Monday, November 15, 2010
Friday, November 12, 2010
Our clinic room... looks just like your OB/GYN's office, right? (Well, maybe except for the fact that they usually change the bed covering there more than once every two days or so...)
"Meet the Team", continued... (Sorry, these keep kind of posting in random order and I'm scared to mess with them once I finally got them up successfully!) This is Pat with Dr. Calvin Williams, his wife Latrice and daughter Brittany, from the St. Louis area.
Another couple of views of the operating room, for those who haven't seen it before...
The next one was supposed to be posted last Sunday or Monday, as a "meet the team" picture... Heidi Bell, Cyndi Lawton, Keith Nelson, and Pat Peabody (with a little cameo appearance by my three-year-old, Isaac, there in the front)
And an "action shot" in the operating room-- fairly modern for local standards, but it probably looks a little bit different than any operating rooms any of our readers have been visiting lately!
I will report briefly that all of our patients were doing very well at my last checks on them, and I am grateful to Dr. Nelson and Dr. Lawton for finishing up rounds on them in the morning and likely discharging them all since I have come out to the Fickers's farm to fly out to do a little bit more jungly-medicine in the morning.
Also some quick follow-up on our cervical cancer lady-- she did go home yesterday after receiving a bag of blood from a family donor and feeling a bit stronger for it. Thanks again to God for her supportive extended family, which is all she has right now... may they continue to be a light to her in a way that we can not as we walk in and out of her life ever so briefly during such a difficult time. She really personifies many of the struggles of very short-term missions and it hits hard emotionally, but I thank God still for the constant reminders of how very, very blessed we all are to live such wonderful lives with our health, our homes, our supportive spouses, and our medical care system in the U.S.
Now I'd better get to pictures before waxing too political or being too completely cheesy (After all, it is 3 am and a blogger is NOT to be trusted at this hour!) so here goes... Enjoy!
(Okay, four hours later here... the internet connection is NOT cooperating for posting pictures, so it appears as if I have lied and let you all down again... SO sorry! Will try again this afternoon...)
Thursday, November 11, 2010
The first picture is of a couple whose mother we operated on earlier this week and sent home yesterday. She did great post-operatively, and the family was very supportive and gracious. They were also very nice to let us take some good pictures of them... I explained that I wanted the picture because the "traje" or traditional dress that they wear-- from their hometown area near Solola-- is my favorite in the whole country! Especially since the men are more likely to wear their traditional dress there. I wish we could see more of the men's traditional dress from other areas, but they have mostly been converted to used clothes from the U.S., sadly.
The next picture doesn't do the scene justice, but we really enjoyed a few minutes of watching these young Guatemalan kids playing with bubbles and Isaac. They were waiting on their mother, who I think was waiting to be seen by the local doctor, and had been sitting perfectly still and stone-faced for at least an hour before we remembered to break out the stash of dollar-store wedding bubbles that we had brought down! That certainly livened things up in the courtyard of the hospital, and brought quite a bit of joy to both us and them. They went through every bottle of bubbles I brought before the end... then it was on to Play-Doh! (Thanks, Tana, for sending down your Halloween leftovers...) I had almost forgotten how much fun-- and how cheap-- it is to give small playthings to children here. It is ridiculous to think that Isaac has more toys in his little backpack that we traveled down here with than many of these children will ever even see...
Yesterday's OR cases went very smoothly-- Three vaginal repair surgeries that Dr. Nelson and Dr. Lawton really did with minimal help from me (My favorite kind of day in the OR, for those of you who know me!)-- I learned some new tricks from watching them, and got to take care of paperwork and checking back in on patients and organizing and tying up loose ends and such, which was a huge blessing to me.
We also were asked to do an inpatient consult on a lady that one of the local docs had admitted the night before. In the interest of time I will spare the details, but suffice it to say that telling a 30-year old, mother of four, whose husband left her for another woman during her last pregnancy, that she has inoperable cervical cancer is NOT one of our favorite things we have had to do... Please pray for Juana to be able to get the care that she needs to survive for a while to take care of her children. She has accepted Jesus Christ as her Lord and Savior, thank God!, but her struggles here on this Earth are very significant right now. We are also grateful that she has a supportive family here with her. They were looking for family members that could donate blood to her to help with her weakness from anemia when we left yesterday without any complaining or arguing, which is a minor miracle down here... so please be sure to also thank God in your prayers for them and ask for their continued support and patience.
Now it's off to the hospital to see what else the day holds in store for us... We hope that the patients are doing well and that a few are ready to go home, and will continue to pray for their recovery and salvation.
Tuesday, November 09, 2010
Sunday, November 07, 2010
Today was our typical looooonnng travel day from Greenville, NC, to Chichicastenango, Guatemala— praises always to God for safe and smooth travels! Today ended in a special treat for me, of course (that would be Heidi, for those of you whom we have confused over the years with mixed blog authorship!) in that I was reunited with Matt and Isaac after being away from them all week! They’ve had a great week out at the Fickers which I am very jealous of, but I am really looking forward to getting to work with Matt again a little more closely in here in Guatemala! It is sure to bring back many amazing memories…
So our group this time is a little bigger than usual, and I am feeling very blessed to be a part of it. I am travelling with Pat Peabody, who regular readers have come to know by now and who will be running anesthesia for us again. She is joined this time by a special surprise in the form of Dr. Calvin Williams, who joins us from the St. Louis area (a friend of the Ficker family and from their home church) with his wife Latrice and daughter Brittany. Cal is an anesthesiologist with a long-term interest in medical missions, and we of course pray that he has a great trip and wants to come back and help out with anesthesia plenty of times in the future. As most of you know, providing anesthesia for surgeries is a major expense if we don’t have someone with us to provide that service, so I continue to stand in awe of the way God provides in this and so many other areas.
