Wrapping Up and some Updates

So we got back safely, as many of you are now aware ;-)

Sorry this is delayed, but wanted to point some of our regular readers to a fantastic new site you need to check out!  Katie Ficker is keeping a very regular blog now updating you on the progress out in Canillá, which is nothing short of amazing currently!  God is really moving towards getting a 24-hour care center or small hospital that is focused fully on the people of that area!  Here is the link:

http://theaaronfickers.wordpress.com

Check it out!

We will be back in August with more news as usual, "primero Dios"...

A last couple of pictures of the Widow's basket project if any of you are interested in some great gifts!  (Stolen from my own recent facebook post...)

I'm so proud of the Ficker family in Canillà, Guatemala and Rachael Elisabeth Needham for starting this great project-- Will YOU help me help them?! There is a village where they do a medical clinic every Tuesday in a very remote area in Guatemala. There are a large number of widows there who are struggling to feed their families, and Leslie Ficker has looked for a way to help them besides just giving them food for years now. So Rachael taught them how to make these baskets out of natural materials (pine and other types of straw) and provided them with needles to sew them together. We then help sell them to help cover the costs of food for their children, which is being provided through the clinic. Each basket has the brief story of the widow who made it attached, and they sell for suggested donations of $5 to $18. They make great gifts! I have a suitcase full if anyone is interested... Let me know!

Quick Morning Post

Group shot at dinner the other night...

And apparently Angelica agrees it has been a great week!

So this morning we got off to an early start, and we are headed down to the hospital now to check in with Marta, our ovarian and cervical tumor patient.  There might be another patient or two waiting according to the local rumor mill from yesterday, which is why we decided to wait a few hours before flying out to the Fickers.  We will join them in their clinic in Chimistan as soon as we get there and Duane can drive us out to the clinic (about 45 minutes to an hour away, if I recall correctly-- probably faster if he takes us on a four-wheeler as I suspect is his plan!)

This trip has been loads of fun so far, and I pray and believe that people have really gotten to witness some true joy amongst us that can come only from Christ.  It has been all laughs and giggles and hugs and toys for the kids and warm smiles and silly faces and... well, you get the idea!  Our prayer is always that they see God's LOVE and not just the North American's MONEY when they come to see us, so we will continue to pray for these things and strive to accomplish them.

On a personal note, please also pray for me and my work colleagues-- i.e., all my dear, dear friends.  We just found out yesterday that another of our (already very low) number is leaving the program.  He will be dearly missed, and now the generalist division will add "help support the MFM division" to its growing list of "more things to do with less resources".  I can't begin to express, though, the quality and tenacity of the group that I work with-- I thank God for them every day, and am so blessed to have a group that is cohesive enough that Keith Nelson even texted me here in Guatemala to let me know when the announcement was made!! We will find a way to continue to provide quality care to our patients and quality teaching to our residents-- but again, prayers would be appreciated as we navigate through that!

Also on a personal note, I think one of the purposes of this trip might have been rekindling my old passion of uniting the local missionaries together and getting people in contact with each other to match up needs and resources.  More to follow later on that, but it's really great to see all of the people that I admire and love working with each other in ever newer and more exciting ways!

Catching Up...

OK, a little bit of catch up work this morning—I was a little too lazy to blog last night, but mostly just because I was enjoying great fellowship with the team over dinner and then stargazing here on the roof!  The week has been going very well, and the pace has been much less overwhelming than usual.  Even to the point that I would appreciate your prayers about the direction of the mission right now—I really hope that only three gynecologic surgeries this week is just a total fluke and not an indicator of some problem with our reputation or the integrity of our ministry!  Tom is seeing and sending me plenty of prolapse patients, but literally none of them showed up this time.   Maybe it just means we’ll be really slammed in August when I’ll hopefully have another gynecologist helping, though!

So Monday we saw another eight or so patients (a very light Monday also by historical standards) in between our two cases, which both went outstandingly well.  We repaired one lady’s prolapsed bladder, and she looks great post-operatively despite being over 70 years old and fairly debilitated for her age. 

