Sunday, February 11, 2018

From Kimberly today!


Hola!  My name is Kimberly—I am a third year OB/GYN resident here helping out Dr Bell on her missions to this beautiful mountain town.  Today was numero 3 of our trip!!!  I have always loved to participate in mission activities and having been to Guatemala before, I had an idea of what a difference we could make.  The last time I participated in a mission trip here, I was a medical student.  Now as a resident, I am so happy to be able to make even more of a difference.  My team and I have been super busy seeing patients in clinic (up to 30 per day!!) and filling up the OR (shoutout to Alma—our amazing scrub tech).  It has been nothing short of awesome what we have been able to do together.  And I mean together.  I am so so so blessed to have such amazing mentors helping me mature as a physician and surgeon as we operate on such inspiring patients.  I love rounding on our little ladies and getting to know their families.  Speaking of—it’s getting late and we have a full day tomorrow.  Lots of patients to see!  Thank you for your prayers and blessings on our team on our last day here!

Saturday, February 10, 2018

Meet the Team (Sorry; out of order!)

Some of the longer-time readers may remember Dr. William “Skip” Johnstone, who first joined me on a trip back in February 2016.  He was an attending physician at ECU (which is where we met) for a bit and is now in Wilmington teaching the residents there and fighting the good fight to keep the art of vaginal surgery alive.  He is an amazingly talented and experienced surgeon, and I love both learning from and working with him.  In 2016 on the trip, it was his first experience with anything outside of the United States that wasn’t a resort location.  I had the amazing and rare privilege of watching his life change before my very eyes on that trip, as they were opened to a whole, bigger world than he had simply ever known before.  Since then, he has LED two surgical mission trips to the Dominican Republic in addition to re-joining me on this trip! And all of this God has done in a man who hates to fly, folks.  Just imagine what he could do with you…

One of the third-year residents in the Wilmington, NC, program, Kimberly Hildner, is also along on this trip.  I’ve been so blessed by a constant flow of residents from this program since back in 2015 when I initially reached out for help with the trips.  All of the residents have been awesome to work with, and I’m sure Kim will be no exception (no pressure, Kim!)  She is originally from Florida and hopes to move to Denver, CO, after graduation next year to practice a full scope of obstetrics and gynecology.  I look forward to getting to know her better during the week, but am already excited about her heart for Guatemala—she has spent some time here as a fourth year medical student, where she is excited to go back and visit after we finish up our surgeries later in the week!  It’s so cool to hear other people’s experiences here in “my second home”, and it’s nice to have someone else along that can function as a tour guide of sorts.

While spending six weeks here as a fourth year medical student, she was able to travel quite a bit while she was here—but the one place on her list they never made it to?  Chichicastenango, of course!  What a great opportunity (that’s where we are now). 

Our morning got off to an early 4 am start at the RDU airport, followed by two flights with a layover in Miami.  Then the drive from Guatemala City to Chichicastenango, where we will lay our heads for the week and work.  Our little hospital, The Good Samaritan Hospital, is ready and waiting for us to start up clinic tomorrow morning, so it will be the first of several long days.

Skip has requested to write the rest of the blog tonight, so I’m nervously handing off to him now…

Heidi speaks the truth and is very passionate about her role in helping the women of the region who need surgical care. As she so eloquently stated, my life changed when I made my first medical mission trip with her in 2016. I always ASSUMED, and probably correctly, that if I took a week from my practice back in NC and operated on women in need of surgical care but who had no way to pay that I’d be extremely busy. However, my first trip with Heidi opened my eyes to the fact that NC poor and third world poor cannot compare. The profound living conditions of the indigenous population in third world countries is almost unimaginable, yet when you offer to help them, their gratitude and appreciation is all I need! The patients are cared for by their families and they go home after major surgery on Tylenol and ibuprofen and are thankful and smile a lot. Selfishly, I get more out of what we do here than the patients I think. I am looking forward to a great week with my colleagues doing what we do best for a population in dire straights. Thank you Heidi and Agape in Action for allowing me to be a part of a great mission!

