Monday, August 10, 2015

God makes me laugh!

What a day!  Today God sent me Dr. Luis Aquino and Don Allison from Canilla' to help in the OR and the clinic-- huge, huge blessing to get to work with these guys and get to know them better! Great help in the OR, great help in the clinic, and great company.

Our three surgeries today went quite well, and we just saw the patients before bed and they all look good so far post-operatively.  Tomorrow we have two more vaginal surgeries.  We saw 7 more patients in the clinic today (more difficult than it sounds since we just had to hurry and see them between surgeries!) but didn't schedule any more surgeries.  We did unfortunately have to send one lady to the National Hospital up in Quiche for her gallbladder, though... bummer to be here without Dr. Tom!!

Here's how God made me laugh today, though-- At least two of our patients were "gentle" reminders of how sometimes He just has to shove me out of the way to get His work done!  (Or just hide my passport from me, maybe... ;-))

First one:  A lady who has been seeing both me and Tom for years now for non-descript pain and complaints-- always wanting surgery but never with any real indication for surgery or reason to believe that it would help.  In short, she was a patient that I had grown somewhat frustrated with and wasn't very fond of.  I know most of the other medical folks reading this can relate, but it's the simple fact of having a sinful heart-- some patients (or people) just rub you the wrong way, you know?

So-- some of you will remember that I arrived late to my last trip because I lost my passport.  Kelly Pieh-Holder, a chief resident at the time (Now GRADUATED!!!) did clinic by herself on Sunday and Monday.  When I arrived Monday night I went through the charts to see what she had scheduled and came across this lady's chart.  I seriously thought, "HOW did she manage to talk you into a hysterectomy, Kelly?!"  But it seemed that some of her prolapse had worsened and it seemed more reasonable-- plus Kelly had some concerns about some spots on her cervix and actually took biopsies before the patient talked her in to just going ahead and doing the hysterectomy.

Turns out (of course!) that it was a good thing that both the biopsies AND the hysterectomy happened-- this lady had carcinoma-in-situ in her cervix on her pathology report!!  For those of you non-medical folks, that means she had CANCER that just had not "invaded" past a certain level yet!  It could have progressed any day to a much bigger problem.  And now-- because God got me out of my own way long enough to get His work done-- she is cured.  Humbling.  And beautiful.

Oh-- and the pathologists only found the CA-in-situ because we "accidentally" sent the biopsies off separately from the uterus-- If I had realized we were sending them both, I would have thrown away the biopsies since we had the whole uterus and not paid for two pathology specimens.  They initially read the uterus as negative in the lab, but then saw the CA-in-situ on the biopsies and took another look at the uterus.  They had to call Tom and send an amended pathology report with this finding!  Again, "solo Dios".  I would have messed that one up, too, if left to my own "wisdom".

The other story is slightly less striking but still funny and exciting in its own way-- Back in 2009, Chris and I (I think it was her first trip down here?!) went to remove what we THOUGHT (by ultrasound and physical exam) was a large fibroid kind of hanging off the top of the uterus (pedunculated fibroid).  Turns out, we opened her up and found, unfortunately, that the fibroid was inside the uterus and basically taking up the whole uterus.  We were afraid to remove it because if too much bleeding happened, then she would have ended up with a hysterectomy.  She was in her late twenties and not married so had no children at the time so that was not a risk we felt like we could take.

Well, over the years a few things have happened-- (1) the fibroid has continued to grow to the point that she was ready to remove it even if it meant a hysterectomy and sterility, and (2) she got married.  In June she came to Dr. Tom to ask for the hysterectomy and he set her up for surgery.  So guess who showed up with a positive pregnancy test on her surgery day?!?!  Today we confirmed a live, 13 week pregnancy that appears to be situated below the huge fibroid and will hopefully grow normally.  Please do pray for sweet Eva, though, as this pregnancy will likely get uncomfortable for her quite quickly as the baby grows.

Tonight at dinner, I was so blessed to be able to hear more of Luis's story about how he and Naomi met and ended up in Canilla'.  What an amazing instrument God has in him!  Also loved hearing more of Don's testimony and just sharing the amazing things that are happening in our lives.

Hope you all are having half as great a week as I am~  I would still love to have some feeling back in the side of my left hand, but so far surgeries have been okay anyway so just keep praying!

Thanks and good night,


Sunday, August 09, 2015

Fun day in clinic! (Something you do NOT hear me say very often... ;-))

Definitely felt the presence of The Lord today, as it is not within MY power to see 22 patients with patience and without losing my good attitude at some point!  Actually finished up by just before 5 pm to boot... a miracle for sure.  Most of the patients were pretty straightforward, thankfully, and here are the stats for the day:

22 patients, six surgeries scheduled, 4 in-office procedures done (biopsies and polyp removals), just over nine hours.

By far the best part, though, was when one family finally told me why they looked so familiar to me-- they were there with the grandmother of one of our cleft lip babies from back in 2007 or 2008!!!  Maria Buchan was one of the group of 10 or so babies that we took down to Antigua for surgery over the course of a few months when we lived here.   Dad didn't have a photo with him, so he went home and got her to bring to me!  I was hoping he would bring her sometime this week, but there they were knocking on my door just as I finished with the last patient...  She is now 8 (must be nearly 9?)  and has two healthy little brothers.  Isn't she beautiful?!  (First picture before repair, too bad I don't have one on this computer from the front, but you can appreciate that she had a pretty gaping cleft even so...)

