Here's a typical day in caring for Joshua. I thought you might be interested:

6 a.m. - Respiratory treatment - Albuterol
6 a.m. IV antibiotic - Primaxim
8 a.m. IV seizure med - Kepra
8:15 a.m. IV seizure med - Phenobarbital
9 a.m. - IV antibiotic - Vancomycin
10 a.m. - Respiratory treatment - Albuterol
12 p.m. - IV antibiotic - Primaxim
2 p.m. - Respiratory treatment - Albuterol
4 p.m. - IV seizure med - kepra
4:15 p.m. - IV seizure med - Phenobarbitol
6 p.m. - IV antibiotic - Primaxim
6 p.m. - Respiratory treatment - Albuterol
9 p.m. - IV antibiotic - Vancomycin
10 p.m. - Respiratory treatment - Albuterol
10:30 p.m. - IV nutrition - TPM
12 a.m. - IV seizure med - kepra
12:15 a.m. - IV seizure med - Phenobarbitol

-Added to this will be giving several bolus feedings through Joshua's PEG tube throughout the day.
Other medications we give him are Trileptal (seizure med), L-Carnitine, COQ10, and an iron tablet.
-We also turn him every two to three hours, provide mouth care, bed baths, empty his foly catheter & Ileostomy bag, and suctioning him at least once every hour or two due to his pneumonia.
-Joshua's Dr. says we basically run an ICU right out of his room! It's a lot of work, but we have no issue caring for him. He is worth every minute of it!

Just another bit of news about our family pets. Timber, the big white dog in one of the pictures on our blog, who is timber wolf, arctic wolf, and malamute collapsed on the lawn after coming out of his dog run three days ago. His stomach was bloated and he appeared to have a bowel obstruction. I had to carry him in the house (120 lbs) where he laid for three days. We really thought we were going to lose him, but he seems to be feeling better now after Aaron, Caleb and I had a prayer for him and he is actually moving around and walking better. So, needless to say, we were running an ICU in Josh's room as usual and then we ran a veterinarian E.R. at the other end of the house for three days.

Dear family,

This week was awesome! We had a baptism on thursday and
one tonight! I baptized the girl on thursday. We also
got to go to the Orlando temple last night! All 3 of
our recent converts went and had a really good experience.
 Charlene was baptized for her grandpa. We aren't allowed
 to participate in the baptisms as missionaries but i got
 to witness and do confirmations. Ill have to send some
 pictures of the temple.
Sounds like its been a rough week for josh. I pray for all
 of you constantly, especially him. Its amazing how many
 more blessings when you pray a lot more. I decided to pick
 a scripture every transfer when i first got here for a theme
 and write it on our big white board in our apartment. Last
 transfer it was 3 Nephi 5:13. This transfer it is D&C 24:12.
I got your letter rachel. Thanks for writing. You told me
 about your boyfriend and then broke up with him? ... Got a
 new one in mind? jk Hope everything is going well with you.
 Thanks for the 20 bucks! I forgot about that. It came just
 in time cause im out of money for food and needed to do
 laundry and had only 20 dollar bills.
Ah! the library closes in 9 min! Oh ya Ive been feeling sick
the past couple days and then this morning i felt terrible.
 A sore throat and head and body aches. I feel a little better
 now. Some girls brought over a bunch of leftover lasagna from
 Olive Garden. It was from a big branch service project. They
 saw i was sick and brought me some medicine. It was really
 nice of them.
Anyways, the work has picked up a ton here. Our zone had 16
 baptisms this week which has never happened before. Our goal
 for the transfer is 88! It seems impossible but i know with
 enough faith and hard work we can do it. Have a great spring
 break everyone!

Gotta go fill up the font!

