Finishing up the week in Canillá

So yesterday we had kind of a full day-- got up, rounded on our remaining patients (one had to go home with a catheter but they all went home and looked good overall), cleaned up our clinic stuff and put it away for another few months, went out to market for a little while while we waited for the anesthesiologist to come and do Tom's cases, then scrubbed with him on a surgery for very dangerous stomach bleeding (the guy really didn't have more than hours or maybe a day or two to live without Tom's intervention), then rushed over to Quiché on a "microbus" or van with 21 total people plus all of our luggage, to get on the plane and fly over to Canillá for the night!  And if you think that sounded like a run-on sentence, you should try getting all of that done in a day.

We were really blessed to be able to fly out to the Fickers's home last night and spend some time with them.  It is always such a treat to introduce them to my friends.  I've really missed them since I didn't get to see them (except for my brief run-in with Katie in the WalMart parking lot) last trip.  It was so nice to catch up and hear about all that is going on out here.  A 24-hour care center/hospital is actually looking like a distinct possibility some day relatively soon if anyone is looking for any great projects to contribute to.  You can read more on Katie's blog at http://katiessoil.blogspot.com -- very exciting!

Last night we all went to bed exhausted-- unfortunately, though, we (or at least Tana and I) got up this morning even more exhausted.  I kept her up most of the night by getting up with a GI illness regularly.  Unfortunately this morning I was pretty dehydrated and ended up spending the day in bed while everyone else went to clinic.  NOT an easy decision for me to make, for I was very grateful for the opportunity.  Sandy, Tana, and Jared did a great job overcoming all of their fears of heights and motion sickness on the Guatemalan mountain dirt roads and seeing patients in clinic.   (Kelley, unfortunately, had to leave yesterday for her flight from The City)

Tomorrow we will get up and help in the clinic here for a little while until it is time to leave for the airport for the long travels home.  We are all so anxious to get back to our families, but with many fond memories of another great trip...

Pictures today are of the Ficker home from the air and our first Guatemalan "paycheck" of the week... a bag of apples from an appreciative patient.

Scene around Guatemala...

(Thanks to Sandy Williams for these lovely shots!)

Great times with the team

So today was a little lower key, but a lot of fun and with a lot of nice opportunities to spend time with our patients.  We sent one of our surgical patients, Juana, home early this morning.  The other patient from Monday, Magdalena, really could use your prayers.  Once in about every five or six patients we operate on for prolapse down here, we will find a patient with trouble emptying her bladder afterwards-- Magdalena was the unfortunate winner of that lottery this time, and we are praying she will not have to go home with a catheter.   She looks great otherwise, though, and is in good spirits which is always a plus.

The other two patients from yesterday look fantastic... totally humbling how the lady with the largest/most painful surgery that we did has simply NOT stopped smiling every time she sees us in the hospital.  I have had the type of pain she is having (very similar to a C-section) and was certainly a lot less positive about it!  You can see the soreness and normal post-op pain on her face if you catch a glimpse of her right before she sees you walk in, but as soon as she sees one of us the smile is plastered back on and she continuously shows her gratitude.  Again, humbling.  She is the one who has been praying for us with her husband ever since we met the other day.  I thought WE were supposed to be here to minister to THEM, right?  I seem to always get that wrong...

After rounds we went down to see about 12 patients in the clinic, which was also a really positive experience. Five of the 19 we have seen the last two days were actually return patients of "mine" who I have been seeing regularly for about a year now.  What an awesome privilege to be able to establish these relationships and follow up with patients regularly.  One young lady, Aracely, would like your prayers for fertility as she struggles with diabetes and polycystic ovarian syndrome.  Another would like your prayers for us to be able to figure out what is causing her not to have cycles.  Both cases were a lot of fun to see with Kelley and Tana today-- I'm not sure which I appreciated more, the chance to walk Kelley through them as good teaching cases or the chance to get great input from Tana about our next steps in management!

We did have one funny, "this-would-soooo-never-happen-in-the-U.S." moment this morning.  About the time we had kind of hit a wall in clinic and were getting a little down with our moods/attitudes, we spotted a pair of panties that a patient had managed to leave on the floor under our exam table!  Really?!  How does one leave the gynecologist's office and not notice that they forgot their panties?!  To be clear to all you strict theologians out there, please understand I am NOT implying that the Holy Spirit wears women's undergarments... but it was a strange and spirit-lifting gift at the time to our team;-)  As I write this, I realize that was probably one of those "you had to be there" stories, but oh well... hope it made someone chuckle at least!

If y'all see my husband, kids, or in-laws this week, please give them extra hugs and love-- I miss them dearly but am so grateful for their support of this mission and our work here.  Could not do it without them at all...

God bless them and you all tonight!

Fun Days in the OR

I know... "fun" is not a word that I usually associate with the operating room, but with the team I'm traveling with this time you can't help but have fun!  We are thrilled to report that all four of our major surgeries have gone really, really well this week and so far all of our patients are also doing well.  Tana and Kelley have done an amazing job adapting to life in the OR in Guatemala and calling for instruments in Spanish.  And Jared even got to scrub in on a case with us this afternoon!

