Obituary - Philadelphia Inquirer

http://www.philly.com/philly/obituaries/20091222_Mark_G__Garis__72__longtime_educator.html

Obituary - Brethren in Christ Church website

Here is another obituary posted on the Brethren in Christ denomination's website with more information about Mark's church involvements:

http://www.bic-church.org/news/churchwide/09_12_18_mark_garis.asp

Obituary - newspaper link

Here is a link to Mark's obituary in the local newspaper:

www.thereporteronline.com/articles/2009/12/19/obituaries/doc4b2c119cf3cf1678364277.txt

(Not sure if this will come up as a link to click or whether you'll need to copy and paste it)

They also posted it as a news item:

www.thereporteronline.com/articles/2009/12/19/news/doc4b2ce11b749b3470319520.txt

Funeral Plans

We have now finalized plans for the funeral and viewing ...

There will be a viewing on Monday evening, December 21, 5:00-8:00 pm at Williams-Bergey-Koffel Funeral Home, 667 Harleysville Pike, Franconia, PA.

There will also be a viewing on Tuesday, December 22, 11:00-12:30, prior to the funeral at 1:00 pm, both at Zion Mennonite Church, 149 East Cherry Lane
Souderton, PA. Following the funeral, there will be a time of light refreshments in the fellowhip hall with an opportunity for people to share memories and stories about Mark.

Interment will be private at the Silverdale Brethren in Christ Church.

In lieu of flowers, memorial donations may be made to:

* Philadelphia Mennonite High School, 860 N. 24th St., Philadelphia, PA 19130
* Messiah College, 1 College Ave., Grantham, PA 17027, for the Mark and Nancy Garis Endowed Scholarship

Peaceful Homegoing

This morning at 5:45, Mark passed away peacefully. While we are sad to see him leave us, we rejoice that he has now entered into his eternal reward and is with his Savior in heaven.

For the past two days, Mark's breathing was labored. Last night Kris and I sensed that we should stay with him, so we took turns in shifts to sit with him and hold his hand. At around 5:10 this morning, Kris prayed that Mark would go quickly and peacefully and that he would be able to breathe comfortably. Immediately after she prayed, his breathing slowed to a normal rate. It then continued to slow down, and she woke me at 5:30. We sat with him, holding his hands and telling him that we loved him. He then very clearly said, "Love you" two times and stopped breathing.

We are so thankful for God's goodness and mercy in allowing Mark to have comfort and peace in his passing. We thank you all so much for your prayers for Mark and for our family during these days.

Jeff, Kris and I are working on plans for the funeral and will meet with the funeral home later this morning. We expect to post the arrangements later in the day.

Nearing the End

Mark's disease continues to take a toll on his body. He is now in his bed all of the time. Each day brings further decline. He developed a yeast infection in his mouth ("thrush") for which we swab his tongue and mouth. Kris and I are learning new nursing skills and he had been encouraging us when we made mistakes in turning him over in bed,etc. It is going better now, thanks to help from the Hospice Aides. Today Mark is unable to talk or whisper, but we usually know by his face what his needs are. This morning he drew his hand up to his head, meaning that he had a pain in his head. The nurse told us to give him some morphine. He opens his eyes slightly, but is generally asleep. We know that he hears us . . . he can squeeze our hands. When we ask him, he usually indicates that he is confortable. We don't know how long his body can go on, but we do know that it is slowly shutting down. We continue to pray for God's mercy to give him a peaceful goodbye.

Managing Changes

This week Mark's appetite decreased a lot. His swallowing ability became problematic. We were given instruction in how to feed him. Then three days ago Mark was coughing for a period of time after eaing his thickened juice and pudding. He had a short episode of unresponsiveness before resuming his normal alertness. We had a Hospice nurse come to check him. The nurses have told us that his disease is progressing. So at this point he is only able to take a minimal amount of thickened liquids. He has no pain and knows what we talk about. He cannot speak very well, just a very soft whisper. That takes a lot of energy for him. He is content and enjoyable to be with. He continues to be loving and appreciative.

