Friday, February 07, 2014

Friday Morning After a Short Thursday Night

Well yesterday started out slow, but everyone who has ever been in obstetrics knows never to utter those words out loud!  We mostly wandered in and out of market, helped Tom with all of his cases (he had four lined up), and worked at organizing and cleaning up the clinic from the week.  (This included cleaning all the speculums that we had used-- thanks Tia, Elliott, Mitzi, and Sarah for taking care of this while I was still in the OR!  Yippee!)

Anyway, right around lunchtime we were literally walking out of the clinic room to pack up the stuff for another few months in the storeroom when a young lady I recognized came in and asked for a consult.  The ladies up front sent her to ask me since I had told her we were closed as we were packing up and had had no one show up by 11:30 that morning.  

Silvia is a young girl that we had done a LEEP on a few years ago for some pre-cancerous cervical cancer cells, and she is now term pregnant!  It is her second baby, and she had a C-section with her first one for a "sideways" baby, which is all she knew.  I figured it was a quick prenatal care visit and nice continuity of care to encourage her to come back postpartum in a few months for a another follow-up pap, so I had her come on in.

Sometimes the Lord really does guide us when we let Him.  Sometimes we just get lucky.  I'll never know for sure, but I have my suspicions.  On questioning Silvia, she had some pretty concerning symptoms of preeclampsia for several days now, and her blood pressures were consistently high.  Even though the protein in her urine wasn't very high, the team agreed that the best management for her given her other resources for follow-up was to go ahead and get her delivered, so I did my first C-section ever here at this hospital in Guatemala!  (Just to clarify, definitely NOT my first C-section, and not even my first C-section in Guatemala… don't worry, dear readers!)

Her surgery went well, and her baby, Brian Tómas (Yes, the accent is on the first syllable; weird for that name around here…) was born at 9:03 last night.  Please continue to pray for their family.  We went down and  checked on them around midnight because we are a little paranoid about the education of the nurses about checking for bleeding or infant exams, etc… and I'll tell you, it was INDISPENSABLE having an L and D nurse there that felt comfortable really examining the baby for us!  Babies make me nervous, especially when they come out a little too "tranquil" or quiet for my taste, but Brian had perked up considerably and was breathing a little easier by the time we checked back in so all here could sleep much more peacefully!

We will get pictures up soon of the happy family, but for now here are some of Sarah's from the last few days… The rest are on Elliott's camera that I have to get from him this morning…

I love this shot that Sarah surreptitiously took during the worship service the other morning!


Sarah's first tortilla, with the hospital's beloved cook, "Chiky" (That's her nickname; I've never known what it is short for)


Tom and Elliott operating, with Angelica looking on and acting as scrub nurse


The OR "Pharmacy"or Pyxis...


And the OR "Charge keeping/reporting system" for each case… for this case we used 15 sponges, 60mL thimerosal, 1 5mL syringe, 1 3mL syringe, 2 liters normal saline, 2 liters LR, and 5 "peanuts" for dissection!


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