Back Home Again To Reflect and Give THANKS

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!

Finally Home

Snowmaggedon, Snowpacolypse, whatever you want to call it - it managed to affect life not just in the United States, but also in Central America. No, they didn't get any snow, but the airplanes that come to Guatemala to bring people home DID have to deal with the snow.

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!

Welcome, Baby Anna!!!!

Thank GOD for the safe arrival of beautiful baby Catherine Anna Ficker this morning at around 6 a.m. (also, about ten minutes after safe arrival at the hospital in Guatemala City!!) God is sooooooooooooooooooooooo good! More details later... It is really not my story to tell, but please when you talk to God today, thank Him again for his sovereignty, love, and protection of his precious children down here...

More Operating Time...

Wow, God really kept us busy yesterday, so we're really glad we got a little bit of a break today! I don't know if the time stamp on this thing works, but it's about 5:30 p.m. and we are essentially done for the day, after a nice lunch and even a little market time...

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!

In the Operating Room

Thought I'd start out today with a precious picture of our youngest patient today-- It took forever to get her to warm up to us and smile (bubbles are universal, though!) but sooooo worth it! Dr. Hoak repaired a hernia for her with Carrie's help this afternoon, so don't worry; we're not going around taking out EVERYONE's uterus around here! ;-)

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!

Long Clinic Day!

What a great-- but LONG-- day today!

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!

Safe Arrival!

Thanks in large part to lots of prayer coverage, we have arrived safe and sound in Chichicastenango! And the best news is that we didn't have any medications or other supplies "held" (i.e., stolen) in customs, which is becoming a bigger and bigger issue with entry in to the country with any medical supplies lately... Kudos to Pat for being organized enough to get all of her meds listed and approved in advance, and many thanks to Don Tono, the administrator at the Hospital Buen Samaritano, for getting the paperwork done! That's a huge load off of our shoulders already...

Today has been a long day (We left home about 2 a.m. local Guatemala time and it is now 9 p.m.) so this will be a short post, but wanted to thank you all for your well wishes and prayers during this week. We will get up tomorrow morning and probably hit the market for a little early bird shopping before heading up to Church. Then as soon as we can, we will start seeing patients until we are done! We hope for a good turnout, of course, but always pray also that God will never send more than we can handle.

Ideally, we would like to see all of the patients first tomorrow and then just schedule the surgeries that are needed for the rest of the week and not have to try to rush to see patients between surgeries later in the week... But we know that's not always going to work perfectly, so there will be plenty of work to do all week and we will need to pray for lots of patience especially the first few days. It is so tough between surgeries when you have time to see maybe one or two patients before they are calling you back to the OR-- the next patient in line always looks so crestfallen when they realize you are leaving again for what could be another several hours before you can come back down to see them. Luckily for us, Guatemalans are generally a lot more patient than we North Americans are...

Will try to post some pictures tomorrow, of course, so please stay tuned!