Sunday, August 11, 2013

Wrap Up and Ongoing Prayer Requests (Late Post written Saturday)

Well, yesterday we sent all of our remaining patients home looking quite well.  Please continue to pray for Juana, Sebastiana, Manuela, Aura, Tomasa, and Magdalena over the coming weeks and months.  We will be praying that they continue to recover well at home and have perfect healing of their bodies.  More importantly, as always, we hope that their souls have been touched and that they have felt the healing touch of our Lord and Savior.

In the afternoon we had Duane Ficker pick us up for a quick flight out to Canillá, which in my heart is the closest place to heaven this side of the clouds when I am able to be there with my family.  The Fickers, as always, were amazing and generous hosts.  It is so awesome to hear about all that God is doing in that area!

I am now on the flight home, my head swimming with visions and stories of all that He will do in Canillá and the surrounding areas, and my purse full of rough-drawn plans—but PLANS, dear readers!—for a 24 hour HOSPITAL there on their farm!!!  They have a U.S. physician group committed to staffing it, the government’s approval to start a Nursing School there, a dorm/apartment already being built and fully funded to help house the visiting teams, and God continuing to open doors!  I f76577literally had goose bumps just over and over again hearing about how He is moving there!

Please pray for them fervently over the next few months especially.  Pray that they would continue to hear His voice and His direction in all of these plans.  Pray for clear vision, monetary funding, and guidance and wisdom for all involved in this rapidly-growing project.  Most of all, pray for the lives and souls that will be impacted by this project. 

Some final pictures to leave you with... Our dear friend Hermano Julian, the sweet man who does our daily morning devotions at the Hospital Buen Samaritano.

Examining a patient on rounds one morning.  Basically, if they are up and walking and getting some fresh air and sunshine, I figure they are doing pretty well.  But we're still going to lay hands on them for an exam!  This is Manuela, who you were praying for since around Wednesday.  Doesn't she look great?!

Carol with her first hysterectomy patient EVER, Sebastiana!

... And Stephanie with HERS, Manuela!

A view from the second floor of the Hospital, looking down in to the courtyard.

Maria bonding with Grace and Abi out in Canillá... it was hot, so we were swimming in the pond of course!

 A group shot from a walk and property tour in Canillá:  From left to right, Leslie and Rachel Ficker-- aren't they beautiful?!--, me-- on my cell phone in the middle of nowhere?!?--, Katie Ficker with Abi in front, Judy Koutlas, Stephanie with Grace in front, Carol Akers with Maria Koutlas in front.  Oh-- and I just saw little Ana Ficker over on the far left.  She is adorable!

Maria and Judy saying goodbye, before our flight back to the Guatemala City airport.

If anyone feels the "need" to donate to any of the projects or ministries we have worked with this week, to help cover the costs of surgeries that we did (we will probably "owe" about $2000.00 to cover the costs of gynecology surgeries that we did at the hospital for patients who could not afford to pay the full bill, and the hospital in Canillá is still a leap of faith with no funding yet!), here are some addresses to send to:

New Life Christian Center, note attached for "Hospital Charity Fund in Guatemala"
P.O. Box 782
Turlock, CA 95382

Adonai International Ministries (The Fickers)PO Box 337
Marine, IL 62061 

OR, read up/follow them online and/or contribute on line via Paypal at:

Thursday, August 08, 2013

Last Day in the OR

Well, yesterday started out with an answered prayer and just got better and better after that.  When we first got to the hospital, only one of our two scheduled patients had arrived (they were supposed to be there almost two hours before us), which was a huge bummer.  In the daily worship service, we lifted up Tomasa, the second patient, in prayer and asked that she would find her way here after all in order to have her much-needed prolapse surgery.  (We had already asked all of the hospital employees if anyone knew her or had a way to get in touch with her—they often do know the patients, but no luck in this case!)

After the service, we were sitting in the clinic room and two ladies just walked right in to talk to us.  This is pretty rare in Guatemala—and especially in a doctor’s office.  People just don’t walk in places without permission!  They then shyly asked if we had already operated on Tomasa.  I told them no, and that we were still waiting for her to arrive—were they friends or family members of hers?  Did they have her number?  They promptly got their phones out to call her urgently, but that was just as the lady from the front desk told us that she HAD just arrived and was being admitted as we spoke. 