More Aids and Aides for Mark's Care

You may be wondering why I haven't updated this Blog. We have been very busy with Mark's care, since Kris arrived home (a good but long journey for her). We transitioned to Hospice Care recently and continue to have Community Home Service Aides also. Our mornings tend to be quite intensive. After his morning concludes with breakfast and bathing,etc., Mark takes a long sleep in his recliner. Moving him from chair to wheelchair, table or bed has gotten more comfortable with a Hoyer Lift. Although it looks monstrous & takes up a lot of space, it enables us to mechanically lift him. There is less stress on his body and it's easier for us too. Mark remains very pleasant and positive. He sleeps a lot more and is weaker in body and voice. We do use a medication for him in the evening to relax him at bedtime. His faith is strong and contagious. In turn, friends and family's prayers have been an encouragement to us!

Comings and Goings . . .

Mark had his appointment with Dr Kaufman yesterday (Thursday). It is always a major effort to get him in the car & transport him to Grand View, so he was quite tired when we returned. The MRI had some positive aspects, those being mixed with some decrease in his functioning abilities.
We look forward to Kris' arrival from Thailand, arriving by early evening on Monday. My brother Mike, and wife Mary Lou, plan to stay til Tuesday to greet Kris.(I could not have cared for Mark this past week without their help). We're praying for a good trip for Kris and that she will be able to sleep on the plane. It will be great to all be together for Thanksgiving!

Upcoming MRI

Mark has had three treatments by IV and that has gone well. Dr. Kaufman has ordered an MRI for the beginning of this coming week. I'm assuming that we will learn the results at the next appointment on Thursday, November 19. Mark sleeps a lot between meals and goes to bed very early. He is comfortable and content. We are getting a lot of support from our church family,including Kris' support team who are taking turns to come each evening. I appreciate all who call or help in numerous ways. Our morning Aide continues also. We are managing okay, even though it is difficult to see him slowly declining. God is faithful to us always.

Visit With the Oncologist

Mark seemed a bit stronger today. Jeff assisted us in getting to BuxMont Oncology for the office visit with Dr.Kaufman. Although this was the first time to meet him, he was on top of Mark's case & had obviously read the report/recommendation from Dr. Rosenfeld. He noted that his "performance status" is decreasing. He concurred that the Avastin drug is an "opportunity for him to get some response", as many other patients have experienced. So that was administered again today by IV in the port Mark has now. He actually slept through half of the one hour drip. He enjoyed a nice meal at home tonight from Janice Althouse and stayed up to watch some TV. The Home Health Care Aides are doing a wonderful job daily. God continues to direct this journey we're on. Thank you for your prayers.

Managing Some Changes

In the last 2-3 days, Mark was losing strength and needed a lot of assistance. Fortunately this happened when my brother Mike and Mary Lou were here. Mary Lou did the kitchen work and helped in numerous ways and Mike was able to handle Mark's weaknesss when we needed to help him move about. They've had experience with Mary Lou's mother, so showed me how to assist Mark with his mobility. When I called our Palliative Care group to discuss Mark's new needs, Susan Smith, R.N. came within a couple of hours and also sent a Social Worker. So today was a very busy day, meeting with them and deciding what course to pursue. We decided to engage Community Home Services who will send an Aide twice daily, for 2 hours each morning and 2 hours in the early evenings. Susan also felt that a hospital bed would be easier for Mark to get in and out of, and no sooner had she ordered it than it arrived. It is now set up in our guest bedroom, with my bed beside it. Mark is sleeping for the night and I shall do the same soon, as I am tired too. I am so impressed with the speed of making these connections and changes, to say nothing about the sensitive and caring nature of our new medical friends.

