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Logo of AMEN 2019: Christ in You

To Open Their Eyes, In Order to Turn From Darkness to Light

Peter Blackburn

Description

OBJECTIVES 1. A short review of common ocular conditions, diagnosis, treatment, and prevention. 2. Take a tour of ocular mission from Mongolia to Cuba and what God can do, when we see with His eyes.

Conference

Recorded

  • November 1, 2019
    3:00 PM
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Copyright ©2019 Adventist Medical Evangelism Network.

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Well thank you all for having me I do appreciate it my name's Peter Blackburn as I said. And I grew up in Colorado and went to Union College in Nebraska for undergraduate and then med school at the University of Colorado is that Kettering for a transitional year and then residency at the University of Colorado and then when. It's good and then I did have it you're right a fellowship at the University of Kentucky and then ended up staying there and so I've been there since about 2004 so get to teach medical students and residents and fellows and see a lot of patients in Appalachian and in Central Kentucky. So my theme for the talk really is God's faithfulness and this is sort of an introductory part of this. And often you know we're asked for titles before we give a talk way in advance and then as you develop your talk often your title has nothing to do with what your talk is about and so that's what's happened in this and so really if I was to rename this it would be God's faithfulness and he's faithful no matter if we're faithful or not he is faithful and so let's say were prayer Lord I thank you so much for your love and your watch care and I ask that you would be with me this morning and so much that I've learned already here and I pray Father that you would just send your Holy Spirit to be here in our room as we talk in your name I pray a man. Psalms 37 says trust in the Lord and do good do well in the land and feed on his faithfulness delight yourself also in the Lord and He shall give you the desires of your heart commit your way to the Lord trust also in Him and He shall bring it to pass he shall bring forth your righteousness in the light and your justice as the noonday. So full disclosure this is my 1st name in conference so you all actually should welcome me rather than me welcoming you so yeah there you go there you go. And I've learned a lot this was a very very nice presentation thank you so much and lots that I've heard so far so I appreciate that and my contribution today God willing is that what God has really done in my life so it's more of a testimony over the last few years of what God has done in my life and so part of that presentation is talking about o c t And I really didn't know who to expect to be here today and so I thought maybe it would be a little bit of a primer it's obviously not we all have professional so. Yeah so we can probably speed through that really quick as you guys probably know the same amount is what I'll be saying so my apologies for that but I wanted you to understand o.c.d. or wanted anybody that was in here to understand because the story that I tell at the end is a really good juxtaposition of technology and God's faithfulness and so so Ok we'll move along here so Greg Lee is a fellow that used to work with me a really nice guy he's in Atlanta Georgia now practicing but he sent this talk to me while we were in Mongolia Actually this is the talk that I presented at that for the residents in Mongolia I have no disclosures for this this is where I work at the University of Kentucky in the Shriners building. This is our team and if you find my picture in there you'll see that I look younger then than I do now because that was quite a few years ago. So c.t. and that's what we're going to talk about in this 1st few minutes and some of the things he does for us. So that some of the history of. It was developed in the early ninety's at mit and it tough skin Boston. And the 1st was the Stratus it came out I call it the Pac-Man o.c.d. because it's so peculiar pixilated. And doesn't give you a little bit of information but not a lot. In 2006 they came out with the spectral domain o.c.c. which gave us a lot more information. And it's just a much higher level of information that we give if you do a pub med search on o.c. t. you will find about 20000 articles between 2000 and now so it's a very common modality that people use to evaluate retinal disease. This is sort of the physics of o.c.d. and we won't spend a lot of time on there in fact it's easier if we look at a picture and so ace a ray of light comes into the I had bounces off all of the ocular structures it's then compared with a with a regular or a a standard of ray of light and then it generates an a scan and then when we put lots of a scans together what we get is. Of course obese can and so when you have the beast can then you can look at that actually starts to look like an eye and you have some different path ology that you can look at like this need this that we're looking at there. So what is that a scanner beast can have to do with an o.c.d. Well the o.c.d. is basically just Lots of a scans that are performed by the computer and so the the Stratus or the time domain performs about $400.00 a scans per 2nd and that's what gives us that pixilated figure and you can see you know the different layers of the retina You can see the choroid different things like that spectral domain o c t increases that number to about 18270008 scans and you can see this is the image that we get this is a path ology slide and you can see it's actually not bad right and when we compare the path ology slide to the o.c.c. that's generated. And these are some more examples of different types of the serious the Heidelberg and the op to view. If we look at the swept source which is sort of the standard now you can see it's 100000 or 250008 scans per 2nd and that's how we get this kind of detail we get this vitreous detail which is optically clear you can see the choroid the Corrado vasculature really well and the retina layers in the bound banding of the inner and the outer retina are very abundant. So different types of scans that we do you're probably familiar with some of these the cube scan the raster the grid all of those different types of scans that we use and the different terminology that we use hyper reflective shadowing when doing all of these things it's really good at a demon fluid in p.d.s. and things like that. So the types of findings that we get we can get so this is a patient with geographic atrophy and macular degeneration and you can see this window type defect where the skin just goes all the way through the choroid because there's nothing to stop it so it's like a punched out lesion in the macula. Here we see an Epi retinal membrane with this traction and forces that are placed on the retina and how the retina is pulled up into that can see the color scheme up here where it shows the. It's very good it is very good at looking at different