It made me laugh a little, just because it felt like another one of God’s “showing off” moments—you know, the ones where He just gently reminds us that He has this all under control?  I often feel like those happen more down here, where we have less control and over-scheduling or micro-managing of day-to-day life, and it’s one of my favorite things about life down here.

Anyway, the two surgeries actually went great—when we finally got started at about one o’clock!  Those who have operated with me before will be as shocked as I was that I got the two prolapse surgeries (“vag-a-thons”) both done in under five hours.  Definitely a record—AND that was with having the medical students do the initial incision and dissection and putting on about half of the hysterectomy clamps.  It was so nice to have such a smooth day, considering how tired I already was starting out.

All of our patients are doing great except for one that we are a little more concerned about—please send up extra prayers for Manuela, one of our abdominal hysterectomies from Tuesday.  She is just recovering a little slower than expected, and felt even a little febrile last night.  I am anxious to get down to the hospital and check on her this morning—I’m hoping she has kind of turned a corner in the right direction overnight. 

Today will be rounds, re-organizing and cleaning up the clinic, one quick procedure, whatever patients show up, and market.  Tomorrow we will round, hopefully send ALL of our patients home by then, and then fly out to the Fickers in Canillá to see some patients there and reconnect with those dear friends.

(Update now at dinner, since we didn't get a chance to post until later tonight the above blog from yesterday...)

Manuela is doing better, and all three of our last patients should go home tomorrow.  Clinic is packed up, market is depleted of plenty of souvenirs that we are bringing home with us, and naps have been taken.  Life is good, and God is better.  

Pictures for today:  Maria and Carol generously volunteering to wash the speculums for us!

One of our "paychecks" for the week... these beautiful apples are from the orchard of one of our patients from Tuesday

Fun with the sweet and otherwise bored kids in the courtyard

Just in case we made it seem like we worked ALL the time...

Maria mastered the art of taking blood pressures!  (And fingerstick glucose measurements, not pictured here...)

The girls at our favorite restaurant this week... and where we are posting from currently!

Alma, our scrub nurse of over 20 years, in her new duds that we brought her!  She won't wear pants in the OR, so I finally found her a scrub dress like she likes to wear... I think I was more excited than she was, but it was still fun to finally find something she can actually use!

Dinner last night, and by far our best group shot of the trip...

Carol's first ever skin incision (she will probably get less dainty as the years go by... ;-)

And Stephanie's first ever skin incision, too!  How neat is it for these girls to have these pictures?!?

"Wake me up when the anesthesia is in for the next case..."

Wednesday, August 07, 2013

Day 3

We are the guest, “ghostwriters” for DAY 3 of our stay in Guatemala serving the special people of Chichi at El Buen Samaritano Hospital.  Bless Heidi’s heart for the very long day of not only operating on patients but teaching all of us along the way the ins and outs of  hysterectomies as well as communicating to the local people- including patients, families, hospital staff, and the Delta representative in Guatemala City who finally got the final suitcase that was promised to us on Sunday delivered today.   We had 3 successful surgeries including 2 abdominal hysterectomies and one vaginal hysterectomy late in the day who was supposed to arrive yesterday.   She was hesitant to come due to financial reasons, but after reassurance from Heidi that the fee was negotiable her family was convinced to bring her.  We have lots of fabulous photos showing Stephanie and Carol as primary surgeons….with Heidi guiding them through the cases very patiently.   Maria and Judy gained experience scrubbing in and learning how to cut sutures and suction.   The staff of the hospital have extended their kindness to us in every way by welcoming us every morning at the front door and allowing us to sing/pray/ and worship with them before the work day begins.   The operating room staff have been patient and encouraging as our “pack of 5” fills up their room with questions, lack of quick skills/experience, and giggles- but we greatly appreciate their kind words and smiles as we all were working toward the same goal of giving the best possible care to our patients.   The small children who are patiently waiting on their family members at the hospital have brightened our days as well.  Their smiles and laughter when we give them toys /treats and as we are interacting with them brings us all much joy and fulfillment.   Our group has been working diligently everyday; however, we have found time to enjoy the local cuisine from our homecooked meals at the hospital to our evening dinners out in the town.   We have not been disappointed.  Well, maybe Carol was a bit sad when her fish arrived as a fillet and not an entire fish.  We all made up for it with the fresh tortillas at every meal and the ice cream on the way home tonight after dinner.  Spiritually, we are blessed to have God guiding us to work together, be humble, and support one another in all that we are doing.  There is no one complaining or being negative---now that is pretty rare when you get 5 women together and you are all tired and in close living /work spaces.  Truly God is with us and we thank you for continuing to pray for us. 