Mark's port was successfully put in last week, so he will never have to suffer the poking and probing of his veins again. Then on Friday his IV with Avastin went well. It took 2 hours and will be repeated every 14 days. He will see an oncologist every two weeks before the IV. I was referred to a service there at Grand View Hospital in which a nurse practitioner is assigned to a patient to monitor progress and potential problems between doctor visits. Today Chris Hanson came to our home, did an assessment, and has another appointment with us here in a week. Meanwhile she will have a raised toilet seat and a wheelchair delivered for times when Mark needs assistance. His size makes it difficult for me to handle (sometimes) when he wants to get up or down. We are very pleased with Chris, the NP, and thank Laurel Landis for referring us to her.
Family is so important to us. Jeff was here yesterday and tomorrow my brother and sister-in-law (Mike & Mary Lou) will come for 2 1/2 days. On Saturday Wesley and Viola, our grandchildren, will come with Beth for a visit. Mark may doze off for a while, but that's okay. Kris "Skypes" daily from Thailand. It's almost like she is here too. Most of all we know that God is here with us.
Here's a promise from Isaiah 41:10 that Robin wrote out for us:
Do not fear, for I am with you;
Do not be dismayed, for I am your God.
I will strengthen you and help you;
I will uphold you with my righteous right hand.

Upcoming Intravenous Treatments

Today we met with a new oncologist at Bux Mont Oncology Group in Sellersville. Dr Spears went over Mark's history and report from Penn and plans to follow through with that. We then went to the area where he will get the intravenous medication and had his blood drawn today. Mark's veins are increasingly difficult to get blood from, so they feel that he should have a port for the upcoming treatments. Therefore, on Thursday he will get a port implanted at the short stay unit at Grand View. Then on Friday he will have his first treatment at the Outpatient building where the oncologists practice. His treatments will only be on every 14th day. We were told of the possible side effects and what to watch for. We are ready to move forward with this new treatment because of the potential benefits.

Change in Treatment

Today Mark had his scheduled MRI and other tests at Penn and met with his neuro-oncologist. She explained to us that the chemo he's been on for 2 months is not taking care of the tumor, so she recommended a medication approved for brain tumors that shows good promise. Interestingly, I was going to ask her about that medication, Avastin, as I have been researching about it too. She also is suggesting that we get an oncologist locally so that it can be administered bi-weekly(intravenously) without us having to travel to Philadelphia. She and we are looking into Grand View Hospital as a site for that and expect to have an appointment soon with an oncologist who is on staff there. We'll keep you posted on that. Meanwhile, Mark will continue with his Physical Therapist to improve his balance.

We're grateful . . .

The past 5 days have been encouraging, as Mark's appetite has improved; his physical therapy is making him more active; and we have gone out three times to eat with friends. We also enjoyed having Jeff, Sara and Tess here today for a barbecue. It may be one of the final picnics of the year. The weather was perfect.
To those of you who have written responses, mailed cards, called, visited or spoken to us, we say a big thank you! To the many who have prayed for us, again we say thanks! It's definitely helping!

Side Effects from Chemo

Resuming chemo 5 days ago also meant resuming a poor appetite with weight loss. Instead of begging Mark to eat, I asked his oncologist for the "megace" prescription that he had 3 years ago which successfully pulled him out of that problem. So tomorrow he will begin that and also his physical therapy. PT has taken so long to get set up. I'm sure it will be helpful too. It's been a vicioous cycle: eat less, be more tired. I'm hoping we break this cycle! Please pray with us for that to happen.

Doing Better

For the last two days, Mark has been eating quite normally. Yesterday he went with me for a ten minute walk. I'm thankful for small progress! I expect it to continue.

Doing Better

Today's Appointment

Mark had an appointment today with his neuro-oncologist and Nurse Practitioner. I drove us to Jeff's house in Germantown & he took us the rest of the way to the hospital. (No trains for us today). They will keep him on his course of meds as prescribed. They believe that he will get stronger again and have decided that they will order physical therapy for him. This will probably be done locally, at Grand View Hospital, per my request. He needs to hear someone else tell him to get up and move around, not just me. (It's too easy for me to do things for him when he asks me to.)