The other case was definitely my favorite new experience of the week—We tried out the “new” laparoscopic equipment here, and ended up doing a beautiful para-ovarian cystectomy case that was really truly the ideal laparoscopic case—a young girl, with pain concerns, thin, healthy, with a cyst that was really mobile and just kind of hanging off of the end of the ovary—no tough dissection or anything, and it would have really pained me to make a big incision in her abdomen just for that!  We will pray that Olga feels better now after surgery, and we’ll be able to follow up with her through the Fickers who sent her.  For those of you interested, there are some screen pics below in the last post—Keep in mind that the equipment is a little older, but more importantly, these are photos of the screen which accounts for some of the quality loss. 

Tuesday we saw another 11 patients, and helped Tom with a gallbladder—then settled in for our long case of the day, which we were kind of “hoping” was an endometrial (uterine) cancer that would be relatively easy to dissect out.  It turned out to be a pretty nasty ovarian cancer, with a question of ALSO having cervical cancer—rare and confusing for us.  I am looking forward to reviewing the pathology and talking the case over with expert colleagues, but more importantly please be praying for Marta, who has a quite deadly disease at this point.  She is a Christian, and lost her husband several years back, but still has plenty of family here that really don’t want to lose her!  She is only 42 years old, which is looking younger and younger to me all the time as I am only a couple of years behind her ;-)

We’ll see what today brings—I’m hoping to get over to Quiche to pick up some things we had to leave down here last trip because we were overweight in Duane’s plane, and who knows what else the Lord will send us?  We’ll be helping Tom with four cases in the OR today also. 

Some highlight stories from clinic before I sign off:

·      Juana’s chief complaint was that she has burning in the vaginal area, which she figures probably has something to do with the time that her uterus fell out and landed on the floor once—about fifty years ago!  She had to have some ladies help her get it back in, apparently.  Luckily now she only has a yeast infection, but some of the histories we get here are pretty convoluted and tough to work through sometimes!

·      Lucia had been told by some doctor in the Guatemalan medical system that she needed to have both her uterus and gallbladder removed to relieve the sensation of pins and needles she was feeling in her LEFT, UPPER part of her abdomen—nowhere near those organs!  Pretty sure that was a case of operating for what we call a “positive wallet biopsy” down here, since she paid for a CT scan before her consult that day!

·      Alicia was told that her white discharge during pregnancy caused her son’s eye infections as a baby—now chlamydia can do that so we treated her and her husband just in case, but now she is thoroughly paranoid about a very normal finding in pregnancy!  It was pretty fun to diagnose her live little 7 week pregnancy by ultrasound, though—that is always a joy.

Just a small sampling for you of the fun days behind and ahead!

Speaking of random sampling, here are today's pictures--

"Decisions, decisions"-- the assortment of laparoscopic trocars available...

Nicole and Preston waiting for me to scrub in and get started on Monday!

Apparently something really interesting was going on in the surgical field here...

From "Guest Blogger" Karen Carr!

Thanks so much to Karen for stepping up when I was whining about not feeling like typing up a blog post tonight!  It's been that kind of week-- every time there is a need on the team or for a patient or for one of the hospital staff or whomever, it just gets filled.  To God be the glory, indeed:

Today was one of those days that you just had to say that GOD YOU GET THE GLORY!! Going down 45 degree angle roadways to get to the people that need water, to standing in on a surgery for the first time all the way to washing speculums; it’s makes one smile to themselves knowing that a patient from el hospital del Buen Samaritano is all the better because of the things that we think are small, goes a long way. God’s ways are TRULY above our ways.

It was one of those days to overcome fears.  I never was fond of heights, but Mr. Snoddy, one of the leading doctors at the hospital wanted me to tag a long to interpret for him on his road trip to see about people needing water for their homes.  With tears in my eyes and white knuckles, looking over the cliff at a 50 foot drop made me realize that this whole trip isn’t about me.  It never was. It’s about going to fulfill a need WHEREVER God needed me.  Gripping even tighter coming back down the mountain and tears dried, I remembered smile on the faces of the family members of the patient that got operated on this morning post-op.  It’s about walking in faith and not fear, about love and not laziness. 