From Skip's Heart (Thanks for the Guest Authorship!)

Our day is winding down after a marathon clinic at Good Samaritan Hospital seeing prospective surgical patients. The Mayan women and their families are very patient. We started at around 8:45 and finished around 8:00 this evening. 32 women were evaluated, treated, and 9 were scheduled for surgery. We have several operations scheduled over the next few days and will be busy but our patients will be much better and back to their daily normal activities soon. We are exhausted but in a satisfying fashion. I am always reminded of mercy, God’s mercy, when I come in contact with these women and their families. Their families, by the way, are so caring, supportive and participate in their care and recovery. They do it with style and with sincere love, appreciation and support. We learned so much today from the interactions with the patients and their loved ones. We learned patience, compassion, out and out honesty with no secrets, faith-faith in our ability as well as in their belief in a mighty power, trust- in us and the blessing of God, the power of a smile or a laugh and the power of a touch, a human touch. We ask for your prayers for us as surgeons for agile, healing, skillful hands and prayers for the quick and full recovery of our patients.

Dr. Heidi has had a most eventful week thus far. I was amused by the fact that she volunteered to check her carry-on in Raleigh through to Guatemala City but failed to pick it up at baggage claim. It has been entertaining watching her make call after call to American Airlines who has now issued a statement informing Dr. Heidi that  they will make a one time exception and deliver her bag to Chichi tomorrow. Tag the bag and your finger Dr. Heidi!!! Don’t forget the bag! Secondly, she arrived in Chichi with a horrendous cough. After clinic this evening, she experienced an ill timed coughing spasm and has pulled a muscle in her lower back. Poor Heidi! We will support her and care for her and pick up the slack. To top it all off, she somehow managed to microwave her tea this morning with a set of keys still in the microwave~  Mind you, she and Tom have used the “leave the keys in the microwave as you come or go” system for the last almost ten years, so that statement is not as weird as it sounds.  Luckily, it seems the vinyl and leather wallet keychain thingy that they were in seems to have saved them from actually combusting.  So there’s that.  Feel better Doctor!  And also, please try not to burn the place down?

More to follow. For those of you reading this blog who are not a part of any missionary work, listen to me! I am very new to this concept and, in fact, I shunned the idea for years! Believe me, I had many opportunities and requests, but felt that I should care for women at home. I finally gave in and accompanied Dr. Heidi to Chichi in 2016. My life changed in 24 hours and I realized that the needs of women in third world countries far exceed the needs of women in the US. So, I ask you to involve yourself in some form of missionary work. Agape in Action is a great choice. Time or cash! Remember, Jesus tells us that what we do for the least of my children, you do for me. Think about it. Double shot. You do for Christ and your fellow man!

Let us know if you want any further information about how to get involved~  sending money, of course, is pretty easy.  Unfortunately, you will find that most missionaries have learned to kind of dread the question, “what do you need?”—because the answer is pretty much always “money” and missionaries HATE asking for money!  So if you ever want to make a missionary’s job easier, that’s how to do it.  But also, please don’t ever, ever, ever forget or underestimate the power of prayer.  Every missionary—definitely including use this week!—covets your prayers and appreciates them more than you will ever know.  Let’s go change the world together, folks!

In Christ~

Tuesday, October 17, 2017

Day Two in the OR

So Day Two in the OR, Day Three in the clinic today, and all is still well.  We are thankful that both Chris and I continue with good health and good energy levels, as there is still plenty of work to be done!  All four of our operative patients from yesterday looked great today, including the one that we lost nearly a liter of blood on.  We were thankful that she started out with a great hemoglobin, so today she was still doing well and it doesn’t look like she will need a blood transfusion.

That is a particularly good thing, since both Chris and I gave a bag of blood each to a lady who DOES need probably at least four bags!  We are giving three of them tonight BEFORE her surgery tomorrow, to remove the uterus that is causing her to bleed to these levels!  She saw the local gynecologist who works at the hospital a little over a month ago for the same problem.  Her hemoglobin was just as low then, but he recommended that she wait and see us since she could not afford to pay him to operate on her.  Sigh. 

