Saturday, May 12, 2012

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!

Thursday, May 10, 2012

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.

Tuesday, May 08, 2012

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.

Monday, May 07, 2012

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...

Sunday, May 06, 2012

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…