Tuesday, February 12, 2019

Winding Down

Wow.  We are so very exhausted right now, but happily so after a very full OR schedule for 3 days—We are happy to report that we got out of the OR just before nine last night, and then we didn’t go to the hospital until 8 this morning.  We rounded on our eight patients, and discharged five of them who looked great.  We have prevailed upon the good graces of one of the local doctors to round for us tomorrow morning on the last three and hopefully send them home.  Please be praying for continued healing in their homes.

One of the coolest parts of this trip/mission is that we have so much more follow up and long-term relationship than most other “short-term” trips.  Our patients will come back in a couple of weeks to be seen by one of the nurses here who Dr. Hoak (the general surgeon from the US who has been working here since 2006) has pretty much trained up as a mid-level practitioner at this point—She will review their pathology reports, send me copies of them via email, and call me if there are any concerns or issues.  Very cool and reassuring.

Today we will take a small van up the road about 30 minutes to the town where I used to live, then catch a private plane out to  Canilla, a smaller town a little up north where my friends (basically family by now, though!) the Fickers live.  You can read more about what they do at www.adonaiinternationalministries.org, but they do amazing, amazing work—especially in the medical realm.  They have literally built a whole hospital!  Although we are still praying for staff for the hospital to come—especially OB, anesthesia, and peds.

Apparently as of 8 am there were already 15 patients waiting there to see us, so it looks like we will be busy this afternoon too!  It’s definitely nice to be able to provide occasional OB/GYN consults there, though, so they schedule them in the intervening 3-4 months.  Unfortunately quite a few infertility patients, and then a mix of other things.  We are grabbing a good breakfast before we go, just in case 😉

We will leave you with some pictures from around the hospital... enjoy!

The women's ward... and the overflow ward...

The beautiful courtyard!  By far the hospital's best feature...

And three of the hard-working nurses who take good care of the patients... bless them!

Saturday, February 09, 2019

Tired Ladies...

Whew!  We are now at the end of two long days in the OR so far… yesterday we saw 11 more patients before the anesthetist arrived, and we scheduled one more for surgery on Sunday.  Unfortunately, we had to turn 2 more away that wanted surgery but we simply don’t have time to do this week.  It’s good to be “popular”, I guess?!

Yesterday we operated until somewhere after 10:30pm, which as you can imagine was exhausting.  That was three major cases after our anesthesia arrived, plus one minor procedure under local before we saw the other 11 patients.  The cases all went well-ish, although one was significantly more challenging than the others.  Thankfully, all the patients have looked good today and should go home tomorrow. 

Today started off with a great blessing—Some of you may remember that when Kathryn was last here with me in June, we saw a lady who was 32 weeks pregnant with preeclampsia.  This pregnancy was actually the result of infertility treatments (Clomid) that I had given her previously, so it was such fun to see her pregnant!  And then sooooooooo scary to have to send her to the national hospital when we left!  And then sooooooOOOOOooooo much scarier to follow along as we prayed for her quite premature infant who only weighed three pounds to gain weight and be discharged.  And then scary still as we prayed for him to stay healthy at home and really put on some weight.  I’ve been able to keep track of her with phone calls here and there, and we unfortunately missed each other on my last trip in October.

TODAY I GOT TO MEET HER SWEET BABY BOY, Tomas, for the first time!!!  And thus started our day.  It was an amazing blessing and many pictures were taken by both her AND us.  There were gifts that I had for the baby (tiny things) and a gift from her to me—a really nice tablecloth that is very typical of this area.  I can’t even describe how wonderful it was to see his sweet, chubby little cheeks. 

That was definitely the highlight, then began the hard work—four full and difficult but rewarding surgeries.  THANKS to all of you who were praying for Matea, the lady with the horrible prolapse (y’all do NOT want to see pictures, but I have them if you do 😉) and ulcerated skin that we needed to try to sew up—We are happy to report that her surgery seemed to go way better than expected, and we are super-hopeful that she will feel amazingly better and heal well.  Keep those prayers coming, though!