Lastly, seeing the nonstop long-working hours that the medical team has put in on this missions trip, have caused me to take a leap of faith and make missions my life legacy to wherever God would have me go to spread the Gospel of Jesus Christ around the world.  Thank you to Dr. Heidi, Nicole, Dr. Dan-the workingman, Dr. Preston and the 2 Mark Snoddys (Jr. and III)

Thank you for the opportunity and for changing my life.

So for today's random assortment of pictures, we have:  Me doing my first Guatemalan laparoscopy.  

Our para-ovarian cyst that we removed, for the 2.8 of our readers who are actually interested in the surgical pictures!

Preston holding a really, really cute baby of one of our patients today-- although there really is no other kind of Guatemalan baby!

And Karen, the star of today's blog, with one of the friends that she and Mark went out to meet in an outlying village...

Great Clinic Day!

Wow. What a great clinic day!  What a great clinic team!  I have no idea what God has in store for this week still, considering that we only scheduled three surgeries out of the 17 patients we saw, but we will try to be ready for it when it comes.

So today we got off to an early start in the market and picked up a few souvenirs of course… but more importantly, we went to set up for clinic around 9:45 and got started a little after ten.  Thanks to the excellent skills of my last team, the clinic supplies were beautifully organized and easy to set up.  We had 17 patients waiting, so we tried to get started…

Which was about the time Dan and Preston joined us!  Perfect timing, really.  They all quickly settled in to a work flow and we got down to business.  We saw a few patients with problems that they didn’t need surgery for, then came one of my favorite stories of the day.

Our third and fourth patients were both referred from Dr. Tom and were both here for something strange-appearing on their cervix.  So Dan had just put the speculum in for the first exam and he and I were both trying to figure out exactly what we were looking at, when in walked—and I kid you not—my friend Stephen Patrick, who just happens to be an experienced gynecologist!  Really, God?!  Really?!  That’s some pretty serious showing off… I love it when He does that.  So it was great to have a second opinion on that and on the next patient, and to see Dr. Patrick again!  Looking forward to getting him up here to operate with us in August.

My other favorite story from clinic today was the one post-op patient that we saw.  Some of you will remember Tomasa, the patient that Hale Stephenson and I operated on in February to fix the complication (cuff prolapse) from a year and a half ago.   She looked fantastic, and was so happy and grateful.  I was even more grateful, if possible, for her great outcome.  Her second surgery was truly a gift from God.  She is also still attending Church with her daughter, and her daughter thinks she is “really close” to accepting Christ now.  We will keep praying for her.  I couldn’t believe it when she handed me a gift—a beautiful hand-stitched “guipil” (woman’s traditional blouse) for Micah, who met Tomasa when she was 5 weeks old!  What an awesome gift.

So for now we have three surgeries scheduled—tomorrow we are going to attempt my first laparoscopy in Guatemala, which I’m pretty excited about.  I’ve never used Tom’s equipment here, and I’m really looking forward to seeing what he really has and what I can work on bringing down for him later.  Basically, an answer to one of my prayers for a while now, so we’ll see what comes of it!  We will also be doing some vaginal repairs on an older lady, then tackling a very large and likely cancerous mass on Tuesday. 

Tomorrow we will see if anything else comes in to clinic, and take care of whatever does!  Thank you all for your prayers.

The pictures below are of Dan and I reading some X-ray pictures (an HSG, for you gynecologic types out there-- wow!), Karen and Nicole enjoying the sights in town in front of the cathedral, me with Tomasa and her daughter with the beautiful gift for Micah, and Karen and Nicole again with some of the kids in the "waiting room", bringing much-needed joy and levity to their lives!

Greetings from the Past...

Good morning and Happy Mother's Day to all you fabulous Moms out there!  Just wanted to share another quick story from last night before we go down to market and the clinic...

Sitting at dinner last night, my Guatemalan cell phone rang (a great blessing to be able to keep the same number for years now and just recharge it every time I come down!).  It was Cecilia, or "Ceci"-- our former translator from ASELSI!  Some of our more regular readers might remember she was and is near and dear to our hearts-- we learned so much from her about the people here and how to love and teach them more effectively.  