types of leakage into retinal leakage and diabetic macular edema also with age related macular degeneration with these pigment up at the old attachments and so bright no fluid and so the Hallmark and what we're going to talk about mostly today's video macular teachin or interface problems and you can see here is that he's in where there's. It's not evident to me but I don't know if it is to you or not but you can see how the vitreous is attached to the retina in this place here it starts to pull a little bit more in here we start to have a macular hole formation. So the types of scanning errors that we can get just to go through this quickly you can get movement errors where the patient moves you can see here you have 2 phobias not really anatomically correct here you can get segmentation errors where the computer draws the line in the wrong area and so it might show edema where there's really no edema there so you have to look for that. Disinterment decent ration in macular edema is very common where the they put the phone in the wrong place or put it under the or something along those lines a blink defect gets in the way of if you're trying to see something that's a blink that's in the middle of the scan or a vignetting where this outer edges of the scan are just not strong enough to get you a good and edge. O.c.t.a. is used a lot in fact in San Francisco with our academy last week it was a presenter that said you have to have an o.c. to be able to press to practice retina I think that's overstating it a bit and now but it's really a good tool the concept of an. Is that it takes 2 total scans and then compares those to each other and any difference that it picks up is is placed on movement of red blood cells and so they can magnify those and we get asked actually like a floor scene angiogram but it's a non invasive tests so no and no die has to be injected and yet we can see the vasculature here really well and you could look at different layers of the vasculature you can look at the interact and you can look at the middle part of the retina or the outer Ratan even into the choroid and you can see sort of the pathophysiology that is done that's really nice here you can see a branch right no vein occlusion where there's no blood flow to the retina You can see a caret on the vascular membrane all non-invasively And so I went to fast. Let's see. Yeah and so. What's nice about that is you can really show patients pathology and you can show it to them quickly you can say hey look this is what's happening to your retina because your diabetes the same thing is happening to your feet it's happening to your kidneys it's happening everywhere you need to control your sugars and so that's basically that's my spiel that I give them let's let's work harder because you're a one c. of 10 is not cutting it. So enter operative o.c.d. is something that we're starting to use now I tried one the other week and in the o.r. it's not going to be readily available because it cost $200000.00 but it's really cool technology because you can see what you've peeled you can see the tissue that you've removed as you're doing it so it's real time data. Ok so I'm going to let's I'm going to fly through these cases actually really quickly tell I get to the one that I want to talk about and so this is a 85 year old with an Epi retinal membrane can't really see that on here you know if you look just at the picture things look really pretty normal 20402025 in the left eye but if you look at the. You'll see there's a little vitriol macular traction right there and he's 2040 in 2009 and then we'll watch the progression as he gets a little worse at 2050 and then a year later he's 2040 but that is starting to release and here it's totally released and he's back to 2025 So here's d.m.t. that has happened released on its own we didn't have to do anything we just watched it over time and that happens. So these are the different types of if your talk about post your vitreous detachment and floaters and normal aging process that can be accelerated by trauma or surgery or high myopia inflammation different things that produce a p.v.d. interruption of a normal p.v.t. process. Can happen and can cause some of these anomalous things that will develop visual retinal interface problems. Going through what happens in a p.v.d. the liquid vacation of the vitreous it starts as early as 4 years old increases in the teens 20 percent of the vitreous at that point is actually liquefied by age 70 greater than 50 percent of the vitreous is liquefied there you know as you know. So weakening of the vitriol retinal it helps to produce some of these past pathology states that we see. And so when they all release you get a complete p.v.d. and Weiss ring formation when they don't all release then you start to see that your macular degeneration macular traction or macular hole formation so these are the different stages of a p.v.t. different pictures that we kind of look at and you can see the vitreous separates. P.v.d. is not just an acute process it's a combination of liquid liquid occasion and weakening of the vitreous that he's ins I'm informing of a wife's ring. And anomalous p.v.t. produces some of these things like vitreous traction and epi retinal a vascular proliferation and they're not mutually exclusive you can get both of those you can get pictures traction and he r m at the same time. So there is these are the different disease states in that I've got pictures of them via may. And this is this is terrible but this just popped into my head. You can also if you're struggling to find a billing reason for an o.c. t v m a is your answer because you can see that all the time sorry that was just my that's terribly cynical in this case but there you go. Let's see your make your vitriol macular traction where you actually see some a demon in the retina and then full thickness macular hole formation where the traces actually pull the layers of the retina apart in our information where you get this fibers proliferation on the surface of the retina most of those stay sable and a vast majority of the Arabs don't progress and you can just watch them and they really don't need surgery occasionally they will. Whole formation again most of these don't respond very well to surgery in that you end up just telling folks this is what your vision is. So the different stages we have the gas stages of it your macular are of Match of the whole on this side and the new classification on this side if you guys were residents we'd quiz you about that but you're not so we'll just kind of leave it at that yeah. And so this was a case of a patient who had a macular hole here 2257 year old female decrease vision for a month she had this was her o.c.d. with a macular hole and she had surgery her whole close and she got back to 2030 so pretty good her risk and her fellow ah is 3 percent to get a macular hole in that eye and so what we did was we watched her one month post-op in her left eye she's 2046 months later in her non-operative the contra lateral you can see this he's starting to develop a