So far we have operated on three women with prolapsed uteri and one with a large uterus that was bleeding and causing pain and anemia.  Three of the four women are actually Christian but have family members who are not, so we can keep praying for them.  One family was actually brought in by our old friend Matilde, the pastor out in Nueva Santa Catarina if any of y'all remember him from years ago.  It was nice to see him again, and I see he is still truly "pastoring his flock" as the people he brought in aren't even in his church.

We are getting ready to head out to dinner, so I want to try to post some pictures before I run out of time...  Some of them are of us playing with the kids that had been waiting with their families all day for  a consult or something at the hospital.  Bubbles are universal fun!

Then there are the OR pictures... the first one is a little staged, but a lot of fun. It's where Tana and I are going to tell people we stepped out to get a soda and left Kelley and Jared in charge for a while!

Here is Kelley, fourth year medical student, making her first ever skin incision.  She did a great job!  WARNING for the really squeamish--  stop scrolling down now... the next one's a little bloody.  The lady we are operating on has prayed for us three times now as we were praying for her, and I'm pretty sure her and her husband stayed up late last night in the hospital also praying for US.  Humbling.  And beautiful.  And another amazing memory to be thankful to God for.  Reminds me once again what an amazing privilege it is to serve Him in this way.

So here is the uterus after we took it out-- Jared probably never imagined that by age 17 he would have assisted with a hysterectomy!  What an amazing memory.  

Prayers

Well, a few prayers answered today and a few a little less so… pretty par for the course in, well, life in general I guess!  For me it is always an answered prayer when someone that I had given an appointment to on an earlier trip does show up again for her surgery, which today was our patient Encarnacion.  She came referred from the Fickers in May for uterine prolapse but we had some other bleeding concerns that we needed to work up first.  She has had all of that done now between us and Tom, so we will operate on her Tuesday! 

The “less answered” prayers category basically means that ALL of our patients today had complete uterine prolapse concerns.  The translation of this is that they all need vaginal surgery and therefore will not be a very good surgical experience for Jared.  I am still hopeful that we will get some good abdominal cases that he can scrub with us on, though.  God is in control!  I had to remind myself a lot of that today…

The coolest part of the day, though, was when He reminded me of that through our first patient.  We spent a long time talking to her about the surgery that she needed and the logistics and all, and then we prayed for her before she left.  She had her husband translating for her since she doesn’t speak Spanish, and at the end of the prayer she was crying.  I was really worried because I thought she was scared, so I was asking why she was crying.  She was embarrassed about it and didn’t want to tell me at first, but she finally confided that she had just had an overwhelming sense of the presence of The Lord as we were praying that made her emotional.  So then we all cried, of course, which got the clinic off to a slow—but lovely!—start for the day.

We ended up only seeing nine patients and scheduling three surgeries today, but again, God is in control and He will send us the patients we need to minister to this week.  Please pray especially for  Juana, Magdalena, and Encarnacion who we will be operating on this week.  They all are Christians, actually, which is a fairly rare way to start out the week down here.  Please also pray especially for Manuela who is not a Christian and who is struggling with infertility that we likely can not help with.  And for Rosario, a sweet lady who came in today feeling that she needed a good check-up since she has been worried about damage that could have been done when she was raped while in the United States several years ago.  We heard a lot of sad stories today, and are all going to bed thankful for our loving homes and families and our comfy beds, full bellies, and warm showers.

The pictures above (I do not have enough patience with this slow internet connection to figure out how to get them to not be in the middle of the post; sorry!) are the very first patient who made us all cry, the team (as promised from yesterday--Tana, Sandy, Jared, me/Heidi, and Kelley), most of the team with one of the patients that we are hoping to operate on in the future (we diagnosed her diabetes today), and Tana and I with sweet Encarnacion, which we promise we didn't take JUST to make ourselves feel tall! 

Meet the Team

(Written and posted yesterday, or so I thought until I opened the blog tonight and didn't see it there! Sorry...)

Today was, as always on the first Saturday of these trips, a loooooong travel day.  We left around 3 am, and I was very blessed to be greeted by some very good-natured travel buddies even at that horrendous hour!  I’m so excited about the team that we are traveling with this time, so here’s a quick introduction for those of you following along.

There’s “me”, of course—Heidi Bell, an OB/GYN at East Carolina University and co-author of this blog for six years now!  My husband initially started it in 2006 when we moved down and served as full-time medical missionaries in (Santa Cruz del Quiché) Guatemala for two years.  Since our return to the US in 2008, I have been extremely blessed to have the opportunity to continue making these trips every three months to serve at the hospital in Chichicastenango, Guatemala.  What an amazing gift!

Tana Hall, MD, is a colleague of mine from ECU OB/GYN and one of my best friends and strongest prayer partners in the whole wide world.  She is a very talented young physician that I was privileged to know as a resident and now am even more privileged to work with as a faculty colleague.  Her heart for teaching and her dedication to her patients as well as to the residents and students are a continuous inspiration to me.  She is originally from Wilmington, NC, and has been on several other mission trips to the Dominican Republic and Thailand but never to Guatemala.  We have been trying to get her down here with me for a good two years now, so this is a little bit of a dream come true for us and will be a huge help to me on the trip.

