Dale's Health, COVID-19, and Ministry Implications
On Feb 11 Dale was admitted to St. Luke’s Hospital in Tokyo with a high fever, severe joint pain, and bacterial pneumonia in both lungs.…
He did not and does not have the COVID-19 coronavirus. On Feb 21 he was cleared of pneumonia and his temperature was back to normal so he was discharged. His joint pain, however, had not subsided. Ten days later test results were compiled and he was diagnosed with “polymyalgia rheumatica” (PMR)—a treatable disease that causes the immune system to attack healthy joint tissues, resulting in painful inflammatory arthritis.
We are thankful to have excellent medical care here in Tokyo at St. Luke’s. Dale’s PMR treatment began on Mar 4 with the positive results that pain is gradually decreasing and mobility haltingly returning. Those adverbs emphasize that he is on a slow but steady journey in the right direction. Although the pain is lessening, he still has about 10 hours of pain at the end of every 48 hr. cycle. His current pain level is a lot better than 24/7 pain!
His treatment is a gradually decreasing dosage of an every other day oral corticosteroid (prednisolone) until his joint and surrounding inflamed muscle pains subside. The idea is to phase out this med, but we don’t know how long that will take—perhaps 3-10 months. Too much or too little of it too soon might result in a relapse. In addition, he’s taking a weekly oral dosage of methotrexate that manages his symptoms and helps improve his immune system. He will probably be on this med for a long time—perhaps for life. And then he takes a number of oral meds that offset possible side-effects of these. During March his meds were adjusted weekly after blood tests, etc. But starting April the adjustments and visits to the doc are every 2 weeks.
It remains to be seen how Dale’s PMR will affect our longer term ministry in Japan and Asia. However, it seems that for this year we will be able to carry on with ministry at a reduced level, mostly in a virtual online mode.
Starting in late March Dale began to sense enough energy to resume some leadership at TMC—continuing to refine TMC’s ministry framework and leading online TMC leadership team meetings. This was shortly before Japan declared a state of emergency in order to slow the spread of the COVID-19 coronavirus. This emergency state is to last until May 6 but it could be for longer. Residents of cities like Tokyo are directed to stay home other than for necessary and emergency reasons. That’s what we are basically doing. Ann is ordering a lot of our groceries online. She has also cancelled her children’s and ladies’ ministries at Tokyo Multicultural Church as long as this state of emergency lasts. We began Zoom based online Sunday worship services on Apr 5, so Dale has been able to join. Otherwise he would be at home on Sundays, not only because of social distancing to lower the curve of the pandemic, but also because of his low immunity.
International travel is not advised for Dale until he stabilizes—and of course not until coronavirus restrictions are lifted. So we do not know when we can take our home assignment scheduled for this year in the US. But an optimistic guess is that we might be able to fly out of Tokyo by mid-July. Whenever it is that we leave for Maine, we will likely be there for 3-6 months in order to find a PMR specialist. We are hoping that might provide Dale with medical care on both sides of the Pacific. If so, we could continue leading our TMC church planting ministry in Tokyo and our Asia facilitator ministry for the EFC of Canada Mission that entail frequent travel between Japan and Canada/USA, as well as within Asia.
However, if it is not possible to receive that medical care in both the US and Japan by switching between doctors in Japan and the US several times a year, we would like to find a way to continue ministry in Asia while based in Maine rather than Tokyo. This could entail video interactions regularly throughout the year—something we are all doing during this pandemic. In addition, we could take several one or two month trips to Asia every year. But at the moment this is all guess work for us. Any decisions about this will need to be made in discussion with our mission agency and TMC leaders, while keeping our supporting constituency informed.
In addition, beyond the uncertain ministry implications of Dale’s health are the ramifications of the global economic downturn resulting from the coronavirus. The Lord has blessed us with healthy financial support levels since 2012. But this year we are expecting reduced financial support from churches in Canada and the US. We also presume decreased giving by TMC members and attenders here in Tokyo who cover facility rental costs and an increasing percentage of Pastor Moto’s salary. Then there is the significant weakening of the Canadian dollar against the Japanese yen. These “missionary economic” factors along with Dale’s PMR diagnosis make us think that our ministry over the next few years might require significant format changes.
Diagnosis
He did not and does not have the COVID-19 coronavirus. On Feb 21 he was cleared of pneumonia and his temperature was back to normal so he was discharged. His joint pain, however, had not subsided. Ten days later test results were compiled and he was diagnosed with “polymyalgia rheumatica” (PMR)—a treatable disease that causes the immune system to attack healthy joint tissues, resulting in painful inflammatory arthritis.