His weight dropped 11 pounds in the past 2 1/2 weeks, due to loss of appetite. But I think the prayers of our church members, friends, and Kris and team in Thailand have been heard! This morning for breakfast he ate 2 eggs with a little bacon, one half English muffin, one Bran muffin, 10 ounces of orange juice and a cup of protein- fortified hot chocolate! I could hardly believe my eyes! Then on our return home from Philly he asked me to stop at Red Lobster for a late lunch. (He had taken a gift certificate from Jeff and Sara along with him.) He ordered a big seafood platter and ate half of it, bringing the rest home for tomorrow. So it looks like we're on the road to recovery! PTL

Remembering Ted Kennedy

Our "big adventure" today was to go to the lab for weekly blood tests. Before going there we went out for lunch at Java on Main Street. But Mark was not hungry, so he ordered just a bagel and latte. And he was not really hungry for supper. I'm wondering if the chemo is playing games now with his appetite. When this happens it's harder work to entice him with nutritious foods that he likes. Hopefully tomorrow will be better!

This was also a sad day, learning that Ted Kennedy died. He had the same type of brain tumor as Mark. I'm glad that the tributes to him have been so postitive, for he really did accomplish a lot in the political world, especially for the most needy. When I was in college, I worked two summers as a Nanny in the home of Joe Kennedy's personal physician (in Massachusetts.) There were photos and stories of the Kennedys who were in the same social network. I did not personally meet them, but from that time period on, that family was part of our history. May God give them all His peace and comfort.

Trip to the Hospital

Mark continued to be more tired & lethargic, so early Friday morning I called the hospital and talked with the neurologist on call. She suggested bringing him in, through the emergency room. So we drove down to Penn & they began an intensive testing: Xrays, CAT scans, blood tests, ultra sound, etc. Almost ten hours later he was discharged, as all of his tests were clear. They do think that his body is not happy to be off the steroids, even though he was gradually tapered off. So now he will be back on a minimal amount of steroids for up to a month. They gave him a break too, not having to take his chemo on Friday. :)

Again, this Sunday he wanted to be in Worship Service, so we did go to church. It was a wonderful service. He is asleep now to restore his strength so he can go to the annual Garis Reunion right here in Souderton. We will stay only a short time.

Lethargy

Mark's tiredness and lethargy have increased this week. I have been checking in with his doctors at Penn by phone. They say to consider this normal for what he has been through. They expect that it will decrease in a week or more. So we are just hanging around the house while he rests and sleeps. He began his chemo also.

On Monday, August 3, Mark had an appointment with his neuro-oncologist.She is very pleased with his progress. She had two students observing her as she examined and talked with Mark. (She is also a professor at Penn). When she told them that he is an "Energizer Bunny", I spoke up and told her that he has been very tired lately. It seems that going off the steroid medication is leaving him lethargic. On the other hand, it has given him a tremendous appetite. I was sure that he must weigh ten pounds more, but in fact his weight is exactly what it was before surgery! I remember this stage in his recovery from the first tumor surgery. Dr. Rosenfeld said that he will get his energy back gradually. I believe her.

The incision has healed so well. We will visit the surgeon for his post-op on the thirteenth. Dr Kevin Judy is on the Brain Tumor Team with Dr Rosenfeld. He had told us immediately after the surgery that it was non-eventful. He has agreed with Dr Rosenfeld that the preferred treatment now will be the same chemo that Mark has been taking for three years. But instead of one week every two months, he will take a reduced dosage of Temodar pills daily for three weeks, followed by one week of no meds. After he sees the doctor at that point, he will keep cycling the chemo: three weeks on; one week off. He will have MRIs every two months . . . same as he had been doing. The goal is to destroy any remaining cancer cells. Mark has tolerated this chemo well for three years, so we expect that when he starts it again next week, it will go well for him. He will not be on the Clinical Study anymore, so I will no longer be giving him injections of Poly ICLC (interferon).

