“Jehovah Jireh”

All day, I had felt as though someone had taken me aside and beaten me to a pulp. Someone named Influenza, perhaps? Everything ached–my knees, my arms, my neck, my shoulders, my head, my hip joints… I’m pretty sure the only muscle that wasn’t crying out in some sort of distress was my tongue. That, I used to form copious complaints about the various ways in which a professional massage would enhance my life.

Underlying all of this was the impression that something simply wasn’t right. I had gotten only four hours of sleep, so it wasn’t surprising that I should be a bit tired–but not this tired, not this exhausted, not this sluggish and weak and generally fatigued and foggy-brained. The malaise was so irreconcilable with any inclination toward activity that I readily stayed home from church this morning, resolving to have Naomi bring home a CD of the sermon. Something was amiss, and I was pretty sure I knew what it was. The last time I had felt this way, my INR had been significantly elevated. I have Protein C deficiency, a coagulation disorder that can cause severe clotting and bleeding if not controlled by limited Vitamin K intake, Coumadin, and Protein C infusions. That’s what you need to know in layman’s terms–much, much more important is what God did this evening.

The INR is one way of measuring coagulation factors in the blood. Therapeutic range for a person without a coagulation disorder is between 0.8 and 1.2. My therapeutic range has varied over the years and depending on treatment plans, but at the moment, I’m supposed to maintain that INR between 1.5 and 2.0. Mine is an extremely rare form of Protein C deficiency, and those levels can and do change more rapidly than in the average Coumadin patient. Also, more factors tend to affect my INR–stress, the onset of a cold or flu, a slight variation in Coumadin dosage, and especially my Vitamin K intake. The same broccoli that most people, even Coumadin patients, are encouraged to take for consistency of diet, may plunge my INR from 2.0 to 1.7 in a matter of three hours.

Never mind all that–my INR was likely high. I did need to be sure, though, so I mustered every bit of emotional and physical stamina to beg an INR test from Jedediah. The home monitoring machine is a bit visual to use, and no one seems to have found a way to equip the CoaguCheck device with either a Braille display or voice-guidance components. I could imagine that Jedediah wouldn’t really want to do the test, not on a lazy Sunday afternoon with the football game on. I understood the need for relaxation–even if I never will be able to understand the “necessity” of football–but I also understood that an INR test was in order, and that somewhat urgently.

While we prepared for the procedure, I speculated as to what my dinner options might be. My INR was elevated–I had already accepted that premise. Probably 2.6 when it should have hovered no higher than 2.0. With that assumption firmly in place, I determined that spinach-filled pasta shells were in order for dinner, and that they coupled with the spinach-topped pizza I had enjoyed for lunch would probably work to lower that INR right on back to 1.9. Perfect solution!

Then, my INR result appeared on the screen–1.6. Not too high at all, but just on the border of too low. And, considering that slice of spinach pizza, a number that might drop within the next few hours.

Immediately, I swung into action. A little more Coumadin, taken a bit earlier than usual. And, because I could, a dose of Xantax–a prescription that I received for indigestion, but which is contraindicated with Coumadin and which I usually have to avoid if I don’t want my INR to soar. Now, let it climb a bit!

Once the practical concerns were taken care of, I had a chance to contemplate what had really happened. Corrie ten Boom wrote that there are no “what if’s” in God’s kingdom, but that we are to trust His provision. I do trust His protection and guidance, but just this once, I think I’ll make an exception to Corrie’s advice about “what if’s”.

If Jedediah had not done the INR test…

Then, I very likely would have feasted sumptuously on spinach, pesto, broccoli, or eggplant. Those were the selections that seemed most appealing at the time–and, besides, wouldn’t they help to lower an INR that was “quite obviously too high”, sight and numbers and statistics all unseen?

If I had enjoyed such a vegetable-rich dinner rather than resorting to minute rice–the least nutritious, but safest possible food, Vitamin-K-wise, might my INR have plummeted?

And if 1.6 had turned to 1.4 or 1.3… The possibility does not merit elaboration, but I’m sure my medical readers and even those who know little about Protein C can fill in some of the blanks.

Now, I realize that God doesn’t always work this way–that sometimes, be it for our refinement or for purposes of His which we cannot, in our finite minds, begin to fathom, He allows us to go through deep and difficult suffering. Naomi, Hannah, and I are all well-acquainted with medical difficulties and the bittersweet emotions they can bring–everything from fear and anguish at our physical circumstances to joy, peace, and trust in the care of our heavenly Father. But right now, in this moment, I have only one thing to say:

Isn’t God good!? Isn’t He faithful and merciful and compassionate? And doesn’t He protect us from things that we can’t even begin to anticipate? Hallelujah!

Addendum: Title taken from the song “Jehovah Jireh” on the album GIVE THANKS by Don Moen.


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