Tuesday, October 17, 2017

Day Two in the OR

So Day Two in the OR, Day Three in the clinic today, and all is still well.  We are thankful that both Chris and I continue with good health and good energy levels, as there is still plenty of work to be done!  All four of our operative patients from yesterday looked great today, including the one that we lost nearly a liter of blood on.  We were thankful that she started out with a great hemoglobin, so today she was still doing well and it doesn’t look like she will need a blood transfusion.

That is a particularly good thing, since both Chris and I gave a bag of blood each to a lady who DOES need probably at least four bags!  We are giving three of them tonight BEFORE her surgery tomorrow, to remove the uterus that is causing her to bleed to these levels!  She saw the local gynecologist who works at the hospital a little over a month ago for the same problem.  Her hemoglobin was just as low then, but he recommended that she wait and see us since she could not afford to pay him to operate on her.  Sigh. 

I understand that everyone is not a missionary, and that everyone has bills to pay.  But he could have at least sent her to the government hospital to try to get her surgery sooner at a hemoglobin that low!  Or had her get blood donated and transfused in the meantime!  That would not have cost him anything but a little bit more time to explain and write an order.  But some folks just aren’t interested.

On a brighter note, we sent two ladies home today looking great on post-op day one, which was definitely a plus since we don’t have many more beds here!  Tom has some anesthesiology friends from back home that got in this afternoon, so we are planning to run two ORs tomorrow and we are filled up with cases in both—it’s a lot of patients and not a lot of hospital!  We will continue to pray that everyone does well and can go home on time or early this week.

Clinic has remained interesting.  Today we added yet another abdominal hysterectomy on for tomorrow, for a grand total of five of those this week.  We’ve seen the usual variety of belly aches, cysts, and a scattered pregnancy or two—plus a lady today who has pain only when she worries about things (yep, you guessed it—diagnosis is depression/anxiety), a lady who cried with relief when we told her the lump she has in her breast that she waited 14 months to seek care for is almost definitely NOT breast cancer (but we will definitely take care of it with Tom’s help!), and a lady whose prolapsed lady parts we fixed back in July but who now says her feet swell when she tries to walk very far—only since the surgery, of course.  What do you say to that—“sorry we fixed your vagina, but broke your feet?”

Anyway, tomorrow will be another long day in the OR with three major abdominal cases and a minor procedure to do, plus some return patients in clinic or referrals.   Hopefully we will get out to Canillá on Thursday. 

We will leave you with some pictures that we had to have the circulating nurse take in the OR, plus one of Chris braving the HUGE needle used for blood donation here in the ER!

Sunday, October 15, 2017

Brief Clinic Summary

So we just finished clinic at around 8 this evening, which quite frankly is a minor miracle since we saw 28 patients in just under 11 hours!  Told you Chris and I make a great (and experienced!) team ;-)  We are now exhausted, however, so here’s a quick summary:

First some stats:
·      28 patients
·      9 surgeries scheduled
·      ZERO “vag-a-thons” (so weird)
·      FOUR abdominal surgeries (pretty sure that’s more than I’ve EVER done in one week)
·      Only three that had fully non-gynecologic issues (although in fairness, one was told by both one doctor and one lay “midwife” that her uterus might be the cause of her back pain and leg falling asleep!)
·      A full FIVE patients who were told that they needed surgery by Guatemalan surgeons but had absolutely NO indication for surgery that would have ever been operated on in the US. 

This last problem is a perpetual one and one that makes me crazy.  It’s also a very time-consuming one in clinic, as it takes a very long time to explain to a patient why they do not need a surgery that “everyone” tells them they do.  They feel they are being turned away from what “everyone” recommends to them as a great opportunity to get their surgery from us.  Occasionally it’s a judgment call where it is at least not INadvisable to operate, but unfortunately it’s often something where we would have flunked our oral boards if we had tried to defend the surgical management to our mentors back in the day! 

It’s just so frustrating and saddening and maddening what these patients are up against sometimes.  The tiny little drops in the bucket we make of help while here seem so insignificant, but we continue to trust in God’s plan and goodness, and in the power of prayer and The Gospel to affect real change.