Also travelling with me this trip are Drs. Keith Nelson Cyndi Lawton, both co-workers of mine in the OB/GYN Department at ECU. Dr. Lawton is in her last year of residency with us and will be joining a practice next year in her home town outside of Charleston, SC. Please pray especially for her as it is the first time she will be spending any significant amount of time away from both her husband and her one-year old son, Beau, since he was born. Dr. Nelson is a member of our faculty who has quite a bit of experience leading mission trips of his own, mostly to the Dominican Republic over the last several years. He and I work together on medical student education in the department, and he is also very involved in surgical education and administration of the residency program. He is highly regarded as one of the best surgeons in our program, and I look forward to operating with him this week! Many thanks to his wife, Megan, who is once again graciously staying home with their two children while he travels the world to help those in need.
Tomorrow we will start seeing patients in the afternoon and set up surgeries for the week, so we will see what the week brings our way! We will continue to pray that God sends those our way who we most can help, and that we are able to help each and every patient that comes through our doors even if they don’t need our specialized medical care specifically. We are looking forward to a great week, and will keep you posted! Pictures to follow, of course… We were all feeling a little more travel-weary than photogenic today…
Wednesday, August 18, 2010
Here is the front of ASELSI's beautiful facility there in Chichicastenango, for those of you who are less familiar with the area...
Again, you can read more about ASELSI at aselsi.org if you are interested... We have truly been blessed by the opportunity to work with them over the years!
Sunday, August 15, 2010
(OK, I will go back and try to re-post the pictures later; for some reason they don't want to upload tonight and I'm getting impatient to go ahead and post this! Sorry...)
Thursday was a very nice “blast from the past” for me this week—I did clinic at ASELSI (read more about their amazing work in Guatemala, if you want, at www.aselsi.org) with Dr. Sherwood Pope, his wife Areli, and my old friend and most excellent of translators, Cecilia or “Ceci” as we have always known her. She is the Quiche to Spanish translator that Matt and I worked with for two years there at ASELSI, and offered a scholarship to when she eventually became interested in going back to nursing school. She now has what is essentially the equivalent of an LPN (Licensed Professional Nurse) degree and has been able to increase her hours and earning potential with it. She is still a great translator, tirelessly educating patients without even being prompted anymore about hygiene, clean water, hydration, proper care of children, and much more.
Ceci and Areli both are showing great interest as well as skill with the ultrasound machine in pregnancy, so I got to be really in my element for a while and do some teaching! Areli has really been helping Dr. Sherwood quite a bit with the prenatals, and is becoming quite handy with the ultrasound machine. That’s something she probably never planned on using her degree in International Studies for, but I am continuously awed by her flexibility and patience. The first two pictures are of ASELSI's main building and one of our first patients and her baby.
In all, we saw about 50 patients between the three of us—I remained worried the whole time that David Ficker would call at any second and say that they were ready to pick me up in Quiche immediately (I was scheduled to ride out with him to Canilla and hated to think about making him wait for me…) Those of you who have ever either been to Guatemala or had many things scheduled on “FST—Ficker Standard Time” are of course now laughing at my seeming naivete in my concern! ;-) It was only after the obligatory seven or eight plan changes that we met up relatively smoothly in Quiche for the long ride over the mountains to Canilla.
I’ll spare you all the details of that trip (we managed to get there having lost only one lug-nut, having stopped only twice to check on the drive shaft, and to re-wire a headlight directly in to the battery so that it would stay on for more than a few seconds at a time after it got dark…), but it was even more adventurous than usual for that trip! Any of you who have known the “adventure” (read: sheer peril and terror) of driving that road during the rainy season in broad daylight will just have to imagine how fun it was after nightfall with no working headlights! David Ficker is truly an amazing mechanic and driver… and even provided for a photo op or two! The next pic is of him and Juanito, a friend of the family, rewiring the headlight—successfully, of course.
Late in to the night Thursday, we greeted a team from Real Life Missions out of Washington state who are there for the week. They are poised to do some great work, teaching and evangelizing in local schools and building a widow a new home out near one of the clinics. Friday was spent helping them settle in and just reconnecting with the Ficker family (check out their new website at adonaiinternationalministries.org). What an amazing opportunity to work with them again! There was even an afternoon beach volleyball game after the usual trek through the river to get to the court… THAT truly felt like home, sweet home again!
This morning we were able to see most of the prenatal patients who were waiting with the help of a local Peace Corps volunteer, Cali, who has also become a great friend over the last two years. My flight out was around ten this morning from Canilla, so we were actually hoping to get through them all before that… but we got of to a late start due to another unexpected change in plans, of course. When we opened the doors to call for the first patient, we were greeted instead by one of the nurses from the Health Center with a patient in her hospital gown that they were asking for help with. They had brought her over in the ambulance because she had reported laboring all night with no baby yet delivered. A quick review of her “prenatal records” (handwritten in the card that she carries with her from the Ficker’s clinic there) revealed that she was full-term and the baby had been in the right position at her last visit, so we hoped for the best as we put the ultrasound on! We were able to confirm a strong heartbeat, head-down or normal position, and about 5 centimeters of cervical dilation before they popped her back in to the ambulance and took her back to the Health Center where there is actually a doctor to attend her delivery. We heard she delivered about an hour later with no problems, so thank God for that.