little video macular and he's and she still 2036 months after that she's still 2030 maybe just a little bit more pulling on that 2 years later you really start to see that there is some traction in some of the most but she's still 2030 so we keep watching. For years post operative surgery in the other eye she's still 2030 but she has increasing metamorph because of this little bubble of fluid there. And then one year after that she's 2080 and she has this full thickness hole and so she is part of that 3 percent that went on to get whole and so she you know and I will do that if they're complaining enough if they're 2020 or 2030 and they kind of got to talk me into surgery. And so I say look at your how bad is your metamorph obscene and if it's bad enough church will do it. Not very many of them in fact a lot of them were released and so that's why we can end up watching them so. Yeah. Well and absolutely because and the reason is that 2080 I you get that hole to close they may not get back to 2030 they may only get back to 2040 or 2050 So you've made them wait and you've actually sacrificed a couple of lines of vision that they might have had if you would have operated earlier and so it's a balance that you have to make and it's a discussion with the patient some people aren't bothered by 2040 vision they're fine with it but some people you know if you're engineers whatever you know they're going to be bothered by that so so she so this I did well but really only go back to 2050 you can see this is really early post-op there's a bubble in that. So this is my friend Jay Miller and Jay. Jay is a family practitioner and. And Sanford Kentucky and he went to Union College about 10 years earlier than I did and then went to Loma Linda. And he delivers about $200.00 to $300.00 babies a year so you can see Jay if you notice closely he's got a port wine stain or any of us flame is on that side yeah and so if you could see even a little closer you would see that he was part of the 20 percent so port wine stain happens in about point 3 percent of the population of those that have it in a v. one distribution only about 20 percent will get childhood glaucoma will Jay was one of those and he had some treatment but he's totally blind in that left eye he has nothing so he's gone through life delivering babies with one eye and he's fine with that. But he called me in August of this year and he said Pete I need to talk to you about my retina and I said your retina which one and he said my good eye and I said what's going on so he had seen one of my colleagues and he had said apparently I'm developing a hole in my retina and I can't see in the middle of a missing part of my vision and so I am concerned. And right and so his looked like this and he had this thing pulling up on his retina and so he was moderately concerned symptomatic obviously saw my colleague and we both my colleague and I talked and we said you know look your monocular you've got this let's see what happens and we'll just give it a few weeks so we had him come back a few weeks later and he looked like that so it popped off but he's got this whole he's actually still 2040 but the only reason he's 2040 is because he's looking around he's got home. And so we're both really nervous and he's nervous and his wife texted me at 5 am the next morning she's really nervous and and can appropriately so right because this is his livelihood this is his this is everything so I said I said well let's pray together so we prayed and he's. It wonderful man a man of God and I just love the guy and at the point at this moment he had multiple things going on in his life with his practice with the church the devil was really after him and so we prayed together about how the devil was after him and I said he said look I'm going to Philly to see my daughter and my grandkids why don't I go I'll be back in a couple weeks and we'll talk so Ok so he came so we went to Philly and he came back and he saw my colleague again and we were texting as we were seeing and he said you know Oh and I missed this part the week before he came back. He was anointed and. And we prayed over him and we just said Lord do with as you will and he kind of gave it up to God he said God whatever you want to have happen please just let it happen I just want to be in your service and so he came back and said You know I think it might be getting better and so he came back and it looked like that so still with this little chunk of vitreous pulled off but his tissues coming back together and his vision was 2025 and he said I still have the grace spot but I can start to see through the gray spot and I told John kitchen's my colleague I said this is exactly what we wanted to look at one of the to look like if we had operated on him and we said yeah that's right and Jay said you know God is faithful is he not but I ask you the question Would God still be faithful if you didn't if that whole didn't close Yeah so this only good question this only happens 3 percent of the time so Jay Miller my friend and he told me I could not kill her part told him I was going to tell you the story and so he's got a condition in one eye that only point 3 percent of the population yes and then he got a macular hole in his good eye that only 3 percent of the population has and then his eye closed in only 3 percent of the folks that have that happen. Pretty cool stuff right. Yeah yeah so pretty cool stuff so. Ok. Ok So moving on that's so he didn't have a chart to me so we just we just went on with that and yes and cataract and all those things. So he's much better off to not have a vitrectomy in this case. To tear not a fan of so so good any other questions because we're going to leave and go into this virtual room Ok All right so if you have your Bibles or your devices maybe turn to Matthew 14. 22 we're going to concentrate on on this story. And you'll find that in verse 22. Jesus is directing his disciples to get into a boat and go to the other side of the lake to Capernaum and you know what had just happened here he had fed 5000 men or 10220000 people if you counted everybody and I don't want to skip by that because he fed 202-0000 people with 2 fish and 5 loaves remarkable right 20000 people is the same number of people that squeeze into Rupp Arena to watch Kentucky play basketball and they're also the same number of people that fill most of our arenas to do anything or go to concerts watch any type of sporting events I have on a weekly basis about on every Wednesday night to about 20 people that come into my house and it takes I can tell you this for sure it takes about 6 pizzas 6 large pizzas to feed all of those folks so I think that 5 lows in 2 fish is probably wouldn't feed those 20 people that are in my house and less Jesus was there and then it would. Be well we take. So these people that had just seen this were impressed with the power of God on display that day and so impress that they wanted to do something about it they if you look at the desire of ages they wanted to make jesus their king right then and there and and they tried