"As you do not know the path of the wind or how the body is formed in the mother's womb, so you cannot understand the work of God, the Maker of all things." Ecclesiastes 11:5 

We can sing praises to our Maker, even in the uncertainties of life, even when the storms seem to rough to see the shore on the other side and even when we don't get the answers we want. He is faithful. He is good. He is sovereign. He does care about the details of our lives. He hates the brokenness of this world and the consequence thereof. He hurts when we hurt. His love and grace sustains. Even in the storms, His graces are there.

In early October 4th, Gwen had another cystoscopy in Iowa City. Dr. Gelhaus allowed me to see the screen as he performed the procedure. He explained every part of the procedure, as it occurred. He showed how the dye pushed into the kidney and showed that there was no obstructions in or near the ureter and that the bladder showed no signs of new tumor growth. 

After the cysto, she was able to start her first round of chemo. The type of chemo she is receiving is put directly into both her kidney and bladder. She receives two different types, back to back, so each treatments lasts about 3 hours. Although her first treatment was super uncomfortable, the next one didn't seem to bother her much at all. 

Fast forward to October 28th. Gwen ended up getting ill and being brought home from church early. She noticed that her breathing felt more labored than normal. She noticed that she was extra tired, nauseated and had a headache that wouldn't subside. She decided to visit with her primary care physician, here in Des Moines, on Tuesday because she was still struggling to breathe. A chest x-ray showed fluid in both of her lungs. 

Wednesday morning, we made the decision to take her to the ER in Iowa City to keep all her care coordinated in the same medical facility. We arrived around 11:30am. She had her vitals and bloodwork taken at 12pm. We were then ushered back to the waiting room until a room opened up. It wasn't until 9pm that she was brought back to a room. After noticing that her PR BNP levels were high, they were confident that she was in congestive heart failure. They ordered a CT with contrast and a EKG. Surprisingly, it showed that her heart is actually fine. Her lungs showed fluid and several nodules but not many definitive answers. 

She was admitted around 2:30am. Her blood pressure continue to fluctuate throughout the following day. It became difficult for her to stand without almost passing out. They discovered that her blood pressure was dropping about 40 points every time she tried to get up... the reason for her consistent light headedness. A change in heart medication seems to have leveled her BP significantly. 

Later on Thursday, they performed an ECHO and attempted a thoracentesis (draining fluid from the lung), but her blood pressure crashed into the 80's and she passed out. While they couldn't proceed with the thoracentesis, the ECHO showed that her heart is pumping well and that she is not in congestive heart failure. We are currently unsure why fluid continues to build in her lungs. 

Friday they decided to attempt another thoracentesis except this time they would use the guidance of a CT and allow her to lie flat. Success!! They were able to drain 150cc's of fluid from her right lung. They did not attempt her left. Dr. Save (the hospitalist overseeing Gwen) also ordered a PET scan. Because the scan could not be performed until Monday afternoon, she needed to stay admitted throughout the weekend. Throughout the weekend, she experienced a little more difficulty in breathing, a consistent headache and occasional back pains.

Today, we are praying for more detailed answers as to why fluid continues to build in Gwens lungs. Please pray we are matched with doctors that are right for the care she needs and that we are able to discuss next steps for her urology chemo. Please pray that we ask the right questions, that we are patient in our expectations and that we are able to process all that doctors discuss with us. 

Thank you all for your continued support! Thank you to Erin Fish and Meg Jaques for the meals brought to my family this past week. Thank you to those who have called and messaged Gwen, those encourage her greatly. Thank you to those who continue to reach out and ask for updates and how you can specifically pray. Thank you for walking this journey with our family! 

One of my favorite seasons of the year is winter... I know, I'm strange. Snow is one of my favorite parts of winter. Not because it makes roads messy and more difficult to drive through, not because I have the inconveniences of layering my kids to keep them warm, not because our heating bill skyrockets. I love snow because every time it falls from the sky I am reminded of Gods grace and how He cares about the details of our lives. Each and every snowflake is unique, not one the same. While millions of snowflakes falling in a snow storm seems overwhelming, a single snowflake is breathtaking. 

He cares about the details of our lives and we trust Him... especially in the storm! I am praying we don't miss the graces sprinkled throughout this specific storm.