Agape In Action

Just Pictures Today...

2011-11-09T19:29:00.002-06:00

Kelly with Alma and Angelica, the two scrub nurses at Buen Samaritano. (Kelly looks wet because of the cool towel she wrapped around her shoulders before scrubbing-- it gets hot in that OR when the afternoon sun comes through those windows!)

Sweet little girl that is at least as tired as we all are tonight...

Heidi and Chris operating on one of four patients today...

Kelly and Chris anxiously awaiting lunch between cases!

Kelly took a nice shot of the OR here that I stole off of her camera to post (OK, technically I stole all of these shots off of her camera to post, but I was particularly partial to this one!)

Some Pics "Scene around Chichi" and words from Dr. Chris...

2011-11-09T07:08:00.003-06:00

Day 4-5: "Never saying "quiet" applies to Guatemala too!"

by Christina Schwering on Wednesday, November 9, 2011 at 7:30am

Good morning! So the old superstition we develop in residency where you NEVER should say the word "quiet" without cursing yourself to a crazy patient load apparently applies to Guatemala TOO! I had no longer finished telling Tony how clinic usually slowed down on Tuesday when the nurse walked in with our "6 or 7 patients" which were really 13-14 charts... yikes! Then our anesthesia guy, Dr Palma, walks in and informs us that he has to leave at 2:30... uh oh! Thankfully God is good and as it always does, it all worked out!

Me and Kelley and Heidi started our tough case of the day while Leisa screened patients downstairs in the clinic. I have decided that we must have had an invisible extra scrub tech (yep, thats right, Jesus is our scrub tech ;-)) because despite a non-functioning Bovie (cautery), a patient with pretty impressive leg contractures(makes for tough visualization), and miserable tissue, the surgery actually went really well! We removed the really damaged, ulcerated mucosa, took out the tiny little offending organ (:-)), and re-inverted her poor vagina without a lot of problems! It was tedious, but God was certainly with us, because I was completely prepared for a 4-5 hr case like my last trip and we were out in a little less than 3 hrs! We then got some lunch and me and Kelley started our next case while Heidi saw patients with Leisa. At his point I was pretty certain there were some extra hands fishing me stuff from that scrub table, because when Heidi showed up about an hour later, me and Kelley were almost done with the case! Went beautifully... God is SO good!

So today is a busy OR day... not sure about clinic, but worried we may need to turn away people if it is like yesterday. We will probably start a little later as Dr Hoak has an eye mass removal at 8, but after that we have a vaginal hysterectomy for bleeding, 2 abdominal hysterectomies for big goomba uteri (aka lots of fibroids ;-)), and an open ovarian cystectomy for a 10cm complex cyst (hoping for a dermoid so I can gross out my hubby with some teeth and hair *lol*).

For all my prayer warriors... my 2nd case from yesterday DOESN'T know Christ... she has family that does, but has not accepted Him. Please pray that the kindness of strangers here may show her His love in a way that softens her heart and brings her to Him! Her name is Esteban. Pray for all of our patients today that we will see, but I especially feel led to ask for prayer for our little old lady with the VERY large uterus that we are taking out (the size of a 36 wk pregnancy!)... don't know why, just feel wary of it. It is big and will be tough, but something more than that that I can't put my finger on! Sending lots of love to everyone at home!! Tomorrow afternoon we will likely head to Canilla so last full day in Chichi! Its been a great trip! See you soon!

From Chris Schwering this morning...

2011-11-08T07:01:00.001-06:00

Guatemala Day3-4..."Your stomach hurts in your breast??"

(Thank you, Dr. Chris, for being generous enough to let me "steal" this off of your Facebook blog to repost here!)

by Christina Schwering on Tuesday, November 8, 2011 at 7:45am

Good morning! Well I will eventually have to wake my very soundly sleeping hubby who doesn't seem to be bothered at all by the noise here (oh that I was so blessed, but alas, earplugs are a beautiful thing!) but for now, I have a little time to sit in bed with my computer, serenaded by the rooster somewhere outside our room, and share a bit so here goes!