We had a good time together at our house on Saturday for Jeff's forty-fourth birthday. Since Jeff wanted to forget how old he is, little Tess easily got all of the attention. At nineteen months she is a ball of energy, keeping Sara constantly watching out for what trouble she can get into. Big brother Wesley entertains her a lot, which she enjoys. The birthday balloon was a big hit with her until it ascended to the peak of the ceiling. Ladder and Broom Mission needed! Now we are looking forward to seeing Viola here on Friday night with Wes and Beth. Viola has been canoeing all week at Spruce Lake Camp, her fifth year of camp. The recent rains must be providing lots of streams for them. Can't wait to hear her tales.

Tomorrow we will again Skype with Kris. She is a regular communicator with her Dad. Knowing that she is about 12,000 miles away, yet seeing her on the computer screen and hearing her voice, melts the miles away. How fortunate we are with our family! And you, our friends! Thank you for taking the time to read this and encouraging Mark. May your prayers join ours, on his behalf.

Walking, Talking, Enjoying Summer . . .

Mark continues to feel very well. He takes daily walks, enjoying the walking paths here. His steroid pills are tapering off, for which he is thankful. It does increase his appetite, as a side benefit. He is happy to talk with friends and neighbors. And yes, he did go to church on Sunday, six days after surgery! He also spends a lot of time reading. I think the Phillies are making him happy too, as they continue to win each game. Many mornings we enjoy web cam conversations with Kris. Then we enjoy the beautiful weather we have been having, often eating out on our patio. Thanks so much for your interest and prayers.

Home from the Hospital!

Just 72 hours after surgery, Mark was released from the hospital! He has been anxious to get home because he feels so well. The nurses had orders to keep him in bed or in his chair,but Mark kept getting up when he wanted to change places or go to the bathroom. He is strong and has no pain. And he is so glad to be home. He has very few restrictions.
After his brain heals, at his post-operative visit with his oncologist in about 4 weeks, it is expected that he will resume chemo to destroy any remaining cancer cells. On the schedule he had for the past 3 years, he took high doses of chemo pills for 5 days every 9th week. Soon he will begin a regimen of daily, low-dose chemo pills. He has always tolerated his chemo very well. We pray that he will continue to. We are optimistic about his prognosis.

Nan

Day after Surgery

The surgeon, interns and nurses who have Mark under their care are all very pleased with Mark's recovery from the surgery. He was moved from ICU to a regular room on the neurology floor which is thankfully, much quieter. The view from his oversized room with large windows on two corners overlooks the city. The afternoon sun is toasty warm, a nice change from cold AC elsewhere.
With the monitors removed, there are only a few medicines, including minimal pain medication. Mark enjoyed 3 regular meals today. I left the hospital tonight after he was settled in a recliner, watching the All Star baseball game. (Do you think he noticed that I was gone?)
We'll soon learn when he will come home. With this quick initial recovery, I am reminded of the verse in Ephesians 3:20, "Now to Him who is able to do immeasurably more than all we ask or imagine, according to His poower that is at work within us, to him be glory for ever and ever!"

Nan

Successful Surgery!

Mark has successfully come through his surgery with flying colors. The surgery was three hours to remove the small tumor. The surgeon met with us afterwards and said the new tumor was successfully removed.

We visited with him after his surgery, and he was very lucid. He seemed much better than the previous surgery - the difference was amazing! Nan plans to stay here overnight.

Although Kris was not here, she had the next best thing. Jeff was able to keep her constantly updated with email and even sent a video of Mark saying hi after the surgery.

Thank you all so much for your prayers.

Jeff, Sara, & Nan

An R & R Trip, July 8-9

Today Mark did the pre-admission round of tests and paperwork for his surgery next Monday. We will be leaving the area for 2 days on a short trip with our good friends, Vernon & Blanche Althouse. Wednesday and Thursday we'll be away. Mark feels great and it looks like the weather will continue to be beautiful. That's a bonus!

