Ryan Lim threw up a litre of blood. One whole litre.

Pressure from his distended liver drove blood up his oesophagus and forced it out of his body. The 15-year-old cried in terror. His parents’ hearts bled with grief.

Ryan was diagnosed with autoimmune hepatitis when he was five years old. He was a healthy child playing childish games with his childish friends until this affliction. Suddenly, he was in and out of hospitals drawing blood, taking tests, downing medications.

Medication has offered Ryan a relatively normal life in the last several years. However, pancreatitis hit him in early 2021 and complicated his medical condition just as he entered secondary school.

He suffered frequent acute pains and was often doubled over in agony. Being in and out of hospitals just as he entered secondary school, he hardly made any friends.

In July that same year, Ryan was diagnosed with primary sclerosing cholangitis – a rare disease attacking the bile ducts – which eventually led to liver failure.

Ryan needed a new liver.

The news devastated Ryan’s parents, Lim Cheng Kwan, 47, a coast patrol officer and May Lim, 48, who works part time at a bookshop. Cheng Kwan was so focused on Ryan’s condition he forgot to seek God.

“I was so lost I just couldn’t do anything,” Cheng Kwan told Salt&Light. “I just cried and asked God ‘Why?’ But I did not go before God to ask what His plan was and what to do.”

His cell group leader Ng Yong Siong, 53, who had been leading them for the last five to six years in Covenant Evangelical Free Church (CEFC) in Woodlands, reminded him to shift his eyes from fear over Ryan’s situation to God and His promises.

Cheng Kwan quickly realigned his focus back to God and determined to leave Ryan in God’s hand.

“I surrender Ryan to You, God,” he prayed. “You can watch over Ryan at all times and by all means.”

May said: “During this time, we learnt to walk by faith, not by sight.”

Living with pain

Following Ryan’s discharge from the hospital for cholangitis, he suffered that whole year with recurrent stomach pain and fever and had to return often for checkups.

His doctor had to suppress the condition four to five times during the year due to the failing liver. Ryan attended school via Zoom.

Ryan enjoys life despite his failed liver.

Meanwhile, the necessity of a liver transplant was hovering at the back of their minds as Cheng Kwan and May sought God for the best timing to do so.

This May, however, Ryan’s belly and both legs were severely bloated from fluid retention caused by low levels of albumin, a protein in the blood that transports fluids.

The liver transplant for Ryan could no longer be held off.

The National University Centre for Organ Transplantation (NUCOT) moved Ryan to priority one for a liver donor.

Despite the dark times, Cheng Kwan and May, as well as Ryan and Beverly, his 29-year-old sister, never failed to see the gleam of God’s goodness. 

“We had been asking God when we should have the surgery and are thankful it is at a point when Ryan is still well and not critically ill,” Cheng Kwan said. “We thank God He exposed it in time.”

The entire family had their livers tested for suitability. Cheng Kwan had privately pleaded with God to let him be the one to give a liver to Ryan. 

“Just as You sent Your Son to save the world, please send me, Your son, to save my son,” Cheng Kwan had cried out to God.

God answered. Neither May’s nor Beverly’s liver was found suitable. Cheng Kwan’s liver was found to be a match and the surgery scheduled for 12 July.

But another blow struck the family just before the surgery. A final test on Cheng Kwan’s liver revealed an anomaly in his blood vessels that was so tiny it had escaped detection in prior tests. Proceeding with the surgery meant a heightened risk of significant blood loss that could claim Cheng Kwan’s life.

The world collapsed for the family that night.

Cheng Kwan was shattered. He broke down and cried to God, beating his own liver, blaming himself for not being able to help his son. 

Ryan sobbed his heart out when he heard the news.

“This was the first time I saw Ryan really break down,” Siong said. “He had been so strong for his parents.”

The family, however, recognised the grace of God after the initial wave of sorrow receded.

“We thank God the doctor found the tiny vessel just in time,” said May. “Otherwise, I might have lost both son and husband. I felt peace. I didn’t blame God.”

The cost of love

Following the night of crushing disappointment, three pastors from the church met with the family to encourage and pray with them.

“We really felt the love,” Cheng Kwan said.

When the church found out plans for the liver transplant surgery had been scuppered, several members stepped forward to offer their livers as potential donors. 

“We sent out a simple call for prayer to the church family that a suitable donor would found,” Pastor Sandra Chi, district mentor at CEFC, told Salt&Light.

Ps Sandra had been in close journey with the family through this situation. “I was awed and deeply moved when I realised three of our church members had privately contacted the family about being a donor. At that point, we had not asked anyone to consider being a potential donor.”

When Reverend Dr Chua Chung Kai, the Woodlands Centre Overseer of CEFC shared the thanksgiving with the church family the following week, more members of the church began to contact Cheng Kwan about being a potential donor.

“Perhaps they realised, as Pastor Chung Kai put it, that they could be the answer to their own prayers,” Ps Sandra reflected. 

So far, 13 have volunteered to be living donors, though four have been rejected and the remaining nine are in the roster of tests by NUCOT.