Monday, August 05, 2013

Day Two: The OR is now open for business!

Today began with a really nice worship service here at the hospital (they have it every day at 8 am, before patient care starts around 8:30).  Brother Julian spoke on the Lord’s Prayer briefly and really gave a great message for those of us who understand more than half of it ;-)

Then it was off to the races in the clinic!  Trying to finish up before Dr. Iris Gamez, our anesthesiologist, was scheduled to arrive at “ten”.  (She is notoriously late, even for Central America, so we figured we had a few hours anyway!)  Turns out that wasn’t as challenging as we thought—there were only three patients waiting at the time. 

The first one was a 14 year old little girl.  I have no idea how they managed to talk themselves in to a gynecology consult (she was here with her father), but they had a note referring them to “a surgeon” for a mass under her tongue.  Yep, that’s right.  Her tongue.  As in, in her mouth.  As in, nowhere near her girl parts.  No matter, though, we’ll take a look, of course!  It looked to me like just a little inclusion cyst and I was really tempted to just drain it with a needle.  I tried to get up with Tom to make sure I wasn’t missing some kind of crazy mess I could get in to , but no answer.

So I ended up calling my dentist’s office with almost definitely the most random question they’ve heard all day!  If any of you are looking for a great dentist in Greenville, try Earp and Gamboa!!!!  They have been so awesome with both me and Isaac, and Dr. Earp got on the phone and said it sounded like something he would stick a needle in if she were in his office.  So with his reassurance, we did just that and she left “cured”.  For free, essentially.  So it was a total blessing to be able to help her, and her family was very grateful.

We then headed upstairs to operate, and had a really nice result on the vaginal surgery.  The other patient didn’t show up, but we were able to get her on the phone, clear up some miscommunication, and add her back on for tomorrow so no worries. 

The operating room was an absolute blast today—You know I was totally in my element asking the medical students a billion questions and getting them up to speed on hysterectomies so they can each (hopefully) DO one abdominally tomorrow!  Maria and Judy were our group photographers, and you have them to thank for the pictures below. First is the little girl with the mouth cyst mentioned above. Many thanks to Carol for holding the flashlight for me!

THEN we have the obligatory group uterus pictures... our regular readers are used to these by now!  The three of us who were scrubbed right after we got the uterus out...

Then the whole group posing with the offending organ post-operatively!  I love my growing collection of this particular group picture...

Please pray for Juana to have a speedy recovery, and say an extra prayer of thanks for a smooth day today.  It is a beautiful afternoon that we are now enjoying on the roof of the apartment.  Time to go get some reading done (I think I scared the girls in to studying hysterectomies for the rest of the night now!) and maybe stroll around town a bit before dinner. 

First Day of Clinic Down!

Okay, this is going to be a belated post since the internet system that I can usually rely on is down for the week.  The good news with that is that I finally found someone that knew to tell me that instead of just trying to sell me more minutes for the service ;-)  I’m not sure if it is MORE or LESS frustrating when I deal with “first world problems” like the internet being down while I’m actually in a third world country.  That’s perhaps an essay question for the students on the trip if they ever complain of being bored… hee.hee.hee. 

So in clinic Sunday we saw 18 patients and scheduled six for surgery, which is a pretty good ratio in general.  We have a great mix of surgeries scheduled—two abdominal hysterectomies, one vaginal hysterectomy, and three prolapse surgeries (which we affectionately refer to as “vag-a-thons” around here given the long duration of vaginal surgery that it requires).  I’m excited that Stephen Patrick is coming up tomorrow night to help with two of the prolapse surgeries on Wednesday!  It will be great to have his help and mentorship again.

Some of the really fun stuff that happened in clinic yesterday – let’s see…

We did get to tell our cook here (“Chiky” for those who know her) that her grandson will be born in about a month—we did an ultrasound on her daughter-in-law back in May but weren’t sure about the sex.  I told her I was “95% sure” it was a girl, so when I clearly saw that it was a boy, I sheepishly asked what color of clothes they had already bought!  Fortunately, they said “white and yellow”, so we’re in the clear!  They were so excited about the news and knowing for sure.