New Tumor, July 1, 2009

I've reactivated Mark's Blog to bring you up-to-date on what's been happening recently. We have rejoiced in God's merciful care over Mark for three years. He has enjoyed a good quality of life, and has responded well to his on-going treatments to prevent a recurrence of a malignancy. However, at his regular check-up on June 19, an abnormal area showed up on his MRI. A second MRI a few days later confirmed that a small tumor has grown, near the site of the old one. The team of various specialists at HUP (Hospital of the University of Pennsylvania) reviewed the images. Jeff, Mark & I visited the surgeon yesterday and were shown those images. The surgical method and possible risks were discussed. We have been in communication with Kris in Thailand and have decided to move forward with surgery with the same doctor who did the first successful surgery.
Dr Kevin Judy's plan is to reopen the 3 small titanium plates which he screwed in Mark's head after the first surgery, since the new tumor is in the same general area. He says that this will make it less invasive. Mark will have another MRI and lab work on Tuesday, July 7 in preparation for surgery on Monday, July 13. (He is so good about these tests!) I will not know the time of his surgery until a day or two before. We appreciate your prayer support during this new phase.
Nan (and Mark, Jeff, Kris and Family)


_____________________________________________________________________________________

Two Years Later . . .

Today we are celebrating the second anniversary of Mark's medical journey. Just think . . . it's been two years of uncomplicated recovery! As I shared in church this morning, we are SO grateful to God for his mercies, grace and answered prayer every day. Mark stays involved on two boards: Messiah College and Phildadelphia Mennonite High School. We recently attended meetings/events at both. Regularly he shares his testimony with others, especially those who also suffer from brain tumors. What an encourager he is! Yesterday he helped me put our summer plants in the flower beds.
The excitement in our lives comes with learning to know little Tess, our four month old granddaughter in Philadelphia. Also, on April 16 we welcomed our daughter, Kris, home from Thailand for six months. She livens our household with her comings and goings. She is adapting to living with us in a 55 Plus Community!
We will be resurrecting an old tradition: Kris, Mark and I and our two grandchildren, Wesley (15) and Viola (13), will go to our condo in Florida in July for about eight days. Even though it will be very hot and humid, the Gulf water and pool will cool us off. For Kris, that weather is what she has been used to for four years.
Other events that we look forward to include picnics and reunions. We will drive to western New York next month for a get-together with the Haun side of the family (Nan's brothers and families). Kris will continue on to Canada. She is putting on a lot of miles . . . California, North Carolina, Wisconsin and places in between. Her sharing is always interesting.
I'll try to write again in the fall.
Nan

Reflecting on a Year of Blessings

We celebrated Thanksgiving and Christmas with an increased enjoyment of family, friends and the presence of our loving Lord. As we enter the New Year, we've reflected back on a year of spiritual growth through trusting God with the unknown. We are thankful, beyond ability to express that depth, to God who has enabled Mark to sail through his chemo and injections with very minimal side effects. Now, over 19months since his malignant brain tumor, Mark has returned to activities which had somewhat decreased. He is the number one driver when we go anywhere. We've driven to western New York to visit Nan's family, and also to our condo in Florida.

Currently we are retreating from the cold northern winter by being "snow-birds" in Florida. We had left our car down here in November so that we would fly back to Pennsylvania for the holidays & then return by airplane to Sarasota on January 3. We thought that we would miss the birth of a new grandchild later in January, but unknown to us at the time, God had the oncologist change the routine appointment from January 3 to January 2. So when Sara, our daughter-in-law, went into labor 2 1/2 weeks prematurely, we were able to be there immediately after little Tess's birth on January 3. She arrived at 6:15 a.m.; we got off our train in Philadelphia on the way to the airport & were able to squeeze in an hour to visit Sara and Jeff and hold newborn Tess! Then Jeff took us from the hospital in time to catch the flight we had. PTL for God's best timing! We are so often amazed at the blessings we continue to receive!

Nan & Mark