I am now on the plane headed back to my true home, sweet home—my “boys”!! It has been a long week away from them like it always is, but I am forever thankful for the opportunity to remain connected to Guatemala and her people. Leslie is preparing at least one more patient for us for surgery in November—a lady we have known for a long time with a complete prolapsed of her vagina after a hysterectomy, which re-prolapsed after an attempted surgery many years ago. She has been miserable with this for many years now but has refused further surgery. Leslie mentioned to her that we might be able to help with a different procedure (essentially to close up the vagina completely—reserved for pretty unique cases, of course) and she is now actually considering this, so we pray that she will do well with this surgery in November.
Stay tuned for more updates, we hope, as our November trip draws closer as soon as this one draws to an end… We will continue to pray for Maria and so many others in whom we hope some seeds have been planted this week and over the years, and that God will continue to bless our feeble efforts in His Name in Guatemala and the U.S. Thank you all for your support and prayers over the years and during this week!
Wednesday, August 11, 2010
The next picture is of the Church where we set up our mobile clinic-- that's it, the little white speck in the middle of the picture! This picture is, unfortunately, taken from our "parking spot" where the truck could pass no further in the current road conditions. Rainy season has really been rough this year for ground transportation.
Tuesday, August 10, 2010
I also saw several more of my own return patients, which I try to take as a good sign that there is growing trust in me and in our care here at the hospital. I was also able to pull several charts from patients that I had seen in May and referred back to Dr. Hoak for various reasons, and was very pleased to see that they had followed through and had their surgeries done.
I think the best and most exciting new yet, though, is what we spent about half of the morning doing today-- When I walked out from seeing my last patient in the stack, I met one of the nurses who was dressed in an OR gown, gloves and mask in the hallway with a broom. Intrigued by her attire, I of course asked what she was working on, and imagine my surprise to find out that she and three others were cleaning out one of the "bodegas" (storerooms). It wasn't actually a bodega, but more like a big hallway behind one of the bodegas that has been filled literally floor to ceiling with "overflow" junk over the years. They were all climbing in there and sorting through things, and actually throwing a large portion of it away! Those of you who know anything about Guatemala know that Guatemalans voluntarily throwing ANYthing away-- especially at this Hospital!-- is nothing short of a minor miracle. So I threw on a pair of gloves and did what I could to encourage their efforts... especially acting as a "consultant" to look at boxes full of junk disguised as donated medical supplies and equipment and determine whether it was anything that we could possibly ever conceivably need to use or not. The project didn't last long, but it did create a small mountain of trash that I think was later burned... The first picture below is thus of the only "surgery" that we did today-- a trash-ectomy!
The second picture is a new Guatemalan classic for me-- I always knew they could and would grow CORN anywhere here, but seeing it in a planter on the roof was another first for me! Just when I thought I had seen it all... But in all fairness, the rest of the world would surely think we were all even crazier for growing tomatoes upside-down on our porches, don't you think?!
The last picture is just something that amused me when I saw it on the Hospital wall today-- a poster advertising a Medical Conference coming up on "Cancer Treatment in the New Millenium". Apparently quite a few international docs are coming down to speak, including three from MD Anderson in Houston. What amused me, though, were the prices-- $250 bucks for docs from outside Guatemala, 400 Quetzales (about $50 bucks!) for Guatemalan docs! Those of you planning any international continuing education conferences any time soon, just be aware you're being gouged... but enjoy nonetheless!
Tomorrow's plans are still up in the air, depending on whether the Fickers are able to fly me out there or not... We will see what God has in store, and if I don't go out there then I may see if I can help Dr. Sherwood Pope and his wife Areli with Agape in Action or at ASELSI on Thursday or something... My father-in-law always tells me, though, "If you ever want to hear God laugh, tell Him about YOUR plans!"...
We will see what HE has in store for me the rest of the week.
Sunday, August 08, 2010
I then rushed out to market to do some "power shopping" as I didn't have much time before Church (or so I thought... see below.) and lots of gifts to buy! It's always fun to see what is new, and also what never changes... I am seeing a lot more local pride here in Chichicastenango in T-shirts and things for sale with the name of the town on them, which I think is pretty positive. I then ran up to go to one of my favorite spots on the face of the planet-- the "Gringo Church" that meets up at the Hotel Casa del Rey every Sunday! Except sometimes during the summer, apparently, when too many people are gone back to the U.S. to raise funding... oooops...
Anyway, that at least meant that I got to start clinic a little earlier and I got done at a decent hour, so life is good! I saw about 14 patients today, but 5 of those were return appointments that I had made either in February or May for myself! It is so uplifting and encouraging to see people keeping these appointments. Most of the rest were ones that Dr. Hoak had sent, and the others were self-referred. Only two seem to need surgery, and they are now set up for November! So, Keith and Cyndi, get ready to operate!! Hopefully more will come in tomorrow, and still more by the time November comes around. The first picture is a lady we will operate on in November, who needs a vaginal hysterectomy for a prolapsed uterus (or for you non-gynecologic types, "her uterus is falling out"!)
The second picture is another patient, who is talking with me through one of the translators at the hospital (Quiche-to-Spanish translator) about her symptoms. She turned out to have a very treatable infection, so we hope she feels better soon. We had a few more run-of-the-mill gynecology patients (discharge, painful periods, etc...) then two interesting infertility patients. One was a young couple, married for 2 years and in seemingly good health, with unexplained infertility. I have no guess as to why they haven't conceived, but they are quite bright and educated so we went through lots of education about calendar-keeping for her cycles, the most fertile days of the cycle, basal body temperature charting to track ovulation, etc... I hope to see them back in November. There are some drugs available and affordable here to help her ovulate if it doesn't look like she is doing so on her own, so we'll see! It was nice to be able to do some real patient education on a pretty high level with this young couple. You have to keep in mind that with many of my other patients, when they complain about their "period" or menstruation coming in some abnormal way, the first question I have to ask is what color it is!! Often they mean they have a white discharge instead of bleeding... so yeah, there's a big difference here.