First of THANK YOU for your prayer support! This has been a great trip so far! Our patient load has been a little lighter than average but the percentage of people we can help has been higher than I can ever remember. I think of the 18 patients we have seen so far, all but 2 have actuallly had OB/GYN related issues! You always will get the "Macerena patients" as Heidi calls them ("Donde esta tu dolor?"... and they do the Macarena to show you...) and the sweet ladies whose stomach pain is located in their breasts and whose lung pain is in their shoulders (the Guatemalan counterpart to the "every back pain is my kidneys and every lower belly pain is my ovaries" patients), but most were referrals and therefore pre-screened and legitly needed our help!

So people who don't care for the medical details can skip on to the next paragraph, but for those interested... Yesterday we did 2 "vagathons" (vaginal hysterectomy with prolapse repairs) and a D&C for a uterine polyp... All 3 went beautifully. Kelley is transitioning to Guatemalan "instrumentista" beautifully and the two of us (with her functioning as both scrub tech and first assist the first half of the both vagathons) had a nice little rhythm worked out... don't know many scrub techs who could organize and hand instruments from a limited table while functioning as the ONLY assist on in a vaginal case like that... at home I usually have 3 people to do what Kelley was doing here... did I mention she is awesome??? Has an invite back ANY time! Heidi came in for the repair portion of the cases and has kind of let me just be primary surgeon so far which I have to admit, I kind of love! During other times her and Leisa handled clinic effortlessly despite some of the confusing stories given by our patients! Today we have 2 particularly tough vagathons for prolapse patients that even Dr Hoak, the general surgeon here who is USED to seeing ladies with their girls parts hanging between their legs, deemed impressive! Our one lady has a small grapefruit hanging out which is pretty ulcerated, but we are hoping has enough healthy mucosa to leave her with a functioning vagina. We also scheduled 3 for tomorrow including 2 abdominal hysterectomies for fibroids (1 at 22wk size and one at 36 wk size!) and a vaginal hysterectomy for menorrhagia (heavy bleeding).

Tony is doing well here in Guatemala too... he has been busy playing with kids and catching up on some video editing so far, but plans to do some video of what we are doing and maybe help out Dr Hoak with some things around the apt. I am hoping he is enjoying and finding his niche here a little... I know not speaking the language is tough and I want him to KNOW he is valued here even if he isn't Spanish speaking or medical!

Today we continue in the OR... please pray for our OR patients today and for those recovering... pray especially for these patients to understand where our desire to help them comes from! He is SO good and loves them so much... we want them to understand that! Pray for His continued favor today!!! Thanks guys and God bless!

Praise God for a great day in the OR!

2011-11-07T20:41:00.002-06:00

Short note tonight, just to let everyone know that we had a great day-- We operated on Maria, Maria Antoineta, and Tomasa today and they are all doing very well! (Maria Antoineta had a day surgery so is already home, and we just checked on the other two and they look great so far!) Also saw another eight clinic patients and scheduled three more surgeries, so life is good in Gyno-land.

Please continue to pray especially for the patients that we are operating on this week who do not know Christ, and pray that we will be focused on our primary mission of being a blessing to these people that we encounter here and showing them Christ's love for them. It gets harder as we all get a little more tired, so we will try to keep our hearts and minds focused over the next few days.

We were completely delinquent in the photography department today (See? It just proves how hard we were working, right?!), but we'll try to do better tomorrow!

Nearly Perfect Clinic Day

2011-11-06T20:51:00.003-06:00

Well, anyone who knows any surgeons know that a "perfect" clinic day (if there is such a thing) is one where you schedule 100% of the patients you see for surgery! We came closer today than ever. I am grateful that God's mercy seemed to be upon us today in the scheduling. We had eight patients show up (then saw two of the local nurses also, for a total of ten)-- Of the eight first ones, seven actually need surgery, and five are scheduled! The other two are not sure they are ready so might come back tomorrow or might come back in February.