Love,
Elder Carty

Dear family,

This week was awesome! We had a baptism on thursday and
 one tonight! I baptized the girl on thursday. We also
 got to go to the Orlando temple last night! All 3 of
 our recent converts went and had a really good experience. Charlene was baptized for her grandpa. We arent allowed to participate in the baptisms as missionaries but i got to witness and do confirmations. Ill have to send some pictures of the temple.
Sounds like its been a rough week for josh. I pray for all of you constantly, especially him. Its amazing how many more blessings when you pray a lot more. I decided to pick a scripture every transfer when i first got here for a theme and write it on our big white board in our apartment. Last transfer it was 3 Nephi 5:13. This transfer it is D&C 24:12.
I got your letter rachel. Thanks for writing. You told me about your boyfriend and then broke up with him? ... Got a new one in mind? jk Hope everything is going well with you. Thanks for the 20 bucks! I forgot about that. It came just in time cause im out of money for food and needed to do laundry and had only 20 dollar bills.
Ah! the library closes in 9 min! Oh ya Ive been feeling sick the past couple days and then this morning i felt terrible. A sore throat and head and body aches. I feel a little better now. Some girls brought over a bunch of leftover lasagna from Olive Garden. It was from a big branch service project. They saw i was sick and brought me some medecine. It was really nice of them.
Anyways, the work has picked up a ton here. Our zone had 16 baptisms this week which has never happened before. Our goal for the transfer is 88! It seems impossible but i know with enough faith and hard work we can do it. Have a great spring break everyone!
Pay $290 on tithing i guess if i havent paid any yet. Then $500 on my flight loan. let me know how much is in my account first.
Gotta go fill up the font!

Love,
Elder Carty

Update: Joshua has not been eating or drinking at all during the past few weeks and his weight has continued to drop. We have also been giving all of his meds via IV which has been okay, but it would be easier to give them orally. Anyway, we decided to go ahead and have a PEG tube placed in his abdomen which is a small tube coming out of his stomach just on the left side of his belly button. It will enable us to give all of his meds through this tube as well as more nutrition. We did all of this today at Community Medical Center in Missoula. They also replaced his picc line and put it in his right arm this time. Everything went well for the procedure, but it was a long day. It was an interesting experience on the way to Missoula in that I had to give him all his IV meds in the ambulance. What a bumpy ride! We returned home at about 8'oclock this evening.

Joshua has had a tough week this week. His RBC count has been slowly declining during the last few weeks, so we took him to our hospital (Mineral Community Hospital) in Superior where I work and gave him two units of blood and some albumin to boost his protein a bit. We did that on Thurs. and didn't get him back home until 1:30 a.m. on Fri. Josh does much better at home in his own air mattress bed. Since he has not been taking his meds orally very well, we have had to switch all his meds over to admininstering them via IV. Normally they don't let families do that, but our Dr. seems to have confidence that Cindy and I are capable of doing it. He tells us that we run an ICU right out of Josh's bedroom which I guess we do when we think of all the meds, breathing treatments, oxygen, suctioning, and everything else we have to do for him generally on an hourly basis.
Cindy had a spiritual experience early Fri. morning that testified of how the Lord has been watching out and supporting Joshua and his caregivers. We had just gotten him settled in after returning back from the hospital at 2 a.m. on Friday when about 3 hours later while Cindy was trying to flush his pic line, everything just seemed to be blocked off and it wouldn't flush. Basically, if his line had of stayed that way, there would have been no method of administering his seizure meds which would have meant an immediate trip to Missoula to place a new pic line. It was the last thing we wanted to do especially since we were all so tired from having just returned from the hospital with him. So, Cindy said a prayer and prayed that his line would open and that she would be able to give his meds again. After her prayer, she flushed his line with some heparin again and it opened right up. Generally when an IV line is blocked like that, the IV is lost and a new one has to be placed. For some reason, Joshua is supposed to tarry here on this earth at this time. He life could have easily been taken on many occasions. Well, I have definitely learned a lot about life from this experience and we have certainly developed a stronger testimony of the plan of salvation and that this life is just a short time compared to the eternities. Being able to serve in the capacity of his caregivers has been an honor and privilege for us! I believe his calling and election has certainly been made sure!