The other young lady was very different. Married for 8 years with no babies, but did have one on her back that she had just adopted at least! I could take one look at her and diagnose her with Polycystic Ovarian Syndrome, but unfortunately I could also do a fingerstick blood sugar and diagnose her with full-blown diabetes! This is going to be a tough problem for her throughout her lifetime. I did my best to start explaining to her what diabetes is and what she needs to do about it, but I pray that she seeks more ongoing treatment like I asked her to.
The other two pictures are for those of you who may not have seen the Hospital here before-- The "Good Samaritan" Hospital is really a pretty nice facility. Those of you who know anything about Chichicastenango on Sundays know that I cheated and that these pictures were NOT taken today, of course. (Market days are impossibly busy and you can barely see the Hospital for all the street vendors!) We will see what comes our way tomorrow, but for tonight I will sit and enjoy my hot tea, a hot shower, and a nice warm bed! Ah, the difficulties of missionary life, right?!
Saturday, August 07, 2010
I realized too late—as in yesterday!—that I had left everyone hanging on the pathology results from the last trip and for that I apologize. I had heard from Dr. Hoak just a few weeks after returning home that all was well with all of the reports. Nohemi turned out to have a benign tumor after all, which is wonderful. It is such a blessing to have such great follow-up on pathology reports and how patients are doing after flying home again, and something that is really quite unique to the short-term trips that I do here as far as short-term missions go in general. For that I am truly grateful.
This trip is a little bit different in that I do not have any other surgeons or anesthesia help travelling with me. With Dr. Hoak also being up in the States with his family this month, we prayed very hard over what I should try to do on this trip and have felt like it is not my calling to operate any during this particular week. I am certainly open to the possibility of something more urgent than usual coming up, though, so please pray for wisdom and guidance as I evaluate the patients who come in this week.
The hope is to set up quite a few surgeries for us to do in November, when I am VERY excited that I will have one of my Faculty colleagues as WELL as one of the Chief Residents in our program joining me! That will be an amazing trip both from a medical/surgical as well as personal/spiritual standpoint, I hope! This trip is hopefully going to be a lot more about reconnecting with the people here—both the locals and the long-term missionaries—as time might permit a little more liberally if I am not in the OR until all hours of the day and night each day. My bags are packed with everything from charger cords left behind recently in the U.S. to silly toys and things for the Ficker girls to bags of excess toys to take out to remote clinics to eventually be given out at Christmas to small gifts for the Church members that I can’t wait to see tomorrow to vitamins and a few medications! If TSA looked through them, I’m sure they are still scratching their heads pretty good… There is, of course, also plenty of suture, other OR disposable supplies, gloves, masks, glucose test strips, and lots of other medical goodies that are mixed in there. And yes, they are bulky and heavy! They did, for the first time in a LONG time, wave me right through Customs today without X-raying my bags looking for things they didn’t want me to bring in for free, so that was probably the biggest blessing of the day!
Later in the week I will be going out to the Fickers to hopefully help them with a “jornada” or mobile medical clinic out in the jungle areas to the north of them—many of our regular readers will recognize the Zona Reina area as one they have been trying to reach for years now, and we are hoping to make a little bit more progress on those relationships this week, Lord willing.
Thank you all for your continued interest and support of our mission here. Please always let me know if you want to get more involved or if you have any questions! And thank you especially for your prayers for safety and wisdom this week. God bless you all!
Thursday, May 20, 2010
It is always good to be home, but it is also always sad to leave again... It is such an amazing thing to always have a return date already scheduled, though! All of our patients have done well so far post-operatively, and they will all follow up with Tom within the next few weeks. He will also be able to follow up on the pathology results from some of the surgeries we did, which is such a blessing! Please continue to pray that especially Nohemi's pathology comes back benign.
We are also praying very hard now for another surgeon that can accompany me on my next trip to Guatemala in August-- Dr. Tom Hoak will be in the U.S. during that time to get his daughter off to college. I am not sure that operating by myself with no back-up or anyone to bounce thoughts and ideas off of prayerfully will be the right thing to do-- Please pray for both guidance in this area if no one steps forward or for someone to step forward that can come help! We know He has a plan, and just pray that we are mindful of it at all times.
I pray that someday each of you reading this will have the opportunity to be blessed even nearly as each of us participating in these surgical trips has. I will write more when our August trip gets closer, or if we hear something back on pathology reports soon.
Thank you all for your continuing support and prayers!
Thursday, May 13, 2010
All of patients-- thanks be to God!-- looked pretty good this morning when we rounded, and slightly better even this afternoon before we left the hospital. I will check on them again this evening, and hopefully send them all home tomorrow and not have to leave Tom stuck rounding on anyone.
We then treated ourselves to a nice buffet lunch together, which really was a treat considering how little time Pat, Monica, and I have had together all three of us at all! We picked up a few last minute "needs" in the market and this afternoon are mostly cleaning up and planning for tomorrow.
We are still praying for negative pathology reports (i.e., telling us it's not cancer) on Nohemi, Maria, and another Maria especially, so please keep those especially in your prayers.