to and they started organizing and guess who went with them the disciples the disciples wanted it to they were ready to join in the multitude So Jesus sees what's happening and he understands what the result will be he understands that there's controversy already with this Ferris's and the leaders at that time and he says there will be starting to fight there might be bloodshed a lot of bad things can happen and it could even inhibit the development of my spiritual kingdom that I'm trying to have happen so he stops it from happening how does he stop it in verse 22 he says immediately Jesus made his disciples get into the boat and go before him to the other side while he sent the multitude away Jesus immediately sent them away and wanted them to leave so if you continue to read the story in this hour of ages and Chapter 40 the disciples don't immediately leave they stay and they chat and they talk and that's not necessarily a good thing when humans talk is it when we start to talk a lot because what happens is they start to murmur and they start to become dissatisfied that Jesus didn't allow them to make him so. He didn't want to be king but they wanted him to be king right then and they complained and the desire of ages says the disciples talked until they brought on spiritual darkness on themselves nobody else brought it on but they brought it on themselves they reasoned even reasoned could Jesus be an imposture That's how far they got with this spiritual darkness so they get they brought it upon themselves why because they chose. To linger in doubt they forgot what Jesus had just done for them in feeding of the 5000 we would never do that right we would never ever linger in doubt or questions in fact I heard this song mention this morning on I thought of this song as I was thinking of this On Christ the solid rock I stand all other ground is sinking sand we sing that on Sabbath morning strongly right but what happens on Tuesday what happens on Wednesday when we don't know the outcome when we read this story we know how it turns out when our own stories we don't really know what's going to happen at the end of that story and so I was so glad to see that they're going to talk about the match there's a young he's an intern that's going to actually speak to the match the match has to be the worst day ever in a medical students career there's so much stress so much pressure on if you're going to match and where you're going to match and on these young families so so I had a. There was a young medical student that called me. I was a friend of a family and she wanted to do off the Moloch in she's just graduated from Loma Linda this past year and so she was so excited about off the Molly she wanted this to be a career she wanted to do mission work all of these things because she wanted to do cataract surgery for folks and she but she expressed her concern because there was one thing standing in her way the us Emily score and her step one scores were not fantastic and so she was concerned and so we talked and and we talked for a long time and I encouraged her because actually I was one of those students too that was on the borderline. And so I encouraged her to continue trying well she came in she spent a month with us and she did the rotation the residents loved her the attendings loved her and we she. I did a lot to dissuade that score but at the end of the day she still didn't match and she was heartbroken and she said God why have you done this to me gave me this career and now it's taken away and I can't do it so we talk some more and so she decided that she was going to do a research here and try to try to get and so do some research and see if that would bolster get her some letters and things and so she she graduated from Loma Linda she moved out she was ready to start and the day before she was to start her research year she got a call from a residency program that said you know we've decided that we want to expand would you be willing to move out here next week and start your residency and she was jumping up and down excited and she got in her car she packed up her bags that had just been unpacked like the week before and she drove back God is faithful is he not. But would he have been faithful had she not matched would he still have been faithful had that not happened so let's move on. So what did Jesus do in verse 23 it says and when he had led had sent the multitudes away he went up on the mountain by himself to pray to be pray for himself hear the commentary goes on. Yeah when left alone Jesus went up into a mountain apart to pray for hours he continued pleading with God not for himself but for men where the but for men where those prayers he prayed for power to reveal to men the divine character of his mission that Satan would not blind their understanding and pervert their judgement the savior knew that his days of personal ministry on earth were nearly ended and that a few would receive him as their Redeemer intra veil and conflict of soul he prayed for his disciples so he wasn't praying for himself or anything like that he was praying for his followers and they needed it right because as he was praying they were down talking getting discouraged and concentrating on disappointment the disciples had just witnessed a huge miracle they should have been filled with excitement over that but they allowed disappointment to fill their minds instead of faith and hope they forgot the blessing God gave them something else God then gave them something else to occupy their minds we know what happens in the story right they get in the boat and then what happens a storm is approaching If you look at verse 24 but the boat was now in the middle of the sea tossed by the waves for the wind was contrary what a great word right contrary. They were terrified they really didn't have far to go to where they were to meet where they were supposed to meet Jesus but the wind kept blowing them out further out into the ocean and they went in they went to the oars but they weren't making any progress and so it's this is our Of Ages goes on to say until the 4th watch of the night they toiled at the oars then the weary men gave up gave themselves up for lost they just gave up they were done for in storm and darkness the sea had taught them their own helplessness and they longed for the presence of their master at that moment everything was forgotten and they just needed cheese. They had forgotten all the murmuring that they had done before and that storm had give them crystal clear focus that all I need is Jesus the does the story in the desire of ages goes on and it says this Jesus had not forgotten them the watcher on the shore saw those fear stricken men battling with the tempest not for a moment did he lose sight of his disciples with deepest solitude his eyes followed the storm tossed boat with its precious burden for these men were to be the light of the world as a mother tender love as a mother in tender love watches her child so the compassionate master watched his disciples when their hearts were subdued their unholy ambition