Letter from Elder Carty:


yo yo yo!

Everything is going great here! I only have time for a short
letter today. A member is taking us to a barbeque by a lake
soon. My new companion is Elder Probert. He's been out almost
a year and is awesome! We have already had a lot of fun. He
loves campus so far. I took him to the suare yesterday and
we did a lot of contacting. I met a guy from India named
Vishnu and committed him to baptism on the 29th! He believed
every word I said. We are teaching him tonight. He said he
decided to give up smoking that day before i met him. The
Lord has defenitely been preparing him. Theres students here
from all over the world so im learning a lot about different
religions. They are all very similar and i believe are all
just different and twisted versions of Christs gospel. We also
met a girl from China yesterday apartment tracting who agreed
to baptism on the 29th too. Im not sure how solid she is yet
because she doesnt understand english too well. I wish i had
taken Chinese! We also have a very solid investigator who is
getting baptized on the 28th! His name is John and he gave up
drinking and smoking and has completely changed his life. He
loves the Book of Mormon and reads and prays everyday. We have
another one on April 4th! He has gone to the same Trinity church
his whole life but he believes the Book of Mormon is true. Hes
just afraid to leave his church. Hopefully with enough faith and
the Spirit all these people will be baptized. The work has
picked up a lot here. President Newman called Elder Jolley
and I to personally thank us for the work we have done. He
was going to close the area because there havent been many
baptisms here but because of us he is keeping it open.
I love the work here and my shyness has almost completely
gone. The Lord has been helping me a lot to just walk up to
everyone and boldly proclaim His gospel. Its amazing when
all i have to do is open my mouth and the Spirit takes over.
Elder Probert is an extremely good missionary and very
spiritual. He went to BYU for a semester and loves football.
Elder Jolley was made zone leader over Jacksonville west
zone. Last night was a branch party and there were a bunch
of investigators there. Elder Probert is pretty good at ping
pong but i still beat him. I could never beat Elder Jolley
at foosball though when he was here. They started playing
music and dancing around so we left for home.
Yesterday we got 9 new investigators, taught 34 lessons, asked
11 people to be baptized, and set 2 baptism dates. Im not
sure how many total investigators we have.
I looked at the blog. It looks really cool. I havent seen a
lot of those pictures. The new puppy looks awesome! I wont
even get to see her till shes huge! Sounds like your sleepover
was a blast Aaron! What did you guys do? How do you like the
new puppy? I want a letter from you and Caleb! I really miss
you guys and im glad you're having lots of fun.
Prom eh rachel? Send pictures! I still havent heard about this
new boyfriend...
I got that package a while back by the way. Thanks! The
students have actually been taking us out to dinner a lot so
i havent used much of the money yet. I havent gotten your
letter, unless it came today...
well i better go, talk to you soon!

Love,

Elder Carty

Joshua has been struggling again this week trying to get over pneumonia. It has been nearly impossible to get him to swallow his medications, so Cindy and I were instructed today by a home health nurse how to administer his seizure meds via IV. It's actually much easier than giving them orally since it takes almost an hour to get them in him sometimes.
We have been considering putting a peg tube into his stomach which would enable us to give him his medications that way plus we would have another method of providing him with better nutrition. He is very congested still and has completed his antibiotics, so we are possibly looking at another antibiotic for him.

Hey!
Sounds like things are going great there! A new puppy?!!!
Thats awesome! Whats her name? When did you decide to do
that? Send pictures! I want to send pictures but i dont
have them developed yet. I saw a small alligator yesterday