I understand that everyone is not a missionary, and that everyone has bills to pay.  But he could have at least sent her to the government hospital to try to get her surgery sooner at a hemoglobin that low!  Or had her get blood donated and transfused in the meantime!  That would not have cost him anything but a little bit more time to explain and write an order.  But some folks just aren’t interested.

On a brighter note, we sent two ladies home today looking great on post-op day one, which was definitely a plus since we don’t have many more beds here!  Tom has some anesthesiology friends from back home that got in this afternoon, so we are planning to run two ORs tomorrow and we are filled up with cases in both—it’s a lot of patients and not a lot of hospital!  We will continue to pray that everyone does well and can go home on time or early this week.

Clinic has remained interesting.  Today we added yet another abdominal hysterectomy on for tomorrow, for a grand total of five of those this week.  We’ve seen the usual variety of belly aches, cysts, and a scattered pregnancy or two—plus a lady today who has pain only when she worries about things (yep, you guessed it—diagnosis is depression/anxiety), a lady who cried with relief when we told her the lump she has in her breast that she waited 14 months to seek care for is almost definitely NOT breast cancer (but we will definitely take care of it with Tom’s help!), and a lady whose prolapsed lady parts we fixed back in July but who now says her feet swell when she tries to walk very far—only since the surgery, of course.  What do you say to that—“sorry we fixed your vagina, but broke your feet?”


Anyway, tomorrow will be another long day in the OR with three major abdominal cases and a minor procedure to do, plus some return patients in clinic or referrals.   Hopefully we will get out to Canillá on Thursday. 

We will leave you with some pictures that we had to have the circulating nurse take in the OR, plus one of Chris braving the HUGE needle used for blood donation here in the ER!



Sunday, October 15, 2017

Brief Clinic Summary


So we just finished clinic at around 8 this evening, which quite frankly is a minor miracle since we saw 28 patients in just under 11 hours!  Told you Chris and I make a great (and experienced!) team ;-)  We are now exhausted, however, so here’s a quick summary:

First some stats:
·      28 patients
·      9 surgeries scheduled
·      ZERO “vag-a-thons” (so weird)
·      FOUR abdominal surgeries (pretty sure that’s more than I’ve EVER done in one week)
·      Only three that had fully non-gynecologic issues (although in fairness, one was told by both one doctor and one lay “midwife” that her uterus might be the cause of her back pain and leg falling asleep!)
·      A full FIVE patients who were told that they needed surgery by Guatemalan surgeons but had absolutely NO indication for surgery that would have ever been operated on in the US. 

This last problem is a perpetual one and one that makes me crazy.  It’s also a very time-consuming one in clinic, as it takes a very long time to explain to a patient why they do not need a surgery that “everyone” tells them they do.  They feel they are being turned away from what “everyone” recommends to them as a great opportunity to get their surgery from us.  Occasionally it’s a judgment call where it is at least not INadvisable to operate, but unfortunately it’s often something where we would have flunked our oral boards if we had tried to defend the surgical management to our mentors back in the day! 

It’s just so frustrating and saddening and maddening what these patients are up against sometimes.  The tiny little drops in the bucket we make of help while here seem so insignificant, but we continue to trust in God’s plan and goodness, and in the power of prayer and The Gospel to affect real change.

Now back to the lighter side—I did, as always, have a few more “firsts” again today, and here they are:

·      Had to get a patient’s husband on speakerphone during the surgical consent because he has been in the US for the last ten years.  At least he is still involved and sending money!
·      Had a patient’s husband ask if there was anything he did “wrong” during sex that caused her fibroids—such a sweet and concerned guy…

·      Had to wait for one patient to finish her call on her cell phone so we could pray for her.

I'll end with a couple of pics that Chris snuck in during clinic.  One is me giving my pre-clinic shpiel about "please be patient; we won't turn anyone away, and no one needs to be fasting, and Jesus loves you".  One is a super-sweet grandma that we couldn't resist taking a photo of.  Pray that she gets a large mass in her chest taken care of so that we can take care of an uncomfortable gynecologic problem for her in February.