You have multiple blood clots in both lungs

“You have multiple blood clots in both lungs.”

I think the rest of my life just changed….If I have a “rest of my life.”

It began last Tuesday evening. I was reading and relaxing on a chair at home. I felt a sudden tightness in my neck area; a building pressure that then began to spread down my chest and arms. It was not very painful and I was not breathless, but I realized something very odd was happening. I felt hot and a bit disoriented.

Thankfully my wife, Shona, was at home; her Ladies Bible Study had been cancelled due to Tornado alarms going off in our area. Although the symptoms only lasted about 10 minutes, Shona (a Family Physician in her Scottish days) felt it was unusual enough to merit further investigation. When we arrived at the local ER, I felt perfectly normal again. I then spent 10 minutes trying to persuade her that we should just go home rather than waste our time and money (I knew that I wouldn’t get out of ER without a $500 plus bill!).

Thankfully Shona prevailed and we went in, with my last words to her being, “I’m doing this for you, not me!” (Poor woman!). Although all the heart tests were normal, and the doctor felt 95% certain that all was fine, he said that it was best to get blood enzymes checked at the local hospital just to be 99% certain that there had been no heart attack. Again I dithered, but Shona decided, “Yes, we’re going.”

“Just a muscle strain”
At the hospital, the initial tests all seemed clear. In the course of the second examination, I happened to mention to the doctor, just as he was leaving my bedside, that I had had a pain in my calf since Sunday morning. But I quickly explained it away as “probably a muscle strain from practicing Tae Kwon Do without a warm-up.”

He paused, turned back towards me, and narrowed his eyes: “Have you traveled recently?”

I said that I had driven to Canada on Friday, preached a few times in Trinity Baptist Church near Toronto, and arrived back in Grand Rapids on Monday morning. The calf pain was with me when I woke on Sunday morning and throughout the day. Admittedly, I could hardly walk on my right leg when I arrived in Grand Rapids on Monday after driving non-stop from Ontario, but I had just assumed I’d torn a muscle.

The doctor said that he would screen my blood for clotting, just to rule out a deep vein thrombosis (DVT) in my leg. An hour later (just after midnight) the test came back with a very high positive. For the first time alarm bells began to ring in my mind. Thankfully, Joel Beeke and his wife Mary were with me at that point, Shona having returned home to check on the kids. Joel read briefly from Hebrews 4v14-16, and sent me off for a CAT scan leaning on the wonderful sympathy of our Great High Priest.

Life-changing (ending?) words
Thirty minutes later, I heard the life-changing (life-ending?) words. “I’m afraid you have multiple blood clots in both lungs (pulmonary embolii), probably having spun off from a clot (DVT) in your right calf.”

I had been walking around here and there over the past few hours. But now I was told to stay on the stretcher and be as still as possible lest more clots break off from my leg and block my lungs. I was given a large bolus of Heparin and an IV drip of the same, to stabilize the clots and start thinning my blood.

The next 36 hours were deeply solemnizing. All the blood clot anecdotes I’d heard over the years decided to flood my mind. My wife’s reaction to the news on the phone was confirmed by the doctor’s parting words, “You have a life-threatening condition.” Pulmonary embolism is the second most common cause of sudden death, and those who succumb usually do so in the first few hours after the event.

After committing my soul to Christ and taking a few soul-pacifying minutes to meditate on the sufficiency of His crucifixion, I typed out a quick note to my wife and children on my phone, just in case I didn’t make it.

And by God’s almighty grace, that’s where most of my anxieties were focused – my family. I did not want to die, but I was not afraid to die. Christ alone was more than enough. I experienced steady peace regarding my own salvation, and a sure hope of heaven, all and only through the death and resurrection of Christ. But, I confess, I felt tremendous anxiety about my own family and the sorrow that would transform their lives. (Having just buried my girls’ pregnant cat 24 hours earlier after an auto accident, their anguished weeping faces were still very fresh in my mind!).

Spiritual schizophrenia
This spiritual schizophrenia has often plagued me. How can I have such assured faith in Christ’s salvation, and yet doubt His providence? How can I rest my soul entirely upon Him, yet think I need to carry my family myself? At times, albeit briefly, I was able to leave my family in the Lord’s hands, but mostly I felt deep concern for them, and also personal sorrow at the prospect of not seeing them come to know the Lord, marry in the Lord, and serve the Lord. And how would my darling Shona ever get over this. Submitting to the Lord’s salvation was relatively easy; submitting to the Lord’s providence was an intense spiritual battle.