Kelley Haven is a fourth year medical student whose father is a practicing OB/GYN in Greenville, NC—We met her last year when she did her required rotation with us in OB, back before she thought she wanted to go in to OB/GYN as a specialty!  It was such fun to watch her fall in love with the field, and I was thrilled when she was able to work this trip/rotation in to her fourth year schedule.  She is the mother of a beautiful three-year old, Minerva or “Minnie”, so please pray for her especially this week as I am sure she will miss her dearly.

Sandy and Jared Williams are friends from our church, Integrity Church in Greenville, NC, whom we have known for just over a year or so now.  Sandy has trained as a Certified Nurse Midwife but has been at home with her kids full-time since Jared was born 17 years ago so she thinks her skills might be a “bit rusty”.  We are totally praying for a nice delivery or two while we are down there, though, to confirm that delivery skills really are “like riding a bike” and not soon forgotten.  It’s actually rare that we get to do deliveries, though, so it’s kind of a special request ;-)  She became interested in the trip when Jared (the oldest of their four children) began to express interest in a possible career in medicine, so we are praying for positive exposure for him during this trip also.  (A little bit selfishly, we are also praying that God sends us plenty of patients that need abdominal surgeries as opposed to all vaginal surgeries which might be a little much for a 17 year old guy… even a very bright and mature one like Jared!)

I am so excited that both Tom AND JANA Hoak will be in Chichicastenango this week with us—Jana has lived in Guatemala City with their girls up until July when they sent the youngest one off to college, with Tom only seeing his family on the weekends.  I haven’t seen dear Jana in over a year, I don’t think, so I’m very excited to reconnect and celebrate her recent good health news!  (Long story short, we really thought she had cancer for a couple of weeks but are very relieved to find that everything is benign…)  For those of you new to our adventures, Tom Hoak is a very talented general surgeon originally from Minnesota who has served the people of Guatemala full-time for about seven years now.

I will try to get some pictures up as soon as we take any—Sandy brought her good camera and is very excited to try to get some good shots as photography is a favorite hobby.  I’m really excited about her getting those, too!  I tend to otherwise be lazy about getting pictures, so you will have her to thank for those when they do come…

Again, please just pray for God to send the patients that need our help, and to give us the strength, patience, and love to minister to each and every one of them in a way that allows them to see a tiny little spark of a reflection of the amazing love that our Lord Jesus Christ has for them!  To Him be the glory.

Last Days...

Well, yesterday's plans changed when the Fickers called and let us know that a cargo plane had crashed on the runway here in Guatemala City and had the airport closed up for an unknown amount of time.  (I did just now find an internet story that confirmed everyone was OK...)  We had planned to fly out to Canilla to see them and help with clinic this morning.  When we weren't sure when the airport would open back up, we went ahead and hired a car down here to The City and got a hotel room for the night.  Thanks to knowing a LOT of great people here in Guatemala, we are in a really, really nice room for the night that we probably couldn't afford if not for knowing people in the hospitality business here (Thanks, Matt Capehart!)

Before leaving out of Chichi we said goodbye to all of our patients for the week-- Thanks to great anesthesia, Sarah being a great surgeon, and lots of prayers going up, they all looked fantastic and were ready to go home.  Here are a few pictures Sarah shot of us saying goodbye...

And a nice shot of Angelica (the circulating nurse), Don, Marianne, and Alma (the scrub nurse for 27 years at the hospital!)

Today will be another loooooooooonnnng travel day, but it will end in the best part of the trip-- quick kisses to our sleeping babies and husbands!  Then waking up tomorrow morning to the best Mother's Day present ever-- being together with family again.

We will continue to pray for Elias, Juana, Perla, Maria, Oralia, Mikaela, Candelaria, the other Juana, and Marta in their recoveries from surgeries-- many of them had to travel over two hours to their homes, much of it on foot, after discharge yesterday.  This is something I can't imagine doing two days after an abdominal surgery-- You can ask Matt about what a wimp I was just climbing in and out of the minivan on post-op day two!  The difference in "first world problems" and reality for most of the world is astounding... 

Thank you all for your love and support this week.  We will be back on August 11th of this year, and I'm super excited that my friend and colleague Tana Hall will be joining me along with Sandy Williams and her son Jared from Church (Sandy is trained as a midwife but hasn't practiced in a while so we'll be helping her brush up her skills again)  Stay tuned then for more follow-up!  I will try to also keep y'all in the loop as I get pathology reports back-- we are worried about a possible endometrial cancer with Marta and possible cervical cancer with Juana so we are really praying that is not the case. 

When you guys see Sarah Gore, please thank her for her HARD WORK this week and talk to her about her experience-- Can't wait to see some of YOU down here in the future!

Feliz Dia de la Madre!

 (For any Guatemalan mothers who happen to be reading this-- since today is the day we celebrate Mother's Day in Guatemala)  Rounds were particularly fun this morning after Sarah and I got up early to hit the market and buy some pretty flowers for the patients.  They are all mothers and we got a few smiles out of that-- they are generally quite stoic people here.  The picture here is of Maria, who we discharged this morning as she is doing quite well after a very successful prolapse surgery on Tuesday.