We still don't have a straight story on the lady that came in "just for an ultrasound" and we found the postmenopausal ovarian mass, but we are fairly certain she does NOT know Christ (although she considers herself Catholic, her neighbors consider her also to be a "witch"-- and unfortunately the Catholic Church down here has suffered from so much syncretism that those two are not mutually exclusive anymore!) We also found out that her son actually owns one of our favorite restaurants in town, so we did ask her to kindly pay her whole bill and not just the tiny bit she claimed to be able to pay before she left. This she did, to her credit, without grumbling-- I guess she knew she was essentially "busted".
It is always frustrating to know that would certainly not have been the first time we were taken advantage of by people who really do have the money to pay for their services, but the "Serenity Prayer" has been the only thing that has ever helped me come to grips with that in my years here...
"God, grant me the serenity to accept the things I can not change, the courage to change the things I can, and the Wisdom to know the difference..."
I hope that my Grannie is looking down and smiling on me quoting those words I first learned from her needlepoint sampler that still hangs in her old apartment, as I struggle to truly rely on God's sovereignty even in our human need for his unending Grace at every level.
Oh-- and the pics are mostly just for fun today... One is a "paycheck" from one of the patients, that brought us these beautiful plums from their tree (one of my all-time favorite Guatemalan treats!), one is of Pat feeding the Parrots at the restaurant (tortillas, of course! What else would a Guatemalan Parrot eat?!), and then there's the beautiful view out the back window of the resaturant (Try to imagine if that were a real waterfall and not just a "waterfall of trash" as one of our students once dubbed it ;-), and the other is just some of the patients waiting around to get well! Thanks be to God that they are indeed well on their way...
Wednesday, May 12, 2010
Thanks to all of you who have been praying so faithfully for us, today was a million times better and one of the best days I've ever had down here! The patients from yesterday looked fantastic this morning, the one from Monday went home, there were only three consults waiting for us, and four good surgeries scheduled. For the first time this week, we actually got all the scheduled cases done today! Tomorrow should be a relatively light day in theory, so maybe we'll have time to catch up on odds and ends (and shopping, of course!) that have eluded us earlier in the week. There are several of the nurses at the hospital that want to talk to us about something or other so we can finally see them tomorrow maybe.
Today we have a few fun pictures to share also... One is of Monica receiving a random but much needed shoulder rub from a young girl who came with her mother for her consult today! Never mind that they had been waiting by that time a good five or six hours to even see us and we had relatively little to offer for their non-gynecologic problems-- The girl saw that we looked tired and took over trying to help US out, which is just another example of the spirit of the Guatemalan people we are so privileged to serve.
Warning: pictures that follow are not for those who really don't like gross stuff...
There are also some pictures of a great big uterus that Tom and I took out at the end of the day, which was actually a lot of fun considering how smoothly the surgery went. Also pics of Tom and I operating (Monica was nice enough to be operating the camera for this one) Monica got to be a little more involved on the cases today since they were going more smoothly, which was a blast for me (and hopefully for her, too!) to get to have her open up and close up her first surgery!
Thank you all for your continuing prayers-- We really felt them today in the operating room and in the Hospital in general and are feeling refreshed even after such a long day by being reminded once again how great our God is.
Monday, May 10, 2010
We scheduled three more surgeries today out of clinic, which we were able to mostly get done before we got started in the OR. Then Monica and Tom went up and did a prostate surgery (slightly outside the scope of most general OB/Gyns...) while I finished up clinic, which made starting our vaginal case much less stressful with no one waiting on us. The case-- a vaginal hysterectomy with anterior repair, culdoplasty, and perineorrhapy for a complete prolapse for you gynecologic types-- or what we often affectionately refer to as a "vag-a-thon" for the others!-- went quite well overall but was very challenging. We will pray that she recovers well and doesn't have her problems recur in the future-- her name is Maria.
Our third case today was supposed to be the lady we blogged about yesterday with the ovarian mass and no complaints, but her labwork showed that her hemoglobin (measure of anemia) was at about half the level it should be (7.3) and we needed to get some blood donated for her before we could safely start! The husband's blood type was not compatible with hers and they only have one son in the area whose blood type they don't know, so it was looking a little iffy for a while. Then the family members of the first lady we operated on offered to "donate" theirs for her (for a fee, of course... I stayed out of those negotiations!) and we thought we were back in business.
Then we got set back again by the laid-back culture of Latin America-- It turns out that the lab tech, who is of course the only one in the hospital who knows how to crossmatch the whole blood and test for HIV and Hepatitis before transfusing it, decided to stay "a few extra hours" in her home town a few hours away this weekend and wouldn't make it back until tonight. She is usually back around 3 or so on Monday, but not so much today... So to make a long story short, we managed to send the men up to another private lab in town with some blood storage bags we found in the lab here, where they donated and brought the blood back. It is now waiting in a refrigerator overnight until it can be screened and prepared tomorrow and this lady can finally get her surgery! Of course we already have a pretty full load for tomorrow, so we'll see how we end up getting through it all. Somehow we will manage with God's help; we always do.
At least we got to take advantage of our early evening by a nice dinner out with some other local missionaries-- thanks to Roy, Erna, Sally, and Ervin for such a great time with old and new friends!
Will let you all know what tomorrow has in store...
Pictures today are of Monica and Tom operating on a prostate, then the "obligatory" first uterus picture of me and Monica after her first hysterectomy that she scrubbed in on! There's also one of the upcoming women for surgery with her husband in the courtyard of the Hospital, which is looking a little better every time I come down. What a lovely place to be called to work...
Sunday, May 09, 2010
Today was a great day, but quite long-- started out to market around 8 or so after going to bed around 8 last night, so at least we started out well-rested! Monica got to experience the market for the first time, and Pat was there to faithfully help shepherd her through and give her the personal shopping experience that only Pat can... Then we hopped up to Church at the Hotel, which was another great service as always. Then it was off to the races when we arrived to a "standing room only" waiting room at the hospital!