After that, there were two “vag-a-thons” and then a (thankfully relatively straightforward) abdominal hysterectomy.  To say we are tired now is an understatement, but we did manage to get home just after nine tonight so it feels early!  It’s been ramen for dinner the last two nights since everything around here closes by 8 or sometimes 9, but impressively this team’s attitudes and willingness to serve just keep being positive and amazing! 

Here are a few more OR pictures from today and yesterday, plus a cute one of Mili serving a pre-op patient with a new pair of cozy socks to protect her feet in the OR...

Tomorrow you can please pray for straight-up supernatural energy in the OR—we have 3 vag-a-thons plus another difficult vaginal surgery scheduled!  Why I did this to us, I am unsure.  I usually try to keep a rule of no more than two vag-a-thons daily.  But this is the most commonly needed surgery, so we are praying that as we are faithful to do what God has sent us to do, He in turn will provide some favor tomorrow in the OR.

Thanks, God bless, and GOOD NIGHT!

Thursday, February 07, 2019

Group Pictures (Finally)

Selfie time!  Heidi, Mili, Kathryn

Dinner selfie time!  Mili, Heidi, Kathryn... and no, those are sadly NOT margaritas... but that probably IS this blog on my computer in the background ;-)


Getting ready to set up clinic!  The cool thing about this mission is that it has been ongoing for so long and has been so sustainable. This is the storeroom where we keep the clinic supplies on designated shelves when we are not here.  (Heidi pictured)

Three sweet sisters!  I love this picture and these ladies-- we are operating on the one on the right tomorrow...

Mother and daughter, operating on mom this week

Unflattering picture of me, but at least I look passionate?  I'm praying fervently for this lady, who we are doing surgery on this week-- We are really worried about the state of her tissue that we are operating on.  Please do pray with us for Matea's surgery!

Part of our clinic set-up this morning-- pretty state of the art exam lamp, right?  (#itworksfinethough)

Heidi and Kathryn giving a quick talk to the patients before starting clinic, asking for their patience to wait their turn on this long day, and letting them all know they will be seen eventually but can EAT in the meantime (they all tend to show up fasting!)  

From the second floor of the hospital-- I have always LOVED the open air here!  I swear it helps them heal to be out in the sun on their post-op days and not cooped up in a sterile hospital room!

Three of our nurses that will be worked HARD this week once we start admitting patients tomorrow... feel free to keep them in your prayers also.  They manage to keep great attitudes all day and all night long despite the tripled or quadrupled workloads while we are here.

Photo cred for ALL of these to Mili!  THANKS!  I'll try to upload one with her in it in a minute...

Meet the Team! (A day late... sorry!)

So these are out of order because, long story short, I posted this to the wrong blog this morning-- sorry!

Long-time readers know that the first post of the week is always “meet the team”…

FIRST-TIME or new readers, WELCOME to “meet the team” that invites you to join our journey this week—there are three of us traveling together this time, and I’m super-excited to once again be blessed with two other awesome attending physicians.

First I have to tell you who “I” am, though—briefly, my name is Heidi Bell, and after finishing residency in 2006 my husband Matt and I moved down here to Guatemala to serve as full-time medical missionaries for two years.  It was an amazing privilege then, and it’s been possibly even more of a privilege to be able to keep up a practice of sorts here in Guatemala by coming down for a week every three months on a regular schedule.  God has been super-faithful to provide for this mission through six years on faculty of a very busy medical school, contracted pharmaceutical work, unemployment for nearly a year, and now full-time work with a pharma company.  I mostly left clinical medicine in the US in 2014 for a better work-life balance, so now I live in Cary, NC, with my husband and two crazy-but-fun children- Isaac is 11 and Micah is 7.  Gotta give mad props, always, to my husband and especially my in-laws, who faithfully support this mission by driving down from Michigan nearly every time I come down here to help with the kids!