biking by a small lake on campus. Gainesville is basically
a swamp. I have been meaning to call Beverly but i keep
forgetting. Ill try to call her tonight.
Elder Jolleys friend from Kingsland, GA who was baptized
in August is hanging out with us today. Hes a pretty cool
guy and he took us out to lunch. Im at Charlenes with them
now to use her computer.
Someone else is taking us out to dinner tonight too. I
think the students feed us more than other family wards
do. We have to have a nonmember there to eat with them so
the students invite their friends.
Charlene told me the message about you going skiing today!
Ah! But its ok cause the Lords work is the best anyway! Its
spring break this week so campus is almost dead and all of
our investigators are out of town so we've done a lot of
finding people this week. We actually met a lot of cool
people. Our focus is only young, single adults so when we
go tracting and find families we give them to the other
missionaries in the area. We met a really cool family from
Brazil last night! The mom is in Brazil for the next week
but they all felt the Spirit a lot as we taught them the
first lesson. The dad said he could feel the different
energy as we entered the room. His two sons are Gabriel,
14, and Naue (Na-whey), 8. Gabriel was really excited about
it and really wants to get baptized! The dad said he would
after he reads and prays. And we dont even get to keep
teaching them cause its a family so we handed them of to
our zone leaders. I really wish we could cause Gabriel is
really cool and plays soccer. He was excited when i told
him i played in Brazil. He lived really close to where i
went. But its ok cause i know they will get baptized in
less than a month. We found out we technically werent
supposed to be there cause it was university family housing.
A guy said we probably shouldnt be here and we almost left
but then really felt like we should keep going and 2 doors
down we found them! Then we got kicked out by the apartments
manager about 20 doors later. Its awesome how the Lord
provides a way for those who are prepared. We found some
other really cool people this week so them plus our
investigators coming home from spring break will keep us
really busy next week.

Love, Elder Carty

Hey!
Sounds like things are going great there! A new puppy?!!!
Thats awesome! Whats her name? When did you decide to do
that? Send pictures! I want to send pictures but i dont
have them developed yet. I saw a small alligator yesterday
biking by a small lake on campus. Gainesville is basically a swamp. I have been meaning to call Beverly but i keep forgetting. Ill try to call her tonight.
Elder Jolleys friend from Kingsland, GA who was baptized in August is hanging out with us today. Hes a pretty cool guy and he took us out to lunch. Im at Charlenes with them now to use her computer.
Someone else is taking us out to dinner tonight too. I think the students feed us more than other family wards do. We have to have a nonmember there to eat with them so the students invite their friends.
Charlene told me the message about you going skiing today! Ah! But its ok cause the Lords work is the best anyway! Its spring break this week so campus is almost dead and all of our investigators are out of town so we've done a lot of finding people this week. We actually met a lot of cool people. Our focus is only young, single adults so when we go tracting and find families we give them to the other missionaries in the area. We met a really cool family from Brazil last night! The mom is in Brazil for the next week but they all felt the Spirit a lot as we taught them the first lesson. The dad said he could feel the different energy as we entered the room. His two sons are Gabriel, 14, and Naue (Na-whey), 8. Gabriel was really excited about it and really wants to get baptized! The dad said he would after he reads and prays. And we dont even get to keep teaching them cause its a family so we handed them of to our zone leaders. I really wish we could cause Gabriel is really cool and plays soccer. He was excited when i told him i played in Brazil. He lived really close to where i went. But its ok cause i know they will get baptized in less than a month. We found out we technically werent supposed to be there cause it was university family housing. A guy said we probably shouldnt be here and we almost left but then really felt like we should keep going and 2 doors down we found them! Then we got kicked out by the apartments manager about 20 doors later. Its awesome how the Lord provides a way for those who are prepared. We found some other really cool people this week so them plus our investigators coming home from spring break will keep us really busy next week.

Hello! Sorry i didnt email last week but we have been crazy
busy the last two weeks getting ready for 2 baptisms! We
played beach volleyball last saturday and so we didnt even
get a chance to do some other stuff too. Our pdays are
always busy cause we dont have a car. I got to baptize
Fabiola on thursday! Both baptisms were really cool and
very spiritual.
Pres. Newman wants us to part our hair so we all do. It's
not a rule but we all just do it. The bike is working out
great! Its a really nice bike and i paid an extra 50 bucks
for a lock package. It came with a U-bar lock and a cord
that goes around my front tire so it doesn't get stolen
and a seat leash that keeps my seat locked on. And it came
with front and back lights.