We saw a little over 20 patients today, which won't sound like many to some of you but it took us almost 8 hours... We write up pretty full histories and physical exams on them all and try to make sure they all leave feeling like it was worth their while to wait the 8 hours to see us, which is sometimes more challenging than others of course! Either way, it was more than I've ever seen in a day at this clinic by at least 25%, and we turned many away to come back tomorrow. So there's no telling what tomorrow will bring, but God will provide for whatever He sends our way...
So speaking of what He is sending, our most interesting patient of the day was the 9th one we saw-- she was the first patient we saw that literally had no complaints-- she just wanted an ultrasound to make sure everything was OK "before I get any complaints from anything". She literally repeated and harped on the fact that she had no complaints until Monica learned that word quite well in Spanish! So we figured this one would at least be quick and easy and we could give her what she wanted as we walked over to the ultrasound room. It got less quick and easy when we diagnosed an ovarian mass the size of a small orange (she is post-menopausal so this is particularly concerning) and set her up for surgery tomorrow! I am now quite suspicious after reviewing some blood work that she may have ovarian cancer. If she does, though, it will be picked up early and maybe even cured without further treatment. Those of you who know anything about ovarian cancer know that this is rarely the case, so praise God for sending her today! I do not think she knows Christ personally yet, so please pray that we can really use this opportunity to minister to her and lead her to Him.
Please also pray for a young lady-- in her 40's, I think-- who has inoperable cervical cancer and likely only a few months or so to live. There is nothing I can do for her but hug her, pray with her, cry with her and her husband, and give her some pain medication. As a physician, those are some of the hardest times. As a Christian, though, it was a huge relief to know that she knows The Lord and is planning to spend eternity with Him in His kingdom. We will see her there someday and it will be a joyful reunion.
If any of our old regular readers remember the young lady that we tried so hard to help with her breast cancer a few years back (Maria was diagnosed while both pregnant and breastfeeding-- no-showed her mastectomy, tried some "faith healers" and such then finally did go to The City to get treatment but way too late...), we saw her family in the market today and they seem to be doing well. The first picture is a picture that I took of her husband's cell phone-- He has her picture as his home screen, which I thought was a beautiful reminder of her this Mother's Day. I get to see one of her daughters and her husband almost every time I come down, which is a great privilege in my travels here to have such continuity with a family.
We also scheduled several vaginal hysterectomies for prolapse, and a bladder evaluation (cystoscopy) for a lady with no prolapse but lots of bladder complaints and blood in her urine that is unexplained. I'll save some of the other clinic details for tomorrow or the next day; I guess y'all get the gist of it by now... the other pictures are some of the ladies we will be operating on this week, and the last one is just for fun, showing the "glamorous" side of gynecology which Monica snapped when I had stepped out to wash some speculums!
I did have at least three patients today that I had given appointments to come back and see me myself, which is always exciting-- one post-op from February and two other follow-ups for an abnormal pap smear and fibroid uterus. It is always wonderful to start those relationships and be able to provide continuing care, even when you're only here every three months! What a privilege, and what a wonderful way for God to prove just once again how good He is...
Saturday, May 08, 2010
GOD IS GOOD.
Tomorrow will be another long but exciting day, so we are pretty much tuckered out and ready to turn in, but I thought I'd post a quick photo of Monica and Pat (they asked me to remind everyone that this is around 5:00 a.m., after getting up to travel starting at 2 a.m.-- they weren't exactly thrilled with me for taking it, but I think they are beautiful! ;-)
Monica is on the left, and Pat is on the right... just to put "faces with names" for those of you praying with us this week... Good night!
Please pray for safe travels and some rest for us today-- we all got up before 2 a.m. to get here to the airport! Also pray, as always, for the patients that need to be seen to show up and that each patient walks away with what they need or what God wanted them to have from us this trip...
Thanks and God bless you all! We are boarding now so I'll try to update again probably tomorrow night after a full day of Church and clinic...
Monday, April 19, 2010
The team this time is Heidi, Pat, and Monica. Pat has been several times already but this is Monica's first time. Please pray for their preparation and safe travels.
Plane tickets have been purchased and a packing party is imminent.
We'll post more details as we get them.
Thursday, February 18, 2010
Well, we didn't manage to get a blog post up Monday like we tried, but hopefully we can still go with "better late than never" for the follow-up?!
Anyway, we've all been back in the full swing of things in our clinics and at the hospital, so Pat and Carrie and I have seen very little of each other this week. I know they have both had some opportunities to share some of their own stories from Guatemala last week with colleagues and friends, though, and for that I am always thankful.
Our week finished up relatively without incident-- Glory to God for seemingly very safe healing of all of our gyn surgical patients, who all went home on Thursday! Thursday we had another few general surgeries-- a gallbladder and two biopsies on possible enlarged lymph nodes in a brother and sister from the same family. We also did a more involved case on an older gentleman that Tom had been observing for a day as an inpatient, who had come in with severe abdominal pain overnight on Tuesday. He was finally starting to convince us that surgery could help, and we were glad to find out upon operating that we were right! (well, okay, "we" is really just Tom; Us gynecologists don't spend a lot of time on the men's ward usually!) He had what looked like a pretty long-standing appendicitis, so Tom and Carrie cut out that section of his intestines to cure him of that. He will have a large surgery to recover from, but should be feeling better soon. This is the type of patient who could truly die if it weren't for life-saving surgery, and we are always grateful for God's faithfulness in providing for his children.
