due to the swelling of his brain. And so they introduced a medication that would reduce swelling. He received more blood transfusions, platelets and fluids. Through all this, Timothy continued to be totally unresponsive to even painful stimuli and his pupils were fixed. It seemed as though he would not make it at this point.
Through all this time, our family was still down at the reunion site in Lincoln City. And as the time came for them to return home, different members of our extended family made their way up the coast to the hospital before they were to fly out from the Portland airport. As Wes's mother and her husband, his sister and brother-in-law, his brother and children came in to see Timothy, it was a sad scene – sort of surreal, as his condition appeared so grave.
Later, each of our children came in to see their precious brother. It was tender and pitiful to watch and hear their grief and helplessness as they each one said their goodbye's. A few mustered up the courage to sing to Timothy and pray together. I looked into the eyes of each of our children and told them God's ways are good, and that whatever happened, everything was going to be well. Amelia had brought a few small flowers in her hand and as she tearfully turned to leave, she tenderly placed them Timothy's hand. This is not an attempt to be overly dramatic, but truly, they had to make the drive home not knowing the outcome of the day or if they'd ever see their brother again this side of heaven. It was heartrending.
Teams of doctors, medical students and interns continued to visit Timothy, monitoring his condition, checking his vitals, charts and monitors. They were searching for answers. They were doctors–they were students. They asked us what seemed like hundreds of questions. Having never had a case of malaria – let alone cerebral malaria – in that hospital, Timothy was somewhat of a celebrity around there. They would later tell us that his case would give them a great education as they were "growing" the malaria parasites in his blood for further testing and research.
It was an enormous blessing having a couple of friends surprise us there at the hospital – they had come down to be an encouragement to us – and they surely were. I don't think we realized at the time just how much we needed this encouragement and their "partnership" in this journey. They joined us in praying Saturday evening about some decisions we needed to make. They saw Timothy at that lowest point. And I would later be encouraged that God would remind me that they witnessed both sides of the miracle – it was a great comfort to me and to Wes to have them stand at Timothy's bedside and pray with us for Timothy.
Because of the pressure and potential damage the brain swelling was causing (in addition to the retinal hemorrhaging in his eyes), there was concern and a proposal that a tube needed to be inserted into Timothy's skull (an Intracranial Pressure monitor) to monitor his condition. This would have been such an invasive procedure and we felt apprehensive about giving the "go ahead" for it. So, we prayed with our friends and talked over with them what we ought to do. We all agreed that we should ask if we could wait and make the decision later – because we didn't have peace to go ahead with that procedure just then. The nurse and docs agreed. It was late. It was the evening of the second day of that coma.
woke the next morning for prayer and to prepare for the day and
I tell you seriously, I so fervently prayed for Timothy to be healed. I asked the LORD
once again for His Hand on Timothy's life. I was overwhelmed
at the peace of God that passed understanding as I prayed, saying to
the LORD: Lord, the docs don't even give Timothy 50/50. And then as
I prayed, I concluded: Well then, Lord, if they give
Timothy as 50/50 chance, then it's a
win/win. And with that, I got up from prayer and began to sing.
I don't know about tomorrow... but I know who holds the future and I
know (that I know) who holds my hand. I honestly didn't fear
and don't fear now – even though
this was a very, very serious thing. I've trusted in the Lord and
seriously have peace.
He indicated his throat was extremely sore, offering a word or two now and then. He was taking in ice and slowly exerting more and more control over his body, shifting his leg and lifting his arm.
Later in the afternoon he asked for what I thought was "frosting" and I wondered at this – thinking: he doesn't even really like frosting. But a bit later he again said frosting... frosty. Frosty? You want a Frosty, Timothy? He nodded, Yes. Our friends, Brian and Lisa, were still with us and Brian said, "He wants a Frosty? I'll go get it!" And he and Lisa were off! And, Yes! They did return after a little while with a Frosty and Timothy seemed delighted to take a few bites. He was too weak to take any more. [He now says that was the best Frosty he never remembered. He does not remember that day nor the next.]
Later, that day, the neurology team came by and ran him through a series of tests/requests; to which he complied and passed!! We laughed with joy as his nurse, Penny, told him that the goal for this day was to get him up and in a chair. And when asked by his nurse if he had any questions, he asked, 'when can I leave?' It seemed Timothy was doing so well - answering questions and complying with requests. But it was soon apparent that he was still so very weak and was not doing as well has he initially seemed. It was not discouraging though, because we knew the LORD had healed Timothy and the healing process would just take more time. That day's goal had to be revised a bit... with Penny telling Timothy, "tomorrow would be a good day to sit in the chair!"
The MICU doc came by and we talked with him about the great improvement Timothy had made and I told him how I had prayed that morning and was comforted that the less than 50/50 prognosis was truly a win/win. True to form, the ever-blunt doctor Khan simply answered me: "Well, he's not out of the woods yet."
Timothy continued to improve hour by hour to the amazement of the different teams of doctors, interns and caregivers. A few different friends come to see him — visits he regrets not remembering at all. We were and are continually thankful for all the outpouring of prayers, encouragement and support from friends, family and acquaintances all over the world.