The next 24 hours were a sleepless blur of tests, tests, and more tests. Results fluctuated throughout the day, raising hopes, then disappointing and worrying me. My Pastor, Foppe Vanderzwaag, skilfully ministered Psalm 46 to me and my gathered family. The doctors and nurses were superb. The senior Pakistani doctor was the best communicator and sympathizer I’ve ever met. (He laughed when I suggested he could teach pastors a thing or two about bedside manner.) He saw my Bible and said that he was sure it was giving me strong peace at such times. We spoke a little and we parted with him asking me to pray for his upcoming Fellowship exams.

The drugs gradually began to thin my blood and after a second night in hospital I was allowed to return home. I’m receiving two shots of Lovenox every day as well as daily Warfarin (Coumadin) tablets. My blood is tested daily to check if my clotting levels are reaching the right levels. At the moment it is still too thick, but once the right level is reached, the shots will stop. I will probably be on Warfarin for the rest of my days as initial tests indicate a genetic clotting abnormality. 

In the light of this, I have to cancel all unnecessary traveling for the rest of the year. I also have to seriously re-consider future international commitments. As I have to avoid unnecessary stress for a while to keep my blood pressure/heart rate down, I will be canceling speaking and preaching engagements for the month of May, and trying to focus my preaching in Grand Rapids thereafter. I’ll begin to work from home next week, and hopefully return to work at the Seminary the week after; all “if the Lord wills.”

The big lesson
There are lots of lessons for me in this and, if I’m given more strength, I hope to share some of them in the coming days. But let me just leave the biggest one with you. It’s this: the immeasurable goodness and amazing kindness of God to an undeserving sinner. Whatever emotions and thoughts I had these past few days, not once could I/dare I/did I say, “Why me?” I know very well, that every day of life is a mercy, that almost 20 years of marriage and ministry is a mercy, that having four children even for a short time are four great mercies, that to be saved by grace and know Christ is mega-mercy. God has never dealt with me according as I have sinned. If he had ended my earthly life this week, He still would not have dealt with me as I have sinned. His goodness and His mercy have followed me all my days.

And even in the course of these days, there were so many divine mercies:

  • He spared me from instant death when the leg clot spun off and spattered over my lungs.
  • He sent a Tornado alarm to keep my wife at home that evening.
  • He gave me sufficient symptoms for a sufficient time to sufficiently alarm me.
  • He sent a persistent wife to push a stubborn husband into ER.
  • He prompted me to mention to the doctor, as an aside, my leg pain.
  • He gave me a doctor who picked up that cue and ran with it.
  • He provided not just the technology to diagnose the problem, but the medications to treat it.
  • He used this brush with death to uncover the genetic pre-disposition to clotting and take preventative action for the future.

I’m not out of the woods yet, and still feeling very fragile, but in the light of all this, how can I, why do I, doubt for a moment God’s providential kindness and goodness!

Good to be afflicted?
In the few minutes of privacy that I had in the maelstrom of Tuesday night, I picked up a book my wife had left with me. It was Milk & Honey, the RHB daily devotional. As I wasn’t sure of the date, I turned to April 27 & 28 to find Pastor Jerrold Lewis’s meditations on:

Psalm 118:5 I called upon the Lord in distress: the Lord answered me, and set me in a large place.

Psalm 119:71 It is good for me that I have been afflicted; that I might learn thy statutes.

What more can I say, but “Amen.”

CrossReference: Give Me Your Son.

Here’s the fifth in our preview series of ten films on the Old Testament appearances of Christ in the Old Testament.

The first two videos will be permanently available online. (Episode 1, Episode 2). The remaining episodes will be released once a week for the next seven  weeks. Each of them will be available for online viewing for seven days.

DVD, HD download and Study Guide available now from HeadHeartHand Media.

29 ways to stay creative

Here are 29 ways to stay creative.

What works best for me:

1. Make lists
2. Carry a notebook everywhere
4. Get away from the computer
16. Allow yourself to make mistakes
19. Get lots of rest
27. Clean your workspace

I’d add a #30: Pray to the Creator for creativity.