Lim Mee Yean, 55, a family friend and fellow church member, stepped up without a second thought.

May had, in fact, urged Mee Yean to first pray as it was a major surgery with significant costs involved with the tests. Potential liver donors had to go through a series of up to six tests, each costing about $600. 

“Yes, it is costly but life is more important,” Mee Yean replied.

She went through two rounds of tests before she was taken off the list. 

Siong was also one of the 13 to come forward. He has been walking with the family on their faith journey since they started attending the church. Siong has completed initial tests and is scheduled to proceed to the next stage. 

The family – (left to right) Cheng Kwan, Ryan, Beverly and May – has grown in faith over the whole ordeal.

Tina Chang, 55, has never met the family, but was grieved when she heard of Ryan’s plight from the pulpit .  

“Ryan is not my family by blood but he is my family in God,” Tina said.

Although Cheng Kwan did offer to help defray the costs, she assured him that God would provide financially and physically.

Tina was especially burdened because Ryan belongs to the next generation.

“He will go forth and win his generation for Christ,” she said firmly. “Ryan is strong in his faith. He never asked ‘Why me?’ It was a wake-up call for me and I hope it’s a call for everyone, especially the children and youths.”

Tina is awaiting her test results.

Another volunteer, Rachel (not her real name), happened to attend the Woodlands centre of CEFC on the Sunday morning when the pastor shared about Ryan’s need.

“As long as there is a need, I can’t just sit back and ignore it,” Rachel thought. She got her parents’ blessing to go ahead and contacted Cheng Kwan.

Rachel had committed herself to missions as a calling and believed that the cry “Here I am. Send me” (Isaiah 6:8) was not limited to missions, but to any area to which God was calling her.

“All we have to do is be willing for God to use us as His vessel,” she added.

“It is a testament to God’s transforming work in our lives that different ones would consider such a big sacrifice to someone totally unrelated to them,” Ps Sandra reflected. “It involves financial cost, time taken for comprehensive testing, and, of course, health risks through the transplant surgery.

“Yet, when God prompted and convicted each of them, they answered the call with what I believe was a response to God’s own sacrificial love for us.” 

NUCOT has now stepped up tests from two donors at a time to three, and has advised the Lim family to garner support from more donors.

Light in the darkness

Throughout this ordeal, the treasure that stands out in this darkness is the beauty of the Lim family’s faith, especially Ryan’s.

Despite his enlarged liver, discomfort and the shadow of uncertainty looming over his life, he has been serving quietly and faithfully every week for the past year on the audio visual team at the church.

He is still smiling and “doing fine” he said. He visits friends and family to share what God and his church is doing for them.

When asked by his pastor how the church can pray for him, the teenager said simply: “Pray for peace and that I will be faithful to Jesus.”

“That is amazing from a boy that age in that condition,” Siong said. “Ryan has always tried not to worry his parents too much. He would remind them not to be distressed.”

Although the disappointment from the postponed surgery was massive, Ryan said he believed God was giving him more time to prepare himself mentally for the surgery.

“I know God is still in control,” he proclaimed.

Despite his failed liver, Ryan has been serving quietly and faithfully on the AV team.

“I talk to God more now – before this, I only prayed before meals and only when I needed help,” Ryan admitted.

“But now I pray more and tell Him all my problems.”

Ryan’s sweet and simple faith reflects the faith of his parents.

Before this adversity, Cheng Kwan had been fighting his own demons for 20 years. The year before they found out Ryan needed a new liver, God had set Cheng Kwan free from the grip of adultery. The men in church had journeyed with Cheng Kwan through the ordeal.

He rebuilt ties with his family, built his faith and began to take spiritual charge in his home – leading family devotions, studying God’s Word and praying together with his family. Had God not delivered Cheng Kwan from his stronghold, the family would have found it difficult to make it through this trial, said Cheng Kwan. 

The family has learned to lean on God’s Word and His promises.

“I trust that God dealt with me first, as He knew we had to deal with the next level, which was Ryan’s medical condition,” he said.

May, a self-confessed nominal Christian before Ryan’s health difficulties, said she learned to draw close to and depend on God to lead her through these rough times.

The scrapbook reminds the family of every step of Ryan’s journey and God’s presence with them.

Together, the family learned to lean on God’s Word and promises.

Each day at the hospital, a word would pop up that would encourage and comfort them, said May.

During this season, the verse they cling to is 1 Peter 5:10: “And after you have suffered a little while, the God of all grace, who has called you to His eternal glory in Christ will Himself restore, confirm, strengthen and establish you.”

“We believe the suffering won’t last forever,” Cheng Kwan said simply.

He has compiled a scrapbook of the journey as an honour to God and His faithfulness towards them.

“So, yes, we are still looking for a suitable donor but we cast this to our Father because He knows best,” he said.

“He knows which is the best liver for Ryan. We can just let go and let God because we know He will do His work.”

If you would like to help the family financially or as a liver donor, you may contact Cheng Kwan at +65 9768 4748.

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