quelled and in humility they prayed for help it was given them at the moment when they believed themselves lost a gleam of light as a gleam of light reveals a mysterious figure approaching them upon the water but they know not that it is Jesus so interesting here wow they didn't know that it was Jesus they just saw this figure walking and they were scared of it is there so much there right when we see our deliverance that's coming and we don't recognize it in fact we're scared of it that never happens to us in people right where we see something that we're at 1st scared of but it ends up saving us later on I can tell you multiple times that that's happened in my life Jesus came to them in the middle of the night he had been watching them and did you catch this verbiage here as a mother and tender love watches her child so the compassionate master watched his disciples Wow Have you ever seen a mother protecting her young does the term mama bear ever come into your mind I have one of those in my house in our house Mama is the disciplinary and the girls know that if they really want something they should come ask me 1st and see what Dad says. And if they say my room is a mass I tell them you better get that cleaned up or your mom's going to your mom's going to have a conniption And but I would say this if you are someone outside of the family and you have and you mess with one of those girls Oh heaven help you because all fire and brimstone is going to come down on your head and in fact. Jesus watched after them. As a mother in tender love washed her child that's how he watches to praise God So there's this. These are my girls this is from a few weeks ago and so. So there's this one principle at their school who has does not learn from repetition every single He is the one that makes the decision on whether the kids get into the higher level math or the lower level math and each one of my kids has been put into the lower level math because of a single point score on a standardized test and every single time my wife calls and makes an appointment with the principal and he ends up changing his mind after that meeting and you would think that he would learn right that maybe I shouldn't do this by the 3rd one maybe we should just go ahead and put the no and I guarantee you he is thankful that we don't have 4 children. And so. Yeah yeah and so in verse 27 Jesus says Be of good cheer it is I do not be afraid wonderful words of peace and reassurance that he gives the disciples be of good cheer and Peter what does Peter do he does a very typical Peter thing correct he says Lord if it is you command me to come to you on the water it's so Peter here unthinking brash inappropriate the pejoratives could really go on and on with what he's doing the Jesus ignores that and says one word come he answers in the affirmative come on out even though it's a crazy request come on out and what happens next is stated just so flatly in verse $29.00 and when Peter had come down out of the boat he walked on the water to go to Jesus there's no exclamation point there's nothing he just walked on the water and you have to say really come again say that one more time because this is a crazy story that he walked on the water but we keep reading don't we we know what happens in verse 30 it says but when he says saw the wind was boisterous he was afraid and beginning to sink he cried out saying Lord save me it's the same thing that happened earlier with the disciples right he took his eyes off of Jesus and became and became concentrating on the other things the discouragement that was hand that was happening around him and what happens Jesus immediately reaches out his hand and caught him and to say oh you of little faith why do you doubt I am here don't worry I don't doubt I am safe all. And so and I had to ask one question can you see when the verse says he saw the way and we see wind you know see when. He just got distracted and his focus was diverted from Jesus and the results of the wind. So in October of 2015 our family decided to take a short term mission trip and our church in Lexington. Had been talking about taking a trip for several years now and we thought it sounded like a wonderful opportunity and we'd always talked about it our kids were starting to get to the age that where they they could go our youngest was 9 at that point we felt like that was an appropriate age to go someplace you know crazy. And so. And before I tell this story let me just tell you. Our pastor at the time was was Pavol Goa and you may have heard him he was he has since in 2016 he left us and he's now working for the General Conference he speaks at a.s.i. and all over the denomination and if you've heard him speak in the last couple of years you may have heard this story but I would caution you if you've heard the story it'll be from a different perspective and it's probably not the same story that you heard him tell and certainly not with the same flair and so but I'll do the best I can. So Paul was very instrumental and in our growth in our faith and certainly in my growth as a Christian he emphasized prayer and experiencing God in his ministry his stories of experiencing God and God's leading in communist Romania and later here in the u.s. are remarkable and they're all in a book called One miracle at a time the public story during that period I started to say to prayer prayer and it's I said God please let me be involved in leading someone to Christ let me see that happen on a spiritual personal level Be careful what you pray for God answers those prayers every heartfelt prayer gets an answer. Well the opportunity for this mission trip came and our kids were getting to that right age that I talked about and so they decided this trip was to Cuba and so we thought what a great opportunity it's pretty close not a lot of flying involved. It's to a communist country they'll never have the opportunity to see this really again it's in the Caribbean so it'll be warm we'll get to spend some time at the beach it's win win win everything was go and so but before we even left for the trip some things happened that should have clued me in that this was not going to be a typical trip the trip had been advertised that there would be we would be going to these towns that did not have an Adventist presence or of at least a very small had been his presence and so we would be putting on a an evangelist experience and a d.b.m.s. all at the same time and in hopes that this would help to start a church in these towns. So several weeks before the scheduled leaving day we had a conference call where we the teams were going to be divvied up and so I was excited to see that we were in grammar Oh wasn't totally excited because why morrow is down about 8 hours from Havana it's in the very southern tip of Cuba and. And I kind of wanted to see how van I was a little disappointed but so be it but then I looked at below the Weimer own name and I read the names there was only 5 names me my wife and my 3 kids and I said Really I thought we were going to have a team and Mike this team turns