Without your prayers and financial support, people like this do get turned away from many other hospitals-- or delayed long enough in the government hospital that they get too sick to operate on or die anyway! I thank God regularly for His provision, and for people like Tom and Jana who devote their lives to caring for His children. We look forward to another great trip in May, so please stay posted for more on what we are doing.
Oh, wait-- Almost forgot to explain the pictures today... The first is a relatively rare shot of a Mayan lady smiling! (Smiling in pictures is not a cultural norm here, generally...) She was one of our vaginal hysterectomies from Tuesday, and we were thrilled to see her up and about and looking so well. She is pictured with several of her family members and friends who were there to support her. The one here at the end is of a young lady who delivered her baby overnight at the hospital. They called Carrie and I to come evaluate her because they thought she might need a C-section, but the baby delivered within the five minutes that it took us to get down to the hospital! We were able to print a copy of this out for her, which is a rare gift for the poor in a developing country and brought a lot of smiles to the family's faces. What a privilege to ever be a part of something like that!
Sunday, February 14, 2010
Heidi, Carrie, and Pat arrived at the Guatemala City airport in time for their 1:50pm flight back to the United States on Saturday but their plane didn't. It was coming from Atlanta (in order to return to Atlanta) but was part of the biggest cancellation of flights since 9/11 and was about six hours late.
Of course, with that delay, the girls missed their connecting flight and ended up spending the night on the floor in the Atlanta airport. They were re-booked on a flight for Monday but all needed to be at work on Monday. So they put their names on the standby list, tried to rent a car (which wouldn't be available for 12 hours), and even explored the option of having someone drive in from North Carolina to get them.
But God smiled on them and they were able to get on the first morning flight out of Atlanta and arrived in Raleigh at 10:05am - about 10 hours after their originally scheduled arrival.
With the exception of the more-eventful-than-usual return flight, it was a hugely successful trip and we'll post some more stories and pictures tomorrow. Thanks for all the thoughts and prayers.
When you are considering your giving for this year, please keep this mission in your prayers. We are currently trying to raise funds to help pay for all the surgeries we do in Guatemala. Obviously, the surgeon does not collect a fee, but the hospital does. The patients have to be fed, given medicine, put in a bed, and given nursing care. The average cost of a surgery is $200-$300. The patient contribution probably averages around $10-15. And while the balance is pretty inexpensive by American standards, operating on 10-12 patients per trip multiplied by four trips a year leaves us with a hefty bill.
The members of the team all travel to Guatemala on their own dimes - and most of them use precious personal vacation time to go. If you feel led to contribute, know that 100% of your donation goes directly to patient care. There are no administrative expenses, no doctor travel expenses, no candlelit dinners, etc. Every dime goes directly to helping some very needy patients. And your contribution is fully tax deductible through Agape In Action, a 501(c)(3) organization.
And if this is not where God is calling you to contribute financially, we still appreciate all of your prayers. We can't do our work without those, either!
Thursday, February 11, 2010
Wednesday, February 10, 2010
We did have several consults to do today on clinic patients, and Carrie and Tom stayed scrubbed in to a particularly tough gallbladder case for about 5 hours!! Unfortunately, the other patient we had scheduled for today did not show up, and she is the one who probably needs her surgery the most! Please pray for Julia, who needs surgery for about a 10 cm mass in one of her ovaries-- pray that it is not cancerous, and pray that she gets the surgery that she needs soon to know for sure! Her husband is away working down near the coast right now (cutting sugarcane, most likely...) and likely did not give her permission to have her surgery without him here. A very sad state of affairs on many levels, and one of the realities that many Guatemalan women live with.
We do have good news, in that all of our post-operative patients seem to be doing well overall! Yesterday we operated on three ladies who needed various kinds of hysterectomies (for you OB/Gyn types out there who are interested, a TAH s/p 3 C-sections, a TVH with anterior repair, culdoplasty and perineoplasty, and another TVH with culdoplasty, perineoplasty, and a prayer that it holds since her tissues were too post-menopausal to do anything more substantial!) The second case took much longer than we had hoped but so far the outcome has been good and that's what really matters this week. In the long run, of course, we just hope that they will feel the love of Christ while they are here and know that it is only because of this that we are able to help them at all...
Today brought an interesting "mystery" story our way from clinic-- A lady who is around 49 years old, who came in stating that she had a hysterectomy last September done by some visiting North American doctors down in Antigua, Guatemala. She says she had her surgery because of some heavy bleeding she was having, and that they told her they also took out both ovaries. She was doing well until January 1st, when she started bleeding again like she was having another period, which has kept going through today! She brought in a pathology report with her name on it that said her uterus, tubes, ovaries, and cervix were all sent to pathology and that she had a cervical cancer found on pathology! Luckily, the cancer was small enough that the surgery should cure it permanently.
But imagine our surprise when we went to examine this lady and found that she has a cervix, a uterus, and at least one ovary still intact inside!!! Hmmmmm... where to start?! The patient strongly believes that she had her uterus removed, but was unaware that the pathology report (which is obviously NOT hers as she still has her cervix intact!) read "cancer". So now we have TWO problems-- Someone DOES have cancer, DOES need to follow-up with regular pap smears and doesn't know it! And THIS lady... well, has a uterus, what appears to be a complex cyst in one ovary that probably should come out, but unfortunately also has very uncontrolled diabetes making us more than a little hesitant to operate on her just to find out for sure what's going on!