I’m traveling this time with Kathryn Pool, who some of you will remember from last June!  She and I met in a facebook group that we are both in—and she came down and met me in Guatemala sight unseen from Columbus, Ohio!  I was so impressed that she would do that once in a lifetime, so imagine how excited I was when she said she was coming back!  Mad props to her family, also, for supporting her in it.  Especially with 3 teenage girls!  Let’s be praying for Dad this week, right?!  Dr. Pool is in practice that is fairly heavy in obstetrics and light in gyn surgery, but you would never know it by her skill in the OR.  I can’t say enough about how excited I am to have her back down here!

The third member of our party should “complete us” quite nicely, I think— Dr. Milicent Triche and I graduated from residency together! We’ve been facebook friends for a while, and I have LOVED watching her three kids grow up—Ty is 14, Micah is 12, and Maya is 11.  They are awesome and active, so that’s another Dad to pray for and be thankful for this week!  Oh, if 2006 could see us now… SO cool to get to work again with a friend from residency.  And if anyone that knew us at LBJ’s ears are burning this week, we are definitely why.  Mili opened her own practice (!) in Houston, Full Circle OB/Gyn, in 2008 just two years out of residency, which never ceases to amaze me.  Can’t wait to hang out with her in the OR especially this week.

Our trip got off to a rough start when my flight to Atlanta this morning was delayed and I missed my connection to Guatemala.  These poor ladies have been major troopers all day hanging out in Guatemala City with mostly just medical Spanish skills.  In the market, it’s not really helpful to know how to ask someone about their vaginal bleeding or how well her baby is moving, so you can imagine the stress of waiting nearly eight hours for me!  We are now finally headed up to the mountains and Chichicastenango, but we will likely arrive to our beds after midnight tonight.  Please pray for supernatural rest and strength since we are scheduled for a long day of clinic tomorrow.

First Clinic Day

So today, as always, was a busy clinic day.  We ended up seeing 22 patients, but unfortunately have at least 10 more to see tomorrow between surgeries that showed up today but were turned away.  Clinic tends to run long because each patient gets a full history and physical (in Spanish), and surgical patients also get consent counseling, financial counseling, labwork (fingersticks plus urines), paperwork for admission, and instructions for the day of surgery.  It can take a while!

And today, we scheduled 11 of our 22 for surgery!  There were at least two more that have surgical issues but don’t quite want surgery yet.  Others were an assortment of “macarena” body aches and pains (when they start telling you their symptoms and pointing to where it hurts and it pretty much literally looks like they are starting the Macarena dance!), a lady who is unmarried and had an elective abortion 26 years ago with pain ever since (likely with a psychological component), a couple of abnormal cervical biopsies, one post-op from October that looked GREAT (thank goodness!), and one lady whose problems were really all due to her diabetes that is out of control.  (For you medical types, she had a Hemoglobin A1C of 12.4!)

Surgeries scheduled for the next few days include:

1 Partial Colpocleiesis
6 vaginal hysterectomies with prolapse repairs (what I lovingly refer to as a “Vag-a-Thon”!)
2 abdominal hysterectomies

1 removal of a prolapsed fibroid—who has a hemoglobin of 7!!  She has been bleeding for 2 years straight, y’all… and we were sooooo happy to be able to diagnose the fibroid and not cervical cancer which had been suspected on a recent ultrasound!

Please pray especially for one of our vaginal repairs patients.  Her name is Aura, and she was in tears in clinic today asking for prayer for her and her husband, who she thinks is having an affair with another lady in their church!  He ended up showing up at the end of the appointment after we had explained and arranged everything with her—so of course we got to kind of start over with him!  And this is why many more than 20 just doesn’t work in the day.

We did manage to get some photos today of some of these special women, and a few from around the hospital.  I will share those in a separate blog post hopefully still tonight, but want to go ahead and upload this since the pictures take a bit longer!

Thanks for your prayers and well-wishes this week.  Let us know if there is anything you want to hear more about!