In fact, the really cool thing about this week is that ALL of our patients have done really well post-operatively and they have been very easy to care for.  It is so amazing how little pain medication they take after major surgeries!  There is definitely something to be said for non-overmedicated culture, I am sure...

The coolest thing we have done this week, though (for Sarah and I who are really teachers at heart) is work with Dra. Lindsey Rodriguez, who some of you know through the years as the young lady that worked for years with Agape and was helped through medical school by them eventually.  She now works with them up in Quiche with her husband Paul.  She is interested in maybe doing an OB/GYN residency now, and is doing some training now to learn to do C-sections eventually.  She was a great help  on the vaginal cases Tuesday, then yesterday the cases were all abdominal so we handed her the scalpel for, I'm pretty sure, the first time ever!  She said they would never let her do anything like that in medical school here.  She did a great job both opening and closing and left with a huge smile on her face, much to our delight. There is another picture of the three of us down at the bottom-- note that I posted a "bloodless" version of the picture for those of you with weak stomachs this time ;-)

It has also been really great working with Don and Marianne McLeod again this week.  They are here from the Atlanta area and make a great husband-wife team as he is an anesthesiologist and she is an experienced OR nurse!  Don is able to save us a looooooooooottt of money by providing anesthesia this week and next for Tom, and Marianne has such a heart for helping Alma and Angelica out in the OR and really giving them a lot more breaks than they would usually get in a week like this.  With Don's regional anesthesia skills, we have only had one surgery under general anesthesia this week-- this contributed a lot to how quickly they were "up and at 'em" and being discharged after their major surgeries.  Here they are showing off their posts in the OR.  (They also happen to be AMAZING cooks, which explains why no blogging was happening last night... straight to bed after dinner for me!)

The next picture is just where the ladies sell their flowers on the church steps every market day-- a truly beautiful sight here in Chichi.  I put it in as a reminder of some of the patients we especially need to be praying for:  Oralia who had a great surgery but doesn't know Christ, and Mikaela who is about 4-5 weeks pregnant and truly miserable after her surgery and with her severe nausea.  I checked all around this morning but very little is available for nausea in pregnancy here so prayer it is!  She begged to go home today where she can be more comfortable in her house but I know she really feels horrible.

  

We are still ironing out the details for our plans tomorrow, but will definitely be coming home on Saturday to our friends and families!  Tom is operating today and part of tomorrow and Sarah is helping him (and benefitting from his amazing patience and teaching skill)  Thank you all for your prayers and support this week.

Good Tuesday

Today was really quite a smooth day overall, which is remarkably rare down here.  Three surgeries that went very well and a handful of consults that we easily managed mostly before starting our first surgery.  All of the post-op patients are doing very well and the three from yesterday will probably go home tomorrow.

The one little glitch was that we had to bring a case from the ER up to the OR and bump a scheduled case until tomorrow.  A young lady had come in to be seen in the ER last night with a very early pregnancy and pain in her left side.  Tom had seen her, done an ultrasound, and seen a cyst on the left ovary but was not too worried about her pain at the time.  She was supposed to come see me today or tomorrow to start prenatal care.  She came back in today with worsened pain and appeared uncomfortable enough that we were worried about a twisted or tossed ovary or a hemorrhagic cyst.  So up to the OR she went to find out-- unfortunately, we did not find a definite explanation for her pain, but fortunately we did not have to remove the small ovarian structure that is responsible for supporting her early pregnancy until the placenta can take over making hormones!  The family was very relieved that we had found nothing serious and very thankful that we had taken her seriously and looked.  I'm not sure we would have gotten that same response in the U.S.-- land of the CT scan, MRI, and a "rule-out-everything" mentality so it's  little refreshing to just have to make a decision based on the data that you have and for the patient to be appreciative of that!  And it's a LOT humbling.

It was also really nice to work with Dra. Lindsey Rodriguez today.  She came down from Quiche to work with us for the day and it was really nice to have her.  Some of you will recall that she and her husband Paul both have recently graduated from medical school here in Guatemala and joined Agape in Action in their work in rural clinics in the area.  Then tonight I saw Agape on the local TV news!  I walked in a tienda to buy a soda and there was a TV with local news playing-- doing a feature story on the large shipment of medical equipment that Agape sent to the hospital up in Quiche.  They interviewed the hospital director, who talked of Agape and Dr. Street's support for them over the years and how helpful it has been.  That was so cool to walk in on.

Tomorrow will be three abdominal hysterectomies and whatever else comes our way.  Thanks for your prayers for my health.  Please especially add Candelaria to your prayer lists; she is a 67 year old lady that we operated on for prolapse today.  She does not know The Lord although her daughter that brought her in does, so there is definitely great opportunity there... and with that I will leave you to your own thoughts and prayers.  Thanks again for following along.