I tried calling both the pathology lab and the Hospital where the surgery was done (both generally quite reputable places down here...) and talked to very nice people who promised to call back soon when they found some information but whom I have yet to hear from. Maybe tomorrow we'll hear something, but I won't hold my breath! I checked some lab work to make sure she's not anemic, biopsied her uterus, did a pap smear, and then sent her with some paperwork to try to get a CT scan a little ways up the road to get a better picture of what's going on with this ovary of hers! Tom is nice enough to follow all this up in a few weeks, and we gave her a lecture about controlling her diabetes better in case she needs surgery, but who knows where it all will lead?!?! I'll call the hospital again tomorrow and see if I get any further...
Speaking of tomorrow, just a few quick general surgery cases (gallbladder and two lymph node biopsies), and hopefully we will send almost all of the patients from this week home. Then the girls will surely hit the market hard again, assuming that we don't have another 20 clinic patients to see!
A few random pictures today... The first is of Carrie with the family (or maybe the whole village, it would seem!) of the first patient we operated on yesterday-- Yes, that is the lady's uterus that her husband is holding in the basin there! They like to see the "parts we took out" here after surgery... Usually a new cultural experience for most people that come down here!
The second is from inside the hospital, a nice view of the courtyard that everyone enjoys and takes good care of...
Will try to bring you more stories tomorrow!
Monday, February 08, 2010
Aura (the beautiful little girl above) was actually the third surgery of the day, preceded by two women who needed surgery to repair prolapsed uteruses (?or is it "uteri"? I've never known how to say that! Guess they don't teach everything in "Gynecology School", as my husband calls it...) Carrie did a beautiful job with these two vaginal surgeries and gained some valuable experience that she hasn't had much of in the U.S. recently while busy practicing robotic surgeries instead! These women's lives, with God's help, will be changed dramatically by the relief of their symptoms, and our prayer is that that Rafaela (our second patient today) will come to know Christ eventually through our work here.
The first patient, Paula, was a little bit of a "breath of fresh air" for our friends the Fickers, who recommended she come to see us here and were pleasantly surprised when her Pastor stepped up from her very small little village and said HE would take her! This is about a 2.5 hour trip for them, and he is planning to come get her on Wednesday when she is discharged, too. I called on his cell phone after the surgery to let him know she was doing well, and he asked if I could give her the phone so he could speak to her, too! What a wonderful example he was for so many... A true shepherd to his people and a huge blessing to her.
The third picture is of Carrie and Tom doing a gallbladder as the last case tonight-- This lady may also need a hysterectomy in a few more months, but we are going to try to control her symptoms with medicine first before doing another surgery.
The last picture is one of my favorites of the day... Pat finishing up the anesthesia for the little girl Aura...
We also saw a few more patients in the clinic in between cases... Scheduled a couple more cases for the week and were able to provide some reassurance to a few other ladies in need of it. Lord willing, we will be operating all day tomorrow on three tough cases and then we'll see what God has in store for us on Wednesday and Thursday!
Sunday, February 07, 2010
Started off with market around 8 a.m., which Carrie got to experience for the first time but Pat's an old pro at by now! We then headed up to Church with the other local missionaries at 10, where we heard an amazing sermon on suffering and God's ultimate plan based on the raising of Lazarus from the dead. Then a quick (but really yummy!) lunch at a local restaurant that Pat has been talking about since the last time she left I think...
Then we ran over to the hospital to start seeing patients... 16 total came in, and we scheduled 5 surgeries for this week as well as some that want to come back later in the year for surgery. It's always wonderful to see patients back for a final post-op visit, so picture number one is a lady that I did a vaginal hysterectomy on back in November who is doing GREAT! Please pray for her, though, as she has not accepted Christ as of yet despite her family's efforts to convert her. She is in good health overall but getting on in years and I fear we are running out of time... It was nice to see her back to be able to show her some more of God's love for her today, though, and we just keep praying that our seeds we are planting will one day grow in to a beautiful relationship for her. She is pictured with her daughter. Her name is Manuela.
The next picture is just of me getting ready to start for the day, but it shows our trusty little clinic room, which is actually decently well-equipped with an exam table, light, and lots of supplies we have brought in over the years. Thanks to Carrie for being my photographer today; hopefully tomorrow we'll get some pictures of her and Pat up!
We also saw an assortment of ladies needing hysterectomies, or who needed reassurance that they did NOT need surgery for their tiny ovarian cysts that some of the local doctors want to make money off of. That is an unfortunately common thing here. We also saw a lady with a 10 centimeter ovarian mass that DOES need to come out (pray it's not cancer!), a lady who needed follow-up on an abnormal pap smear which we were able to help with, and a couple of ladies with pains that we aren't really able to explain. At least we were able to offer reassurance that they don't have anything terribly wrong with their uterus or ovaries, though!
After we had seen about 10 of our 16 patients, the local doctor called to see if we could help in the emergency room because there was a breech baby they were trying to deliver! So Carrie and I rushed over to see what we could do... Unfortunately, the young girl had tried to deliver at home and the baby's body had been delivered for quite some time before she arrived at the hospital. We were able to get the baby delivered safely for mom, but it was obvious that the baby was not alive at all even upon arrival to the hospital. How amazingly sad to have to tell a teenage girl that her first baby is a stillborn... and all for lack of delivering where there is a doctor trained to help! I don't even know the young lady's name, but I'm sure God will know who you are talking about if you send up prayers for Him to help heal her heart from the ache it must be feeling tonight.
Tomorrow we will operate on at least two ladies who need vaginal hysterectomies, and see what else God sends us! Hopefully we will get a good night's sleep tonight and be ready to go tomorrow... There are also currently 2 surgeries scheduled on Tuesday and one on Wednesday. I'm sure others will show up, though!