My hip is doing great! This week its actually been a little
sore but its doing pretty good. We bike to the gym 3 days a
week. We get up at 5:00 when we do! Its about a 20 min. ride.
Skiing sounds like a blast! I miss skiing a lot! And every
night biking home we pass a lighted soccer field and it makes
me miss soccer! But i am having a ton of fun here! its crazy
how many different kinds of people there are and the different
responses they have. Theres always 1 person each day who wants
to bash and I learned quickly that i just need to stop them
and end the conversation.
I cant remember if i told you but we were challenged to read
the whole Book of Mormon this transfer. I'm about half way
through but theres only 2 weeks left! I need to read a ton!
Ive learned an incredible amount and have grown a lot
spiritually from reading.
I love all the students here! They are all really friendly
and its a blast working with them! We did splits with a few
girls on campus cause they want to serve missions.
The expiration date of my license is 07/03/2010. It was
issued on 01/12/2009.
Sounds like caleb has been up late. haha. I miss watching
movies with aaron and caleb! I gotta run. Tonight we are
watching Joseph Smith: Prophet of the Restoration with an
investigator and having dinner at Charlene's. The movie
thats playing in Salt Lake! Its an incredibly powerful
movie. I got to see it in the mtc too. Tell everyone i
love and miss them. Tell josh that im doing my best to
follow his example in serving the Lord with everything
i have. Josh I look up to you more than you will ever know.
I think about you a lot and try to do what i know you would
do. Thanks for always being there for me and setting an
example for me throughout my life and for serving a mission.
I love you rachel, aaron, caleb, josh, mom, and dad!

Elder Carty

Joshua continues to improve today and has been talking more. Despite the fact of how sick he is, he actually cracked his first joke in a very long time. When I asked him if he wanted anything to eat he just mumbled something and when I asked him to repeat what he said, he said he wanted a steak. I said, a steak? Then he said "I'm just kidding"! It's hard to believe that he still has a sense of humor even though he is so sick.
Cindy and I were talking last night about how strong we feel his spirit when we walk into his room. His spirit seems to be talking to us and communicating what we need to do to take care of him properly when he can't verbalize himself. His strength humbles me and helps me to see the eternal perspective of our existence. He may have come home from his regular full-time mission in California a year early; however, I believe his mission has never ended. I met our cardiologist, who comes to our hospital in Superior a couple of times a month to see patients, for the first time day. The first thing he asked me after we had introduced ourselves to each other was, "how is your son doing"? Word about Josh seems to have spread to many people, and as a result, it seems that a lot of people are drawing closer to God in their prayers for him. Again, we thank everyone for your prayers for Joshua and our family! We have been strengthened daily and know that angels have been with us to bear us up when we are tired and help us to overcome the challenges in caring for Joshua.

Joshua is an amazing young man! His bowels began working again early this morning, and with the help of some 02, he is reaching the normal oxygen range. His right lung has minimal crackles and he is requiring some effort to breath. Joshua is very weak and sick, but is maintaining and shows strong signs of wanting to live. Cindy and I are giving him two IV antibiotics every 8 hours along with all his other seizure medications.

Joshua took a turn for the worse today. He had some abdominal distention and ended up throwing up his meds and aspirated fluid into his lungs. His O2 saturation level dropped to 62 and then rose back up to 82 where it has stayed all day. It looks like he may be developing pneumonia in his right lung. His Dr. stopped by today and took a look at him. We have decided to treat it with antibiotics but not take any heroic measures. We are also concerned with his abdominal distention since it appears to be getting worse. He received a blessing today by president Farris and his Dr. bro. Tufts. The missionaries were also present. Cindy and I were both able to go to the Spokane temple on two separate trips within the last two weeks and put his name in the temple. Thanks to all of you who have been praying for him and who have put his name in the temple as well. We have all benefited from your prayers.