What would you add?

My “I’m-never-going-to-get-to-it” list

“I tell you what, how about I take you out for a MacDonald’s milkshake this week!”

“Oh, yes, Daddy. When?”

“This week sometime.”

“But when this week?”

“OK, how about Thursday?”

“But when on Thursday?”

“Eh, 4pm?”

“Great! Thanks Daddy.”

We’ve all had similar conversations, haven’t we. Kids sure know how to schedule their “to-do’s.”

When Peter Bregman’s wife told him a similar story, it transformed the way he managed his to-do list. Every evening, he would go through the same Q&A with his wife:

“O, Hi honey! How did your day go?”

“Well, I got a lot done, I suppose, but not as much as I would have liked.” [Sound familiar?]

One day she gently suggested that maybe, just maybe, he was being unrealistic in his expectations.

She was right, of course. His to-do list had become so long that it had become more like an I’m-never-going-to-get-to-it list.

The solution?

A child’s question: “When tomorrow?”

In it, Bregman found a formula for turning an intention into an action. He calls it “the power of when and where.” He says: “Decide when and where you will do something, and the likelihood that you’ll follow through increases dramatically.” He expounds further:

So, once you’ve got your list of things to do, take your calendar, and decide when and where you are going to do your to-do’s. Schedule each to-do into a time slot, placing the hardest and most important items at the beginning of the day. And by the beginning of the day I mean, if possible, before even checking your email. That will make it most likely that you’ll accomplish what you need to and feel good at the end of the day.

Since your entire to-do list will not fit into your calendar — and I can assure you that it won’t — you need to prioritize your list for that day. What is it that really needs to get done today? What important items have you been ignoring? Where can you slot those things into your schedule? Then, once you schedule an item, cross it off your list.

“When tomorrow” turns “I’m-never-going-to-get-to-it” lists into “to-done” lists.

(I’m hoping).


Can we redeem self-esteem?

Deeply rooted self-doubt and self-criticism will often emerge and strengthen during a depression. Depressed people often feel useless and worthless. They have low self-esteem. What should we do to address this?

Some Christians are reluctant to give people any praise or encouragement because of the risk of making a person proud. However, it is safe to say that pride is one of the least risky vices for someone who is depressed. Pride results from having an overinflated view of oneself. Depression usually results in the opposite.

Other Christians misconstrue the doctrine of original sin and total depravity to mean that there is no kind of good in anyone and fail to say anything positive to the depressed person. However, without minimizing the wickedness of the human heart and without denying our inability to do anything pleasing to God apart from faith in Christ, we should feel free to encourage depressed people to have a more realistic view of themselves by highlighting their God-given gifts, their contributions to the lives of others, their usefulness in society, and, if they are Christians, their value to the church.

For example, a depressed young mother may feel like a total failure in every area of her life because she doesn’t have a perfect home or perfect children. We can help such a person see that she achieves a lot in a day, even though she might not manage to do everything she would like. We might remind her of all the meals she makes, clothes she washes and irons, and the shopping she manages, helping her see herself and her life in a more accurate and realistic light. Arie Elshout comments:

It is wrong to pat ourselves on the back when something has been accomplished as a result of our initiative. It is equally wrong, however, to focus on what we have not accomplished. In 1 Corinthians 15:10 we have a clear example of humility accompanied with a healthy opinion of one’s accomplishments: “But by the grace of God I am what I am: and his grace which was bestowed upon me was not in vain; but I labored more abundantly than they all: yet not I, but the grace of God which was with me.”

Paul knew very well that he daily offended in many things (James 3:2; cf. Rom. 7; Phil. 3:12), and yet he did not go so far as to cast out all his accomplishments. I do not believe that this is God’s will. In contrast to sinful forms of self-confidence and self-respect, there are also those that are good, necessary, and useful.

Without a healthy sense of these, human beings cannot function well. We may pray for an appropriate sense of self-confidence and self-respect, clothed in true humility, and we must oppose everything that impedes a healthy development of these things (be it in ourselves or others) with the Word of God (Overcoming Spiritual Depression, 32–33).

Edited extract from Christians get depressed too. Available at RHB and Ligonier. Kindle version here.