out to be us. And I thought my wife has never done this I was supposed to give 12 lectures in 10 days I had never done that I could give o.c.d. lectures but I can't give evangelist sic lectures and so. It was scary and in fact if I would have known that that was how it was going to be I would not have signed up God protects us sometimes from our own fault fail to write so so but it was a little bit late to turn that down I had one and I think when I wrote down my wife and I were shock and we were literally shook we talked about this for a couple of days about trying to get out of this. But I did have one possibility of getting out of this and that's that I hadn't paid the entire feed yet which was pretty considerable right for 5 of us to go to Cuba for the for the for the flight for the chartered flight for the transfers and everything so I prayed about it I said God if you want us to go please provide and I was it this was not a long prayer this was a short prayer because I really didn't want to hear it I was hopeful that none of this would happen. So the previous year I had had my identity my identity stolen and so this had delayed my tax return from getting back to me and so I had had to go through if you've ever had your identity stolen it's not fun and so I had to go through all these interviews and all this documentation to prove who I was and to be honest I'd kind of forgotten about my tax return that I hadn't gotten back from a year and a half earlier and so it came about to a week or 2 weeks before that we were supposed to go on the trip about a week before I was supposed to make the final payment and I open the mail and there's a letter from the i.r.s. and usually you don't like those letters right so but I open up the letter and I looked at it and I said Oh Lord. Really you answer like this there's a check my long lost refund but not just a check to the very dollar for what I owed for that trip and I said Ok God you get you when I give I'm going I'm done. So we went so my wife my 16 year old my 13 year old and my 9 year old at the time there's lots of stories actually on how we got there on the trip there but I'm not going to tell you those because I need to concentrate. On the Story on the on the real stories of what happened so we had some travel delays we got there on late on a Friday evening. There evangelism was supposed to start the next day we're supposed to have a Sabbath service and then an evening service and so we looked at the house it was tiny think think a San Francisco row house so long and skinny really skinny kitchen in the back and eating area then and then a front room and that was it and the front room was a sitting area but it served as the sanctuary for the church and if you open the door and open all the windows and people sat outside it would hold maybe 20 people 2025 people it was tiny. And so I actually wasn't all that sad about that to be perfectly honest because that means fewer people and that was fine and I'd I was good with that I was just kind of rolling with the punches you know and whatever happened happened it was good and just going to enjoy the experience so we had 2 meetings on Saturday a church service which went fine and then we have an evening meeting where we had 15 to 20 people that showed up and then we had about 5 or 10 kids from my wife's c.b.s. program so but there was something happening and why morrow at the same time and that's that it was carnival and if you've ever been around Carneval it's a big party it's a huge party and so right at the intersection where the house church was directly diagonal was a nightclub and so the the guys the locals that we had met that were helping. Yes do this meeting they had rented out some speakers some speakers. And so. To play our praise and worship music and to create some street attraction so that maybe some passer bys might want to come in and so you hear our praise and worship music playing and we're singing and then from across the street you hear the techno beat of the boom boom boom of the dance music and they kind of started a little competition our guys would turn up the sound just a little bit and then their guys would turn up the sound a little bit pretty soon both sound systems were maxed out in this intersection it was the great controversy right there right so and I say that in jest but really probably was right there was a change was around us and there was a evil angels around them oh shoot. And so our meeting went fine we went back we slept for the night and and we got up the next day we came back we had breakfast we had worship we just kind of hanging out planning the day planning some visits and what we were going to do and there's a knock on the door you know I've lost my place. And so and who is at the door a couple of police officers and so the locals come and they go and talk to the police and the Americans Me and my wife we kind of go to the back and we're going to hide and not kind of just look around the corner what's going on and we could see the conversation lots of Spanish you guys have been in rooms like this where the Spanish is flowing and it's fast and they're agitated and all of this and we're like from is going on in this isn't really good and so so they finish their conversation and they come back and they tell us or shut down and I'm like what shut down what does that even mean and so well apparently the organizer of the trip had gotten national permission to have these meetings but we did not have local permission from the local police department to have these meetings and they said if you continue to have people gathering in the house you will be arrested and you're gay and your guests will be arrested. Got I wasn't ready for this I can tell you this is not this is not what I had in mind for my mission trip where I was going to the Caribbean to seek an Cuban culture and hang out at the beach and do some good for you but then go home this is not what I had in mind at all. And it was a little chaos at that point in the house the Spanish folks the Cubans were all talking rapidly with what's going on and in being my wife are kind of talking in what's happening and we started making phone calls so we called to the local pastor we called to the district pastor we called to the conference people we called to the seminary folks in Havana who can you talk to to allow us to have our meetings we've traveled all the way here we don't want to waste this 2 weeks that we're here and so lots of conversations over a few hour period but the at the end of the day there's nothing they can do they are canceled we're going to get arrested if we start if we continue to have the meetings so we're really disheartened we're focusing on the discouragement of the time and so. I think to myself well I want to salvage this week at least for my kids at least so that they have a good experience and not this bad taste in their mouth so I call Pavol and he's in Havana and I Pavol can we come in do let us just come and help you and we'll just come to speak with and with with you and Paul says note in his Romanian