Friday, August 17, 2012

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 -- 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.

Wednesday, August 15, 2012

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!

Tuesday, August 14, 2012

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.  

Sunday, August 12, 2012


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.