One classic little Guatemalan lady was seen here by another doctor last year when she was “33” years old.  By Sunday when we saw her, though, she had turned 37!!  I know it was a long wait to see us, but that seems a little exaggerated even so!

We have a great picture of one of our patients using our Guatemalan “changing room”, which consists of two of us holding up a sheet for them to change behind.  Hopefully we’ll find some internet fast enough to upload it for you this week.

Another one of my favorite pictures is the one I took of Carol, Stephanie, Maria, and Judy ALL four examining a patient on the exam table at the same time!  I really do mean it when I say that consults down here are a team event!   It’s fun to have lots of laughs and entertainment during the day, and these are the moments that really keep me going! 

With Dr. Tom Hoak gone this week, the hospital looks like a ghost town!  There are very few patients waiting to be seen in the courtyard and hardly any admitted.  Our admissions will hopefully help liven the place up some.  But at least since we weren’t busy in clinic this morning we had a chance to play with bubbles and crayons and balloons and candy and…. and… and… with all the cute waiting kids and their parents!  That always makes for fun pictures if we can manage to post them.  (How bad of a tease am I, right?!) 

Anyway, thanks to you all for reading and praying with us this week.  It’s been awesome so far and hopefully will stay that way!  We will tell you more about our surgical patients as we get to know them better this week.

(OK, here I am a little later at the internet cafe, shocked and happy to learn that I can upload photos in under an hour ;)  So here are a few to get you started... Maria with the world´s sweetest baby, her mother and big brother.  Then Carol and Stephanie ready to operate today, and some of our courtyard fun with bubbles!  

Saturday, August 03, 2013

Meet the Team

Well, we've had plenty of time to get to know each other a little today-- too bad we're all so sleepy that the main thing we all know is the color of each of our eyeshadows on the outside of our lids!!!  Still "miles to go before we sleep", but I couldn't ask for a more low-maintenance and positive group of women to have traveling delays with!

So here's the team for this week:

There's "me", Heidi Bell for those of you who don't know me.  My husband Matt and I have been keeping this blog since we committed to moving to Guatemala and spending the first two years of our marriage there in 2006-2008.  I was straight out of OB/GYN residency in Houston, TX, and oh-so-young then, looking back... but since then, I have been extremely blessed to continue spending one week each quarter back in my second home, Guatemala.  I think this is the 19th time I have been back since moving to Greenville, NC to work as ECU School of Medicine faculty in 2008!

Carol Akers and Stephanie Maxwell are both fourth year medical students at ECU who are planning to go in to OB/GYN residencies next year.  It was such a privilege to watch each of these beautiful young ladies (who are also roommates in Greenville) fall in love with OB/GYN while they were on our rotation separately last year!  That is one of my favorite privileges of my job.  They will both be a huge help in the operating room, and have stayed busy all day today working on personal statements and schedules for this year.  It is a stressful but exciting time in their lives.  Stephanie has the added stress of a wedding in September coming up, too.

Judy and Maria Koutlas are two lovely ladies that I met indirectly through Hale Stephenson (the Greenville OB private attending that came down earlier this year... I've made so many great contacts through him, so his contribution-- like so many others before him-- to Guatemala and God's work there just keeps on giving!  Judy is an experienced nurse, currently working at the Leo Jenkins Cancer Center.  She apparently has quite a talent for fundraising.  I think I've had two or three emails every week the last month or so asking me what to spend another "few" donated funds on, so we are well-stocked on some popular medications and supplies for this trip.  Maria is her 16 year old daughter and has already been on several missions trips.  We are looking forward to putting her Spanish classes to the test and hopefully feeding off of her youthful energy this week.

The pictures pretty much sum up the day...  Me on the phone with Delta and us napping in the Atlanta airport!

Quick Group Shot and Update at RDU...

Hi new readers for the week!  We will really update and introduce the group later, but here's a quick photo of this week's team (I had the six-ish year old kid beside me take it for us, so be thankful that only one head is cut off! Sorry, Carol!)

From left to right, Carol Akers, Heidi Bell (me), Maria Koutlas, Judy Koutlas, and Stephanie Maxwell

We can't wait to tell you all about our adventures this week... which apparently will start with a sprint through the Atlanta airport to try to make our flight after a delay here in Raleigh.  Apparently God is still working on that whole "patience issue" with me!  (If He'd only finish that work in me FASTER, though, right?! ;-)  Prayers appreciated-- both for safe and efficient flights AND for my patience...