What a blessing to see her-- What other short-term mission workers in the world ever get an eight-year follow up on one of their patients?!!  Just another reminder of how awesome it is to be a part of what God is doing here in Guatemala.

I also couldn't help taking my first ever Guatemalan selfie with one of our operative patients for tomorrow... I actually got her to smile a little!

Tomorrow we will see whoever shows up in the clinic in between three major surgeries-- an abdominal one to remove a large abdominal cyst (Dr. Luis sent her to me, so he will get some good follow-up on that referral for sure!), then one "vag-a-thon" as we so lovingly call them (vaginal hysterectomy with repairs for prolapse) and one just plain old vaginal hysterectomy.  "Theoretically" should be pretty striaghtforward, but stay tuned.

Can't wait to have Dr. Luis and Don helping!!! Today did get a bit lonely... plus, I have to wash the speculums all by myself ;-)

Saturday, August 08, 2015

Team "YO"

Well, typically my first blog entry on these trips is just letting people know that we got here safely and introducing the team for the week.  This trip is a little unique in that I am travelling by myself!  Can’t complain at all about the provisions God has made so far to help me, though.  I had 148 pounds of checked luggage to deal with, but not once did I have to lift more than one of the bags myself!  Matt got home from work this morning just as I was getting up to go to the airport, so he was able to drive me, park, and come in to make sure all of the bags made it under weight limits.  HUGE help.  Then here in Guatemala, there’s always luggage porters trying to make tip money so I gave in and let a guy help me today.  For around five bucks, he helped me load everything on a cart and get it outside (without being X-rayed; double bonus and thanks be to God!), where Don Tono, the Hospital Administrator, was waiting!

Sweet Aaron Ficker had apparently been way more concerned than I was about me handling the extra luggage weight (in fairness, nearly 60 pounds of it was airplane and car parts he had requested ;-)) – So he had arranged for a friend from Canilla’ to meet me at the airport and take two of the bags off of my hands right then and there.  “Easy-bo-peasy”, as four year-old Micah would say…

Now I’ve had a lovely time getting to know Tono and his wife a little better (we are usually too busy to get very far past polite greetings at the hospital!) on the drive.  Absolutely fascinating to hear about the times of the Civil War here (the early 80’s were the worst) and how the hospital got by with just two nurses and no supplies.  They had little to offer and brought in very little money on which to live.  This is just one of hundreds of thousands of families that have stories like this in the current generation, and was a great reminder of where some of our patients are coming from.  The burdens they carry with them are barely imaginable to a North American who has never truly wanted for anything. 

These gentle reminders from God to have a little extra compassion, spend a little extra time offering anything positive that I can, and to focus a bit more on appreciating what I have been given are all evidence of His grace.  Another HUGE gift is that I will be joined Monday by two of the best helpers I could even imagine having—Don Allison and Luis Aquino are coming to join me from Canilla’!!  Some of you will remember Don as a PA that has spent quite a bit of time down here off and on for the past five years or so, and is currently committed along with his family to at least two years (I think) serving in the currently-under-construction hospital in Canilla’.  He is a great clinician and a great man.

Dr. Luis is someone many of you have heard me talk about—He is such an answer to such a specific prayer that it is nearly mind-blowing!  In order to open the hospital, there must—by law here—be a Guatemalan native Medical Director. There was much anxiety for a while over who that could possibly be—where would we find a Guatemalan physician with a heart for the Lord and their people who wasn’t already neck-deep in their own work or ministry?  Enter Luis—A man to whom God had given the vision of serving Him in a Guatemalan valley for many, many years during his journey to become a physician.  He did his residency in Spain, so has first-world medical training also!  Apparently, when he first drove in to the valley where Canilla’ sits (photo below), he immediately recognized it as “his” valley (he had assumed the vision was more of a “generic” Guatemalan valley prior to that.  The rest is history, and he and his wife (from the UK) Naomi and their two sons Joshua (3) and Isaac (~18 months now?) are now here for at least three years!  You cannot be around this man without seeing his genuine love for the Lord and for the Guatemalan people, and I truly feel honored to know him and his family.  Can’t wait to spend more time with him this week~ just wish that Naomi and the boys were coming, too!

Tomorrow will be a long day, as I will do clinic all by myself—no small task, as most of you are aware!  (Ask Kelly Pieh-Holder about that from the last trip; poor thing!!!)  Please pray for patience for both me and the patients, and that God can use me to provide each of them what she needs.  Also, a strange but URGENT specific prayer request tonight: 

Since falling asleep on the first flight this morning, I’ve had the pinky side of my left hand go numb.  I assume I’ve ticked off my ulnar nerve somehow (from a position I slept in, etc…)—But I would have expected it to be better by now!  Operating with two numb/tingly fingers would obviously be sub-optimal, so I’m very much hoping and praying for full recovery – hopefully even before clinic tomorrow for patient exams!

So that’s all the news from Chichi for now—(I’m typing in the truck on the way up the mountain, actually—ETA around 20-30 minutes)  The country is beautiful now during rainy season—green and full landscapes and lush countrysides and gardens.  All the more evidence of God’s grace, my friends.