Well. if indeed, "All's well that ends well", I will let you know in a couple more hours how today went!  It's after 9 p.m. and Tom and Sarah are working hard on a ruptured appendix case that came in to Tom's clinic today.  Definitely a long day, but so far so good!

I am still feeling very under the weather but such is life.  Makes it more difficult for Sarah to operate since I spend more time whining than helping I think, but she is rocking it out!  I really thank God for her surgical talents this week.  Wish I could post more pictures, but the internet connection here (a mobile modem) is apparently feeling under the weather also... it is very, very slow.

Today we did three major gynecology cases (two vaginal prolapse repairs, 2 and 1/2- 3 hours each, and an open/abdominal removal of a fibroid and ovarian cyst.  To date all three patients are doing very well and resting comfortably.  Pray for good rest for them tonight and quick healing!

In clinic we saw only about 6 patients, but because we could only see 1-2 between each case it took us until after 8 pm!  Unbelievable how patiently they wait... One of the last patients of the day was hugely disappointed also-- she is a lady that Tom sent us for a prolapse repair surgery, which we were in the process of setting up for her while Sarah was busy checking her blood pressure and glucose.  The conversation changed abruptly, as you can imagine, when she reported a blood pressure of 250/112!  I'm not sure I've seen one that high, and you can definitely believe that we checked it over and over to verify it.  Pray that she follows our advice, takes her medication, gets help and surveillance from the local general docs to get it down, and sees us in August for her surgery.  Wow.

Tomorrow we have 3 more surgeries scheduled and will see whatever God sends our way in clinic so wish us luck!  Maybe the internet will be happier tomorrow and I can get some pictures up...

First Clinic Day

Well, we made it through clinic today more or less unscathed... 16 patients in all, with 6 surgeries scheduled.  Most of them are vaginal surgeries, but there's one big uterus that needs to come out and one large ovarian cyst also.  Six of the patients were sent by Tom, 2 of them were return patients that I had scheduled to come back myself, and the Fickers sent us 2 also.

While we're being stat-happy, something that really struck me today was how many pregnancies and lost children these women have!!  The AVERAGE number of pregnancies today was 7.3, with 5.5 living children.  Median was 8.5 pregnancies and 5.5 living children!  Yikes.  Our first patient today had been pregnant and given birth to 10 children with 5 still living (she is in her 50's), and this is a story all too common here.  Seven of our 16 patients had been pregnant more than 10 times.  Wow.   I can't imagine the pain of losing a single child, much less 5... but this is the reality that these families live with.  I keep trying to remind myself that but for the grace of God, I would have been born in to this life, too.  It is mind-blowing to think about, and I am constantly thankful for the privilege of helping in any small way I can.

I do continue to need prayer for healing as I remain miserable with some kind of virus that really has me down. Clinic was bad enough, but operating (and seeing patients between surgeries) will be some kind of un-fun if I don't wake up feeling better!  Here's hoping.  Luckily Sarah has not been struck with this, and I hope to keep it that way.  It was so frustrating to have to shy away every time a patient or old friend wanted to hug me today.  I am so glad that Sarah is a very huggable person to make up for it a little.  I was pleasantly surprised that many of them actually seemed to understand when I told them I was trying not to touch or hug them because of my cold.  There's really a lack of general health knowledge here usually so that was a good sign I guess.

Okay, I'm going to bed now, fully hoping and expecting to wake up a new person tomorrow.  It's gotta give sometime right?  Please continue to pray for Sarah's strength to hold out as well-- the next few days will be really long ones!

Sorry there are no pictures tonight; we left Sarah's cable in the clinic so I couldn't transfer them.  I'll try to get more up tomorrow.

Safe Arrival and Prayer Requests

Well, we are off to a little bit of a rough start down here this week—We arrived safely and smoothly but after a looooooong travel day as always.  Sarah Gore, the Chief Resident from our OB/GYN program, has been total trooper and is really going to do a great job this week I think!  Unfortunately I (Heidi) got really quite sick Thursday night or Friday and am not feeling any better yet.  Sore throat, drippy eye, congestion, and—most importantly—severe body aches and fevers that are in-and-out.  Today I might be feeling a little bit better but I think that is mostly wishful thinking.  Please pray that I am back to full health soon and—especially—that Sarah and Tom don’t get infected!!!!!

Today in a few minutes we will hit the tourist market for a bit and see what we can talk Sarah in to for Guatemalan souvenirs.  Then it will be up to the Missionary Church where there is always a great message preached.  Then we hit the ground running in clinic!  Pray for a manageable patient load and problems that we can help, and that the patients would see God’s love sent to them through us instead of just a snotty and whiny doctor and her friend!

A couple quick pictures that Sarah was nice enough to take this morning-- a shot from the market, the two of us outside our hotel, and the hotel room door for Sarah's room.  The weather is beautiful today so we will hope to get out of clinic in time to enjoy some of it!

Thank you all for following along.  I will try to let you know how it went after clinic tonight…

Home again, home again...

Well, here I sit in the Miami airport, waiting to catch the flight back to RDU and trying to use my time wisely to wrap up the blog. The last two days were awesome! Friday morning we got up early to round on our patients and send the two from Wednesday home, looking great. That left only one for Tom to round on for us today, and he sent her home and said she looked great, too.