The "Infectious Disease" team of docs continued to be very interested in his case as they would use it to set a precedent or protocol for future cases of malaria they might encounter. As Timothy received more blood transfusions and medications to fight the malaria and reduce the swelling in his brain, the docs had more time to research the type of malaria he had and its "life-cycle" in his body. Cerebral malaria (the Plasmodium Falciparum parasite) is, of the four strains, most deadly. Untreated, it's fatal. Knowing this, the docs were aggressively treating not only the blood parasite, but the cycle that would be repeated if the eggs were to hatch in Timothy's liver. The ultrasounds of his liver showed enlargement and the tests showed some liver damage — because malaria parasites feed on red blood cells, his liver was taxed trying to keep up with the disease. Thus, the many blood and platelet transfusions — and the explanation for his very jaundiced appearance.
Brian and Lisa brought Timothy another "Frosty" from Wendy's — another best Frosty Timothy says he regrets wasting since he does not remember it. But, again, Brian reassured him that it was not wasted. I now think those Frosty's were more for the benefit of all of us than for Timothy.
By Monday night, Timothy was moved from ICU to a general care room. This would be a good test for him and with the great blessing of a surprise visit from his dear friend (and fellow missionary) John, who had driven out from Montana to see him, Timothy made even greater strides.
On top of that, we made plans for our son, Samuel, to come by train into Portland to be of further encouragement to Timothy. What a great surprise when Wes went to get me a coffee and returned sometime later with Samuel!! Wes never did bring that coffee. ~wink~
The following and final day of Timothy's hospital stay was a day of "rehab" and tests and more questions by the different teams handling his case. Though he was still battling that disease, and would require a few more weeks of rest and recuperation, the doctors were satisfied with his progress and test results. Timothy was released from Oregon Health and Science University Hospital on Wednesday afternoon.
Timothy slept for most of the drive home but enthusiastically greeted his sisters and brothers who were joyfully waiting for his return. It truly was a blessed reunion that evening!
From that day to this, Timothy's recuperation has been remarkable. He is eager to face each day and return to the work of ministry for the Lord. We a filled with awe and thanksgiving for the great gift of life and health for our son, Timothy and for the precious gift of this marvelous miracle.
There are so many more things I would like to relate here, but time and space do not allow for the recounting of the marvelous miracles and loving mercies of the Lord on our behalf. We will never forget this miracle as long as we live and cannot thank the LORD enough for His compassion and gracious kindness to us all.
A prognosis of 50/50 is a win/win.
May the LORD God be magnified now and forever more.
Health care providers needing assistance with diagnosis or management of suspected cases of malaria should call the
CDC Malaria Hotline: 770-488-7788 (M-F, 9am-5pm, eastern time).
Emergency consultation after hours, call: 770-488-7100 and request to speak with a CDC Malaria Branch clinician. firstname.lastname@example.org
Below is a copy of the Letter
the Timothy sent to the Shield of Faith Mission
following his release from Oregon Health & Science University Hospital
SFMI—August 5, 2010
Well by God’s grace my brother Sam and I made it back safely from Ghana last week.
I would like to offer up a testimony of God’s greatness and healing power. Please let me take the time to recount the events of the last week. On my flight home, I was a little weak. Two days later, my family headed down to the Oregon coast, Lincoln City, for our annual family reunion.
That Sunday morning, the 25th, I was feeling quite ill with a very high fever, my symptoms were the same as last year when I came down with typhoid. I asked my father to take me to the doctor for the necessary meds. I was extremely sick with terrible nausea, vomiting and high and repeated fevers. He took me to urgent care in Salem on Wednesday. Increased nausea, fevers, and heavy sweats showed the meds were not working so, clearly, this was not typhoid! I battled the symptoms but by Friday morning I was so delirious my father took me to the ER at Samaritan Hospital in Lincoln City. I have no memory of the following events. I had a temp of 95, which then shot up to over 102°. My heart rate also shot up to over 130 beats a minute, several liters of IV fluids were administered. At 3pm I had become unresponsive and had to be intubated. The ICU doc tested my blood, positive for malaria. Because of the foggy weather, I was taken by ambulance to Spirit Mountain so I could then be “life flighted” to the Oregon Health & Science University Hospital complex and put in ICU. Several different teams of doctors and interns were involved in my care. Saturday morning I was diagnosed with cerebral malaria, the most deadly and rare of the four malaria strands. Because of the swelling in my brain, a very blunt Indian doctor told my parents, “For 65 year person, I give him 100% dead, for 22 year person, 50/50—and I don’t even think I give him that!” When my mother saw him the next day, she told him, “…well, then, that’s a win-win.”
All Saturday and into Sunday the nurses were pinching and poking me trying to bring me out of my coma, but I was totally unresponsive to any stimuli. An experimental malaria drug was flown down to OHSU from the Seattle CDC. It’s a drug not licensed for use in the US, (not much malaria in the States!)
Finally on Sunday afternoon, after many blood transfusions, platelets, more fluids, etc, meds, etc., I slowly came to. The ventilator and NG tube was removed. Later, when I tried to stand, I had to be supported because my whole body felt like lead! However, since then, by God’s miraculous hand, He has raised me back to full health! This was supposedly the first case of malaria the Hospital, an immense complex, has ever witnessed. Because of this, I was sort of a celebrity amongst the Doctors and Nurses who all had to acknowledge this great work of God!
We continue to hold up in prayer those unbelievers who saw this marvelous work of God, may He be merciful to them as He has been to us and reveal His Son in them.
I did not deserve God’s call into the fellowship of his Son. This last week I have been profoundly aware of the great privilege it is to partake of this resurrection life of Christ! Yet once again, Christ has saved my life and brought me from death to life. Praise the LORD with me for He is worthy!
Your brother in Christ, Timothy Spurling.