Now back to the lighter side—I did, as always, have a few more “firsts” again today, and here they are:

·      Had to get a patient’s husband on speakerphone during the surgical consent because he has been in the US for the last ten years.  At least he is still involved and sending money!
·      Had a patient’s husband ask if there was anything he did “wrong” during sex that caused her fibroids—such a sweet and concerned guy…

·      Had to wait for one patient to finish her call on her cell phone so we could pray for her.

I'll end with a couple of pics that Chris snuck in during clinic.  One is me giving my pre-clinic shpiel about "please be patient; we won't turn anyone away, and no one needs to be fasting, and Jesus loves you".  One is a super-sweet grandma that we couldn't resist taking a photo of.  Pray that she gets a large mass in her chest taken care of so that we can take care of an uncomfortable gynecologic problem for her in February.

Meet the Team

Well, my first blog post of the week is always called “Meet the Team”, although this week it will be pretty short since any regular readers already know us all!  What a great joy and privilege to get to work alongside Dr. Chris(tina) Schwering (née DeLuca) this week again—I can’t believe it’s been 8 years since she first came down here as a resident with me!  Since then she has married, adopted his child as her own and seen her graduate from college, birthed a child who will soon start kindergarten, fostered two babies, become Chief of Staff at her hospital, and clearly is just freakin’ Wonder Woman! 

Her husband Tony is basically running IT support for the hospital out in Canillá, so he will fly out early Monday morning with a full lock and security/badge system to install for them this week while we operate.  Truth be told, I’m pretty sure he’s the one who keeps the Wonder Woman suit and plane clean, available, and running on time, but don’t tell him I know ;-)

I’m still “me”, Heidi Bell—the same OB/GYN who has had the amazing privilege of not only living here in the Department of Quiché in Guatemala from 2006 to 2008 with my own amazing husband, Matt, but also spending a week every three months here for nearly 10 years now since then!  God has been so faithful to keep this ministry going.  I learn something new every trip, and He clearly still has a lot more to teach me.  Also, I tend to be a slow learner on the more important life lessons, so I’m pretty sure I’ll still be coming for a while.  At least I hope so.

We arrived today with  probably close to 400 pounds worth of supplies for two hospitals (the one we are operating at here in Chichicastenango, plus the one our dear friends the Fickers (adonaiinternationalministries.org) and Docs for Hope (docsforhope.org) are building out in Canillá, plus gifts and treats for as many of the “boots on the ground” missionaries as possible.  Since I left my clinical medicine job a couple of years ago, my ministry here has really morphed into a lot less bringing of medical supplies and a lot more just ministering (through physical/tangible gift-giving from the US) to those who serve here.

It’s amazing how often these missionaries are neglected even by visiting friends or groups from their home churches!  Folks who have wonderful intentions, of course, of serving the Guatemalan people when they come down.  But when asked if they could bring down a book or other supply needed for the nursing school or other project or even just a personal need, it’s “our luggage space is really tight with all the supplies we are bringing for the VBS children” and such.  Again, total good intentions.  But after a while as a missionary, you just stop even asking, and you pray for someone to come along and ask YOU what they can bring YOU.

Enter folks like Chris, Tony, and I.  And all of you who have helped or donated to help us meet needs or wants or even provide little luxuries here and there over the years!  And don’t get me wrong—There’s lot of other needs that we are missing or neglecting to meet this one; this just happens to be the one that God has laid on MY heart and very specifically equipped Matt and I to provide for.  We cherish it.

Tomorrow will begin clinic and if recent history is any indicator, it will be a super long day—so now I’m going to bed.  Hopefully I’ll get my modem charged up with some money on the account tomorrow so I can actually post this to blogger since I am just typing it up in Word tonight… If you are reading this anytime before Sunday night, that plan worked, likely meaning that I sent Tony to a store with some cash and a note that says in Spanish, “please charge account number xxxxxxxx with these 50 questzales”!  And that the shop owner could read ;-)

You gotta love this place!  I know I do.