I think one of the best parts was that the two hospital employees asked me for a "consulta" today-- This has been happening a little more commonly lately, and to me it is a sign that we are really gaining their trust and respect. At least I hope it is! I have been working here at the hospital for nearly five years now, and I think the first time this happened was my last trip, so it's been pretty slow in coming. Praise God for the positive feedback!

Biggest prayer request of the day: the couple in the picture below. We will be operating on her tomorrow, and they are actually the only patients we saw today that don't at least claim to be Christians. She is in the Catholic church here, in which it is not acceptable to accept Christ. Very sad state of affairs for the Catholic church here, but unfortunately true and we will pray for her hard this week! Her name is Tomasa Mejia and she is pictured with her husband.

The other pictures are Chris and Kelly with our first "paycheck" of the week... a bag of apples from our first patient! I've actually only very rarely had anyone bring a gift like that to their first consult, so it was really quite nice. The second two are of the group (I took the pictures, using the excuse that most of the readers already know what I look like ;-) One is with the "Welcome to Chichicastenango" sign, and the other is just closer. I am so thankful to be here with such a fun and hard-working group!

Travel Day and Safe Arrival!

2011-11-05T19:49:00.000-06:00

Well, so far today has been our typical long Saturday of travel—I got up just after Matt got home last night to drive to the airport (around 2:30 am) and have been going ever since. Leisa, a Nurse Practitioner from California who knows Tom Hoak from his previous days there, met us in Guatemala City and had us beat—she started at 6:30 am yesterday!! We’re all very tired but thankful to be here safely and planning to sleep well tonight.

Let me tell you a little bit more about who “we” are this trip—Most of you reading this know Dr. Chris (DeLuca) Schwering who is back on this trip with a new last name and her new husband in tow! We are very excited to have him share in the experience that we have come to love dearly here in Guate.

Kelly Cromer also came down with Chris and Tony—She is a scrub tech at the hospital where Chris practices and I’ve been hearing about her and how Chris wanted to bring her down here pretty much since she started working there! We are hoping that Alma (the Guatemalan scrub tech who has been in that position longer than anyone can remember) will let her give her a break during some of the cases this week. It would also give our brains a little bit of a break since we could ask for instruments in English again! I’m pretty sure that in English we won’t try to ask for “scissors with teeth” or anything like we tend to in Spanish.

Leisa, mentioned above, rounds out our team of five for the week. I am here with no children in tow this time, which will be a great disappointment to the nurses at the hospital but a whole lot easier for me! We are so blessed to have Matt’s parents, Mary Jean and Denzil, staying with him and the kids this week to help while I’m gone. Having the grandparents around definitely takes the sting out of missing Mommy, it seems! (At least that’s what I tell myself, since the alternative is to wonder whether they do miss me!…)

Tomorrow will be our typical very busy day—market, then church, then start the clinic and work until we’re done! That and Monday when we start operating AND trying to see patients in clinic are definitely the most stressful parts of the week, so feel free to pray extra hard for us then! We will do our best to keep you posted, and we'll try to get some pictures up soon, too!

OR Day Three

2011-08-10T21:39:00.002-06:00

The last two days have been long but productive ones! Yesterday we took out a 13 and 1/2 pound uterus (the second biggest that Tom and I can remember taking out together) and went to the hospital thinking that was the only case we had scheduled... those of you who know how things go down here are probably snickering at that since you know it didn't stay that way!

So Tom had two patients waiting for him in the ER when he got to work in the morning, and promptly diagnosed one as very sick from her gallstones and the other with a likely colon cancer. We operated on the lady's gallbladder, then did a sigmoidoscopy to confirm the tumor diagnosis before operating on him today.

This morning Tom started with the colon tumor with Maryann while I did what I had hoped would be a "quick little LEEP" procedure in the clinic downstairs. I was so glad that Keith Nelson had just done his Grand Rounds on the use of electrosurgery, since I actually had some idea how to use the machine that we had available. Having NO idea what to set the power at, I hopped down to the butcher shop to buy some meat to experiment with before getting started. Then we spent an hour or so troubleshooting why only one setting would work, and the last experiment I did was with both the meat and the grounding pad on my calf while I cut the meat with the Bovie. (I called Keith at his clinic before trying this just to make sure I wasn't missing anything in my understanding of electrosurgery!)