We then hopped on a van to Quiche and met Duane Ficker at the runway there to fly out and do clinic in Cruz Chich, a village about an hour from the Fickers. After seeing a few hundred patients there, we went home to their house exhausted but happy! It is always so good to spend time with them and catch up. What an amazing family. You can catch up with them at their blog-- there's a link over on the side of this page, I think, if you're interested.

Last night Leslie and I stayed up until nearly 9:30 talking, which any of you who have spent a weekend night out in Canilla with us know is nearly a miracle! I miss being near them so dearly, but am always encouraged by the amazing work that they continue to do with such love and patience and wisdom.

Joey split off from us at the airport this morning (after helping with another 15 or so prenatal visits in the clinic before flying out this morning) and will be in language school this week. She will then join another ECU team down in Nicaragua for another two weeks of mission work, so wish her health and patience! Chris and Tony should be home by now as I still await my connection, but at least I will get to look in on my babies in their beds before turning in to mine for the night.

Thanks again to all of you for all of your prayers and support-- we'll catch up again in May! I am hoping that Pat Peabody (from anesthesia) and one of the residents from our program, Sarah Gore, will be joining me then. Pray that things go smoothly for them to be able to join me please!

Last Day in the OR

Well, today we finished up the surgeries with Tom Hoak doing two minor cases and one major prostatectomy (which Joey and I had a great time scrubbing in on), and Chris and I finishing up an abdominal hysterectomy which went very smoothly. We sent all of our patients from earlier in the week home, and are hopeful that we will leave Tom with only the one from today to look in on and send home over the weekend!

We are thankful for what seems to have been a fruitful week surgically speaking, and just pray that there have been some seeds of God's unfailing love planted in the hearts of our patients and their families. Please pray for this, and for some healing as both Chris and Joey have been feeling a little under the weather with colds and such.

A few pictures that I finally got around to stealing off of Joey's camera-- first is Joey and Chris operating earlier in the week.

Then there's the "obligatory" uterus picture for Joey-- unfortunately not technically the first one she took out because we kept forgetting, but a nice shot nonetheless... one of my favorite poses and I love having so very many different versions of it with so very many different friends from over the years!



The last one is of Chris not being especially happy with me for catching her in a lovely pose as we were once again cleaning our own speculums from the week so they'll be ready for next time! Ah, the glamorous life of a missionary gynecologist!

>

Tomorrow we will get up quite early to round, hopefully send two more patients home, and then head up to Quiche. Duane will meet us there with the plane, and we will go pretty much straight from the Fickers's runway out to Cruz Chich to see probably a few hundred people in clinic there! Wish us more patience to minister to these people tomorrow as we near the end of our week here. Especially as it will be particularly painful for me to be out there with Leslie, Katie, and likely Rachel and definitely Don Allison and won't really be able to visit with them until clinic is over! That will be a little tough, quite frankly. But at least we will have some time to visit after we are done! I can't wait to meet little Ethan and hang out a little bit in my "spiritual haven" (also known as the Fickers's home) in Canilla!

Then Saturday, of course, we fly home (Well, Chris, Tony, and I do... Joey is staying in Antigua at language school for a week and then flying down to Nicaragua to meet another mission team for another week-- color me jealous!) I will be so glad to see my family again. These weeks away are getting harder and harder as the years go by, but are still a great blessing to us all.

Also from Dr. Chris last night...

Well once again, we are almost finished in Chichi and all of us are getting a little worn down I think. I believe I should be buying stock in Halls the way I am downing them, but made it through a couple vagathons intact and plan on heading to bed as soon a I finish writing this. Another good day. We had 2 cases and Tom (Dr Hoak) had 2 cases today. We decided to try and keep clinic light and asked them to give us 5 patients and then only the people with a referral note to see for the morning (Over the past few years, Heidi has developed a pretty good referral base with the local medical missionaries, the nice thing about the referrals is they are pre-screened by someone with some medical knowledge, so they are always people we can DO something for!)... of course those 5 turned into 10 very quickly so Heidi ended up covering the consultas while we got started in the OR. Thankfully (again) my superstar med student was an amazing assist and we actually finished the first case so quickly that Heidi's response when we asked for help talking with the families was, "Seriously? Already?" :-) The second case also went gorgeously... me and Joey had a lovely 3 clamp vaginal hysterectomy and Heidi finished with a gorgeous anterior repair/perineoplasty... nothing to put a surgeon in a better mood than a couple really pretty cases! ;-) We finished up, threw in a bonus consulta for the daughter of Chicki (sp?), the very sweet lady who cooks us lunch while we are down here (let me just say, the woman can cook... if I lived there I would weigh 200 lbs it is so good...), and helped out a little with Tom's cases before finishing off our night at my favorite restaurant in Chichi, Los Cofrades. They smoke everything... it is SO good!