Matt and I also had the privilege of helping her with "scholarship" money to help her put herself (she is a single mom) through nursing school, and she now works at ASELSI with a promotion to a nursing position!  We were so impressed with her enthusiasm for learning from her experiences in clinic.  She enrolled herself in school without mentioning it to us at all; we heard about it from Sharon Harvey who runs ASELSI.  We actually approached HER about our willingness to help financially, and she very faithfully completed the program.

Anyway, last night she called because she had heard I was coming, and apparently she had a gift that she made some months ago and had not been able to give me.  So she was standing outside our apartment door, and I invited her to come meet us up at the restaurant. She and her sister came in just to chat for a minute and deliver a beautiful hand-made table runner that I can't wait to get on our table at home.

Just another quick reminder of God's grace and provision-- It's always just when I start to wonder if I am doing anything worthwhile on these trips that He sends a gentle and beautiful reminder like that.   So here's a picture of me with Ceci and her sister Cristy-- someone tell Isaac his "Tia Ceci" (Aunt Ceci) says HI!

Meet the Team!

Wow!  I can’t wait to see what God has in store for the group of people we have down here this week!  It is something new every time and every trip, and this trip is, of course, no different.  So here goes the obligatory “meet the team” post…

For those of you who are completely new readers, first of all—welcome!  And thanks for following along!  I am Heidi Bell, an OB/GYN from Greenville, North Carolina.  My husband Matt and I lived here in Guatemala as missionaries from 2006-2008 .   Since then, I’ve been extremely blessed to be able to continue coming down every quarter to serve in Chichicastenango for a week.  We mostly provide gynecological surgeries, but also take care of quite a few chronic patients with fertility and bleeding concerns.  As long as God keeps providing, we plan to keep coming.  The amount of support—in prayers, money, donated supplies and equipment, and TIME—has been nothing short of overwhelming over the last 4 and ½ years.

Traveling with me on this trip are Karen Carr and Nicole Jacobs, friends from work and Integrity Church.  They are good friends with each other, and had each been talking about wanting to come down to Guatemala with me individually before we found out we all knew each other.  Karen took her first plane flight with Nicole in 2007, and today got her first passport stamp with her also! 

Karen is a Spanish interpreter at the hospital where I work, and truly has a love of the language.  I’m excited to learn from her this week, and excited about the love and energy that she will certainly exude in the clinics here just like she does at home.  God really seems to be growing her heart for missions, and I look forward to seeing how He works through her this week!  (He is currently blessing me through her in the form of her making up my bed for me while I type ;-)

Nicole teaches Special Education at home, and has a beautiful heart for the Lord.  I also found out tonight that she has had some nursing school, so I can’t wait to get her to work on blood pressures, fingerstick blood sugars, and whatever else she dreams up to do.  Her husband, Brian, works out at the gym with Matt (my husband), and we all go to Church together.  I’m also planning to get Nicole and Karen to scrub in to the OR with me and help (since I will need some help!), so I hope that doesn’t scare them off too badly!

We are also meeting Dan Singleton, a soon-to-be-graduating Family Practice resident who works with Chris Schwering, and a friend of his who is an Emergency Medicine physician also.  They are coming up tomorrow, so more on them later.

Mark Snoddy and his son (also Mark Snoddy) are also down here for two weeks, and I’ve been tasked with “putting Mark to work” and getting his feet wet in medicine, which he thinks he might be developing an interest in.  He’s currently in college, and we are looking forward to having a lot of fun teaching and working with him.  His Dad is a strong supporter of the hospital here (his grandparents essentially built the place!) and serves on the Board of Directors for the “Good Samaritan Hospital” where we will be working on the U.S. side.  It is always a pleasure to hang out with him.  He has been such a blessing to Tom and so many others over the years!

Also for the new readers, “Tom” is Dr. Tom Hoak, a general surgeon from the U.S. who lives down here full-time with his wife Jana.  They have just sent their last daughter off to college this past year, and are working down here “until God sends us somewhere else”, as they will tell you.  They are a continuous inspiration to me, and it is always good to see them and get to work with Tom again!

Pictures below are of Nicole, then Karen, then our attempt at a group photo-- hopefully we will do better tomorrow!