and I'm like what dude you drug me all the way out here and you're going to leave me out You're leaving me out to dry do what I got nothing to do here I want to get arrested and he said God sent you to work there you better stay there and work and he said You better pray and he's very emphatic and Paul is very persuasive and he really should be a car salesman and oh I'm sorry this is on audio verse. And so but he was very persuasive to me and we had prayed but we hadn't really prayed we hadn't done the really heart searching so I said Ok let's pray and so we gathered all the people all of our team and shoot and. So we prayed the rest of the afternoon and we really poured our hearts out to God and we said God why are we in the situation you need to help us and not just us but the local volunteers they had given up time at their jobs with their family to come and volunteer for these meetings there's probably 10 of them that had done that and so we told God all of this and we said God please start to work for us. And he started later that evening after our prayer session one of our team members were out in the street walking around doing some shopping for some food for the next day and a police officer one of the police officers that had been at the house came up to him and he said you know the reason you can't have your meetings is because you're not in an established church if you were in an established church we couldn't have shut you down ding ding ding ding ding light bulbs so maybe we could find a church in the city that would allow us to use their facility maybe if we go talk to those pastors the lawas to rent from them you know it's not it's a small chance but it's a chance you know so we so said Ok let's pray about that so we prayed about that the next day we go out and we talk to them there's not really very many churches in the city it's communist Cuba right but there are a few so we got to talk to all of them we visit with a Baptist pastor 1st and he says nope sorry we have services all week and it's busy so you can't really use our facility and then we go we talk to the Pentecostals Nope sorry the person in charge isn't here you need to talk to the district pastor they won't be back for a week and then we went talk to the Catholics there was no chance that we were going to be meeting in that church I care and to you that after that conversation so. So I said Look I called Pablo back and I said there is what we did we prayed we had this idea but it's not working out can we come talk with Can we come share in your meetings no you cannot come here you better pray again you better go pray some more and so I went and so I went and I and we prayed some more and we said Lord let this work out Lord make work for us please give us a place we want to have these meetings and so the next day or later on that day the Baptist pastor came back to us and he said you know like our stuff isn't really starting for a couple of days if you want to have your meetings for a day or 2 that would be Ok you can do them that well it wasn't really the answer that we wanted but praise the Lord we could have a couple of meetings and so we decided let's do it so everybody kicked into action and we're going to hurry up. And so. We start making visits and phone calls and we went over to the church and visited we were happy because it was actually a real church it held about 100125 people and it had speakers and it had a screen it had all the stuff that we needed and so we were excited so the next thing I had to do was figure out we'd missed a couple of meetings because of the delay and so I had to redo the the the the order that I was going to present stuff and I said well if I want to talk about everything that I want to talk about I need to talk about Sabbath so we're going to talk about Sabbath that evening and so. And so we showed up so we showed up that night and and it was it was actually decent sized crowd we had probably 30 people or so that were there more kids that were there for Deion's for Deion's group and and so I got up to speak and I looked out over the audience and I said. There's a Baptist pastor I'm going to talk about Sabbath and I thought to myself how is this going to go over. And I shot up a quick prayer and I said Lord you inspired me to do this I'm just going to do it anyway and I'm going to say what I had planned to say and I did and it seemed well received by the audience it actually was and I couldn't really read his facial expression he kind of had a poker face on and it was fine so nothing bad happened there was yeah there was no scene or anything but after the meeting I was we were cleaning up getting ready to go and my translator and I were standing there and I saw the Baptist pastor eyeing us and he came over and said Can I talk to you guys for a minute and I was like oh no the foot is about to fall and he started talking and he said you know what you said from the Bible was good and it was prayerful and I think it was the truth and he said you know why don't you guys have the rest of your meetings here the rest of the week and so he gave us their facility to have our meetings there for that week and into the weekend in his long as we wanted to be perfectly honest and so we had a place so we went back and we had a prayer meeting really really prayed because we had a prays meeting that night afterwards and so we were so excited and so. Fantastic so we went back and we showed up the next night for a meeting and I walked in and it was packed every seat was full there was people everywhere Dion had brought 100 sets of crafts and things and she thought I'll just use a few of them and I'll leave them with the kids to use they can use it for the next year at their little church she used every single one for those kids and what had the Baptist pastor done he had gone and invited his congregation to come to these meetings Lord I am humbled I am really humbled at this point because I wanted to have a vacation I wanted to just have an experience and see Cuba but you wanted to do something big and you had me go through this storm to get there thank you Lord for doing that so one more and then I man I'm sorry I'll be done her quick Ok all right all right so so the meetings finished we got to the end and it came time to settle up with everyone so you have to pay the taxi drivers you have to pay for the food you have to pay everybody and so we were so Dion had been in charge of the mission money and she had kind of kept track of that and so we went back to our room to divvy everything up and she started spreading out all the money on a on the bed and I was kind of over on this side kind of getting ready for the evening meetings and she was making piles of money for this person for this person for this person and I saw her and she started to get a little agitated and she started counting things over and over again and I was like what's going on and I didn't say anything but she I could see her I could see that happening her accounting and finally she came to me she said Pete did you get the money it's always my fault