So what is left?? Well tomorrow we have our add on surgery and then we start packing up again. Very early Friday morning, we will get up, round on our remaining post-op patients, and catch the microbus to Quiche to meet Dwayne Ficker. Those who have followed my trips before will remember me talking about the Fickers I am sure because I absolutely LOVE them! Dwayne used to run a private charter plane company and his wife Leslie was a nurse before they got called to Guatemala where they have been for more than 10 years now. They now have a aeronautics/agricultural/medical mission in Canilla which is one of my favorite parts of the trip! Friday we will meet Dwayne and fly to Canilla then drive up to Cruz Chich to do clinic... give me an ultrasound and a room full of pregnant Mayan ladies and I am a happy girl! And then we get to finish out the day with people whose company I truly adore! I am super excited especially to get to meet Katie Ficker's new little boy Ethan (who I had previously only seen through an ultrasound!) The perfect way to finish out a long week! Then Saturday we fly home!!!!

Prayer requests for today... mostly just pray for energy and focus... as we get more tired, it is sometimes difficult to give each patient the love and care they need and deserve. We really just want to continue to see each woman as the beautiful creation God sent to us because He LOVES them, and not just work through a number of patients. Pray that we would be sensitive to His leading with each of these ladies! And personally, pray for me to TRUST that this is all in God's hands... the way things work withour surgeries is that we generally tell them that we work for free, but the surgery costs the hospital X amount... and then we say, what can you afford to pay? They pay what they can and the rest is covered by a charity fund. Not unlike the US, while some are very honest, some I feel try to work the system a bit and don't pay what they are truly able... I tend to get irritated when I realize that is happening, because someone who truly HAS need could use those resources. I need to realize that I can't change their hearts, only He can... I am called to SERVE and show them His LOVE. God will handle the rest. He can convict and soften hearts and he can provide resources for others that need them. I am realizing a lot lately that I really struggle with trusting Him to take care of things. I just want to fix everything myself... I like the illusion of control WAY too much! Other than that, I have no requests, only PRAISE for all of His mercies on this trip!! He really has been SOOOO good and we've been blessed to be able to do a lot! Thanks guys for all your support and prayer! It means the world!! See you all soon~

Stolen From Christina Again...

Thanks to Christina Schwering for posting the following blog tonight!
SOOOO, lets see how this thing holds up tonight... Its Tuesday night and we just finished a lovely dinner at the Casa San Juan with Roy and Jim, two of Heidi's awesome missionary friends (or "grandparent types to her kids" as she described them tonight :-)). Thoroughly enjoyed some limonada con soda, guacamole, and good conversation with great folks! And it was probably a much healthier meal than the ice cream we had for dinner last night... *lol*

The last 2 days have been BUSY!! Yesterday we saw 10 consultas and did 4 cases in the OR. Today we added on another 12 consultas and 2 vagathons (our 3rd OR patient never showed up... hoping she didn't think it was another day because we are FULL now!!) We actually added an extra OR morning Thursday to allow us to fit another case in! And even with that, the less urgent patients have been pushed to the next trip for their surgeries. That is always tough, but I am so grateful to have as many opportunities as God will give me to help out!! The cases have gone well so far. Both vagathons today were long... one complete prolapse that ran about 3 hours, and bled a little more than I would like (I think she must have been taking a lot of Aspirin or something... platelets were NOT doing their job for most of the case) but got a good end result and finally seemed to dry up a bit. The second case was about 2.5 hrs and went a little easier. Joey, our med student with Heidi, has been a Godsend... excellent assistant in some tough cases... bright, hard-working, and a fast learner... really has been a blessing.

A few prayer requests for tonight... First of all, Heidi saw a young lady during our first case that came in for no period and feeling pregnant for 8 months... lo and behold, she is indeed 8 months pregnant. When Heidi told her, she burst into tears... she is married and her husband is in the States and the baby isn't his apparently. The father of the baby doesn't want anything to do with it and apparently she is staying with her parents who will kick her out if they find out she is pregnant. She is terrified... Pray that God find a way to allow her to safely deliver this child and that He finds a place for this little one. I know that God can use the worst situations and some of our biggest failures for His glory... pray that this experience will do just that in her life and the people around her. Sometimes at our lowest point is when we are truly able to look to Him. Continue to pray for our patients and for the people we have yet to see... pray that in serving them, they will be able to see something different than the world around them! :-) A small praise is that 3 of the nurses at Buen Samaritano asked for consultas from us today. God has given us favor here and a good reputation with the locals allows us to reach so many more... people will come if they trust us!

Thanks again for the prayer... we are so grateful for it... and HAPPY BIRTHDAY again to Ashley!! If you see her today, shower her with lots of love!! 2 more days in Chichi, 1 in Canilla, then HOME! Love to you all!

Stolen from Christina...

So I'm totally just re-posting Chris's blog from her Facebook page tonight, since she and I are both too tired to blog again tonight! Here is at least a different take on yesterday-- Enjoy!

