One day, 35-year-old Randy Umble felt fine.

The next, his big toe hurt.

Sixteen months later, he had a kidney transplant at the Hospital of the University of Pennsylvania in Philadelphia.

"It was all so random," said his wife and kidney donor Melanie Umble, 34.

"I don't know what happened," he said. "I had no risk factors."

Now the couple and their children — Johnny, 10; Natalie, 9; Erik, 7; and Katie, 5 — are looking forward to returning home to Shell, Ecuador.

Umble, a missionary for HCJB Global, Colorado Springs., Colo., teaches children of American missionaries at Nate Saint Memorial School, in Shell.

"Obviously we're excited to get back," he said. "We've been out of our home since the beginning of December. It's been really hard on our kids. It's been very difficult."

They hope to depart as soon as the doctor gives him a clean bill of health, which may be as early as August or as late as October. In the meantime, they are residing with his parents, Richard and Ruth Umble, in Atglen.

Also, they long to be reunited with their two foster children, a boy and a girl, both 2, whom they had to return to an orphanage when they left the country.

"It's been overwhelming," Mrs. Umble said.

Ecuador is her home. She was born and raised in the South American country, where her parents and maternal and paternal grandparents were missionaries.

Umble, an Atglen native, graduated from Lancaster Mennonite School in 1993.

He grew up in Atglen's Maple Grove Mennonite Church. This summer, the congregation raised close to $10,000 to supplement his medical coverage.

"We still haven't received the bill,"  he said. "We don't know what it will cost.

"But I'm not worried about it. I remember one time when I was worried, and I was reminded that God will provide."

The couple met as students at Moody Bible Institute in Chicago and  shortly after graduating in 1999 were married in Ecuador.

They served there two years as short-term missionaries before becoming full-time missionaries in 2002.

It took close to a year for doctors to accurately diagnose Umble's kidney failure.

At one point, he was prescribed medicine that made him worse. In a month, he lost 20 pounds.

Throughout the ordeal, he continued to work.

"My hands would be shaking, he said."

"He was cold," his wife said, "which was odd because we live in a jungle."

Doctors continued to reassure him that his problem was not serious.

"But I was going downhill so fast," he said. "The Sunday after Thanksgiving, I had to lie down. I had no energy."

His wife insisted he go to the hospital.

"That probably saved my life. I received 5 liters of fluids the first day, I was so dehydrated."

After weeks of dialysis to try to stimulate his kidneys, doctors finally told him he needed to go to the States for a transplant, which was performed in April.

Mrs. Umble always assumed she could be a donor, but when tests showed she was a match, medical personnel said it was a miracle.

Without a match, Umble would have been on a five- to seven-year waiting list.

"It was scary, but I knew it was what I wanted to do," she said. "The recovery was painful."

His recovery was easier because his incision was smaller.

"They don't take the old out," he said. "She was well and went to sick. I went from sick to well.

"I remember coming out of anesthesia and being so thankful. I asked a nurse to deliver a thank you note to Melanie.

"I felt so much love. I was just overwhelmed by her gift."

Every day, he said, he is able to do more.

"Dialysis kept me alive, but I could not give my kids piggyback rides. Now I can. I'm very thankful."