did you get the money our personal money confused with the with the mission money and I said I don't think so and I went and I opened up the packet my backpack and said No here's our personal money right here. And here's the emergency money Paula giving us some emergency money that we were if we didn't spend he said Don't spend it but if you have to spend it but if not we're going to give it to the pastors So it's like Ok sounds good and so and we had a touch that I still had all of that money right there and she looked at me and she said we have 2000 extra dollars and I said what she said I kid you not we have 2000 extra dollars that I don't know where it came from and so and Pavol tells a story like this in below that kind of didn't go down and he kept giving and really that's what it was we don't have the envelope anymore the envelope is gone but we had 2000 extra dollars And so with that money we were able to give each person that volunteered double and we were able to buy them a refrigerator the church was cooking for 20 people and they didn't have a refrigerator so we were able to buy them a refrigerator we were able to buy them an oven and oven is a cook just a pot warmer it's not it's not much but we were able to buy them and an oven is what the 3 of us actually And so we were able to do all these things because of that extra money God is good right he is faithful loaves and fishes loaves and fishes He multiplies praise the Lord and so. I wrap up quickly. So on the way back we did we finished the meetings we had some baptisms I got to see that and I was involved in that. Lord answer that prayer and. And so we were on the flight back from Havana to. Miami and I was looking out over the water and my thoughts were troubled and I actually just started crying and weeping and I said God I'm not the same I'm different today. Why is that. And the answer came to me that I had seen Jesus and I had seen Jesus working in a real powerful way and it upset me because. Because I had seen these people volunteering that had come in and I knew in my heart how many meetings that I had missed because I was tired or because there was a ballgame or be some reason that I didn't give my full effort some type of evangelist to meeting and yet God used those people who gave everything and so and I really resonated with what Brian said the other night. Last night when he talked about. We have all these resources and we're supposed to use them you know and I went through all the data and I actually looked at it and calculated the odds that you know there are 7700000000 people and in the world there's only $325000000.00 in the United States and every one of us in this room are part of the one percent of the highest level of income in the richest country in the world our odds are much more likely that we would be born in India where there's 150000000000 people or China where there's 150000000000 people our odds are much greater to get born in the in those countries where that standard of living that the what you make per month is way lower in Cuba they live on $20.00 a month you know I have a I have a vice and that vice is coffee because of it's just is it's just is what it is I know I'm at a man and I'm talking about that but I tell you. I spend more money on coffee than what those people live on and that hippie and I said wow Lord I have a responsibility for that I really do have a responsibility for what you've given me and I will never mail it in to an evangelistic meeting again I promise you that and that's what I thought as I was driving as I was flying back the other thing that I thought was this so I got to tell you the story. So we talk about that responsibility so one of the translators Hey Seuss. It's amazing that his name is a Seuss but so they would walk us to our living complex and back each day in fact 2 or 3 times a day because they were worried about our safety and so he says would walk with us and so one day I was walking with a Susan's about a mile and a half walk or 2 miles walk so it's half an hour time to talk and so we were chatting and he sues is an electrician in Cuba and but he can't practice he can't do electric electrical work on the open because he's a Sabbath keeper and so because he's a Sabbath keeper he has to function as an electrician underground he can do jobs but it's always underground and so we were talking and chatting and whatnot and he said Pete what does an electron What does an electrician make in the United States in my heart kind of sank actually because I knew what he made and we had just had our kitchen redone and I had to hire an electrician and I know what I paid him. And I knew that that electrician made more in an hour than his Sushma made in a month and so I just kind of him to hard and I really didn't answer his question and I just kind of tried to make it go away he says would not let it go away he was very direct and he said No How much do they make and so I had to tell him I said well I paid my guy $40.00 to $50.00 an hour to come in to work for me and you know and he looked and I thought I thought oh this is going to be bad this is really going to go over poorly and he looked at me and he thought for a moment and he said you know what that's Ok because I have Jesus. And I thought to myself so might I have to read you this 1st. So you've read Revelation 3 Revelation 317 right this is we're talking talking about Laodicea and have ever thought about the juxtaposition of being the remnant people and yet living in the time of Laodicea and how those 2 things go together I'll leave that to the theologians to figure out but those 2 things how they work so it says because you say I am rich and have become wealthy and have need of nothing and do not know that you are wretched miserable poor blind and naked that's describing. So we think that we have all this stuff that we have all these things to give and yet he says we're poor and blind and wretched why because sometimes we don't have Jesus we can have all the stuff in this world and not have Jesus and we don't have anything. That day was a way richer than I was. And I miss that. And I said I want to have Jesus because it doesn't matter what you have so sometimes we do all this mission work and we go we do good things we we do surgeries and we give our glasses and we take care of people and it's good but sometimes those people are the missionaries to us because we need to have Jesus. That's what I discovered that today and that's why I'm different Let's pray Lord I thank you so much for your love and I just thank you that you showed me that during that trip and I thank you that I will be different from that day Lord be with us today as we continue to talk and help us to learn help us to grow help us to be more like you each day in. This media was brought to you by audio 1st a website dedicated to spreading God's word through free sermon audio and much more if you would like to know more about audio verse if you would like to listen to more servant leader visit w w w audio verse or.

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