Treatment
We are thankful to have excellent medical care here in Tokyo at St. Luke’s. Dale’s PMR treatment began on Mar 4 with the positive results that pain is gradually decreasing and mobility haltingly returning. Those adverbs emphasize that he is on a slow but steady journey in the right direction. Although the pain is lessening, he still has about 10 hours of pain at the end of every 48 hr. cycle. His current pain level is a lot better than 24/7 pain!
His treatment is a gradually decreasing dosage of an every other day oral corticosteroid (prednisolone) until his joint and surrounding inflamed muscle pains subside. The idea is to phase out this med, but we don’t know how long that will take—perhaps 3-10 months. Too much or too little of it too soon might result in a relapse. In addition, he’s taking a weekly oral dosage of methotrexate that manages his symptoms and helps improve his immune system. He will probably be on this med for a long time—perhaps for life. And then he takes a number of oral meds that offset possible side-effects of these. During March his meds were adjusted weekly after blood tests, etc. But starting April the adjustments and visits to the doc are every 2 weeks.
Implications
It remains to be seen how Dale’s PMR will affect our longer term ministry in Japan and Asia. However, it seems that for this year we will be able to carry on with ministry at a reduced level, mostly in a virtual online mode.
Starting in late March Dale began to sense enough energy to resume some leadership at TMC—continuing to refine TMC’s ministry framework and leading online TMC leadership team meetings. This was shortly before Japan declared a state of emergency in order to slow the spread of the COVID-19 coronavirus. This emergency state is to last until May 6 but it could be for longer. Residents of cities like Tokyo are directed to stay home other than for necessary and emergency reasons. That’s what we are basically doing. Ann is ordering a lot of our groceries online. She has also cancelled her children’s and ladies’ ministries at Tokyo Multicultural Church as long as this state of emergency lasts. We began Zoom based online Sunday worship services on Apr 5, so Dale has been able to join. Otherwise he would be at home on Sundays, not only because of social distancing to lower the curve of the pandemic, but also because of his low immunity.
Dale’s immune system is compromised by the short term oral corticosteroids he is taking. And his long term medication will likely increase the chances of getting infections.
International travel is not advised for Dale until he stabilizes—and of course not until coronavirus restrictions are lifted. So we do not know when we can take our home assignment scheduled for this year in the US. But an optimistic guess is that we might be able to fly out of Tokyo by mid-July. Whenever it is that we leave for Maine, we will likely be there for 3-6 months in order to find a PMR specialist. We are hoping that might provide Dale with medical care on both sides of the Pacific. If so, we could continue leading our TMC church planting ministry in Tokyo and our Asia facilitator ministry for the EFC of Canada Mission that entail frequent travel between Japan and Canada/USA, as well as within Asia.
However, if it is not possible to receive that medical care in both the US and Japan by switching between doctors in Japan and the US several times a year, we would like to find a way to continue ministry in Asia while based in Maine rather than Tokyo. This could entail video interactions regularly throughout the year—something we are all doing during this pandemic. In addition, we could take several one or two month trips to Asia every year. But at the moment this is all guess work for us. Any decisions about this will need to be made in discussion with our mission agency and TMC leaders, while keeping our supporting constituency informed.
In addition, beyond the uncertain ministry implications of Dale’s health are the ramifications of the global economic downturn resulting from the coronavirus. The Lord has blessed us with healthy financial support levels since 2012. But this year we are expecting reduced financial support from churches in Canada and the US. We also presume decreased giving by TMC members and attenders here in Tokyo who cover facility rental costs and an increasing percentage of Pastor Moto’s salary. Then there is the significant weakening of the Canadian dollar against the Japanese yen. These “missionary economic” factors along with Dale’s PMR diagnosis make us think that our ministry over the next few years might require significant format changes.
So we are holding our missionary ministry plans lightly, resting in the peace generated by the assurance that our majestic triune God (Father, Son, and Spirit) knows, cares, and is in control. That biblical truth applies not just to us individually, but to our entire stressed out and anxious COVID-19 world. Physical death is the relentless human equalizer that can strike hearts with anxiety and fear. But to those who follow Christ is given hope of eternal life perfected for each of us after our deaths. The holy victim who was sent from heaven to his death on the cross and who by his resurrection was shown to be victorious over sin and death can give peace to all his followers. He is risen!We are expecting 2020 to be a year of transition toward a ‘new normal’ for our life and ministry—but we don’t yet know what that might be.