Briefly, today was a great day-- just busy. All four surgeries done successfully and ten more new patients seen. Had ice cream for supper and now it's time for a shower and a long nap ;-)

So we started off the day with an awesome word at the little missionary church down here... tough word but an important one all the same and one I probably need a reminder of far more often than I get it. Preached on Luke 13:1-5... Jesus was asked what he thought about an event where people had gotten killed by Pilate unfairly. Jesus (as he always did), read their minds and realized they were trying to justify the deaths and says, "Do you think this happened because they were worse sinners?" He then goes on to ask them about another tragedy where a tower had collpased on several people (one which had no bad person to blame) and ask if they also were worse sinners and that is why they died... and then he tells them (paraphrasing here a bit) that they were missing the point.... of course they were sinners (we all are) and yes, they died, but we ALL deserve death and will get it without repentance! The pastor preached it far more eloquently than I am re-expressing it, but I was just SO convicted about how often I miss the point... I get caught up asking why (or, sadly more often, why me?) when probably the better question is why not? I have sinned (far too often) and fallen short (WAY short) of the glory of God... I don't deserve to live an eternity in his presence. But I am so grateful that he loves me enough to forgive me and bring me to Himself for eternity... *sigh* I'm probably not getting this across well, (realize that reading it back now) but wanted to try... ANYWAY...

Picked up a couple gifts in the market and then headed to clinic for the day... its always a good sign when the crowd at the hospital is so thick you have a hard time getting in the door... *lol* We saw 21 patients this afternoon and scheduled 8 for surgery (and have 2-3 more coming back in 3 months that may need surgery then!). VERY productive afternoon! Lots of prolapse surgery, a couple big fibroid uteruses (aka "fireballs in their eucharist" for the Greenville, NC folks... ;-)), and a D&C for a random endometrial mass. Had a very sweet young lady try to convince Heidi that the reason she hadn't had a period in 4 months was because it was going into her feet (they were swollen, in her eyes it made sense), struggled through several interviews trying to determine if ladies were incontinent (yes, we KNOW you urinate in the bathroom, but does it happen other times?), and had our normal smattering (love that word) of back/leg/feet pain... for the most part though, lots of ladies we are actually able to help! ;-) Most of our patients have accepted Christ, but been in prayer for 2 ladies we are operating on who don't know Him! Hoping they see His love through this experience this week!

Finished off our day in an awesome little pizza joint near the hospital, yelling at a TV with 2 other tables of Americans who had found their way to the lone joint with football playing in town! Thoroughly enjoyed the second half of a GREAT game over some tasty pizza and fried plantanes (gotta have a little Guatemalan flare *lol*)! Wasn't exactly a GCF or TCWC SuperBowl party, but it did nicely in a pinch!

SOOOOOO... prayer requests... we have almost booked all of our surgery spots (remember, we share an OR with Dr Hoak, the general surgeon here) and haven't even gotten to Day 2... pray that we are able to utilize our time wisely to reach everyone God would have us be in contact with here. If today was an indication of the rest of the week, we could probably use some prayer for energy too! :-) Pray for restful nights sleep for all of us (ie: sleeping through the cat in heat/fireworks/rooster/noisy vehicles, etc that are not typically outside of my window in Seneca... *lol*). Pray for the sweet women we are serving that do NOT know Christ, that this begin to plant a seed in their hearts and pray that for those that do that we may be an encouragement to their lives!

THANK YOU to those who always take this trip with us in prayer! It doesn't work without all of you!!!! Looking forward to a great week!!!

Productive Sunday!

Wow. Today was long—but not nearly as long as I thought it was going to be when they told me there were 20 or 25 patients waiting this afternoon to see us! I can’t believe we actually got done before 10 pm, much less in time for the SuperBowl halftime show… cool.

Sundays are always long, because they usually start with an hour or two of market, then Gringo Church up at the Hotel Casa del Rey (sooooo nice to see so many of our long-term missionary friends there each time), then some kind of makeshift lunch and we start our clinic. We try to see whoever shows up, although I think some left today when they saw that the wait might be quite long. We at least didn’t turn any away, for which I am grateful.

So, twenty-one patients later, here’s the brief rundown: 13 patients referred and 9 that came on their own, 2 that we had given appointments to come back to see us from November, 1 from one of the nurses at the hospital, and 2 from local docs at the hospital. Eight surgeries scheduled, five of which are vaginal. Two of the patients we are operating on do not know Jesus, so I will focus on them and ask for prayers.

Rosa Tol Guarcas is 73 years old and has a pretty bad prolapsed uterus. She and her family are of the “traditional Mayan religion”, they explained to me. They kind of giggled when I said that I was glad we were operating because it gave us more time to talk about “mi amigo Jesucristo”, but at least they were warned ;-) She is pictured with her daughter, Chris, and Joey.o:p>

The second picture is Catarina Gonzalez, a 55 year old patient from one of the towns where the Fickers have clinic (San Andres Sajcabaja) and also has a significant prolapse. She came in with lots of family members, including her son-in-law who lives closer to Chichi and has accepted the Lord. His parents are still in the “Catholic” church and not interested in accepting Christ so far. We will definitely be praying for her this week. We are operating either Tuesday or Wednesday; I can’t remember right now.
o:p>

Now it’s pretty much time for bed, as tomorrow will also be long. We will do 3 or maybe 4 surgeries and surely see tons more patients also so we’ll see how it goes. Thanks for all of your prayers—and good night!