By then there was a patient in the Emergency Room that they asked me to see-- a 36 year old with 5 living children (although she has given birth to 8...) with vaginal bleeding and saying she is 3 months pregnant. I spent the next 5 minutes or so diagnosing her with about an 18-week sized Molar pregnancy, and the next hour or so trying to explain this to her and her family and talk her in to a hysterectomy. (For the GYN types out there, I'm not really excited about trying a D and C on that with nothing but wall suction, pitocin, and methergine-- Remember I have no blood bank here...)

Unfortunately, so far Marta has refused surgery-- she insists that she feels her baby moving inside of her, and wants to wait out her nine months and see what happens. I am heartbroken over this, but she is supposed to come back in the morning to get the results of some labs so I am hoping for maybe a change of heart overnight. I am afraid she will bleed to death from this if we don't take care of it soon.

The rest of our cases went well today, except for the colon cancer tumor turned out to be inoperable (It was too stuck down to some very important veins for even Tom to be able to safely remove). Tomorrow we have several more lined up, and I will be praying tonight over Marta's case as we might do her hysterectomy. Please join me in that!

(I tried to post a picture of the electrosurgery machine but I can't get my phone to send it to me... sorry!)

OR Day One

2011-08-08T21:24:00.003-06:00

Whew! Long but good day today... started out with trying to go down to the hospital at about 7:30 to get organized for the day, only to turn back around and come back to the hotel when there was no one to open the locked hospital doors for me! So I tried again-- more successfully-- around eight.

Mom and Micah hung out at the hotel most of the day, but did get to come say hi to us in the OR a little later. We were hoping to grab lunch or something together but our timing was off-- Micah had just fallen asleep every time I called when I got out of the OR!

I was happy to see a lady in line this morning with a card from Leslie Ficker's clinic in San Andres-- she had a large abdominal mass that they found yesterday, so I saw her early, admitted her, and operated this afternoon! Turned out it was just a large fibroid uterus, thankfully. We'll send it to the pathologist but I'm fairly certain it is benign.

The first two cases were the ones scheduled from yesterday-- a tubal ligation ("tubes tied", for elective sterilization) who went home this afternoon, and another abdominal hysterectomy for a quite large uterus-- think about 4-5 months pregnant size. Please pray that Valbina's pathology report comes back benign; I am a little more worried about hers...

Sorry I didn't take any pictures today to share-- I'll try to get Mom on that task for tomorrow! But seeing 2 to 4 patients AND pumping after talking with the family, writing the op note, and doing orders in between each case I somehow didn't find the time. The other 13 patients I saw today are mostly non-surgical, except for one lady who will come back in November for surgery since we are afraid we'll be busy all day tomorrow with one very large abdominal mass. Wednesday is pretty fully scheduled with Tom's cases that had piled up already last week! He has another full day Thursday.

Don and Maryann McLeod, who are graciously providing anesthesia as well as some OR nursing expertise for us last week and this week out of Atlanta, leave Friday. It is always so nice to meet other people who have developed a heart for Guatemala over the years in so many different ways.

I actually had a pretty warm shower back at the hotel tonight, and now I'm praying that Micah, Mom/Mary Jean, and my two inpatients get a good night's sleep tonight!

Back in Guatemala Again This Week!

2011-08-07T19:12:00.003-06:00

So yesterday we left the house at 3:30 a.m. and arrived at our hotel in Chichicastenango around 7 p.m. or so-- talk about a long travel day! But we do it every three months so I'm not sure why I'm always so surprised...

Anyway, "we" is me, Micah (now four months old), and my mother-in-law Mary Jean Bell, who is just sweet and crazy enough to come down here with me mostly to help out with Micah. I am so grateful for the company-- not to mention the help! What a blessing.

This morning we got up after variable amounts of sleep (Micah and I actually did much better than Mom... she's not nearly as used to the noise around here as I am!), hit the market for a little while, then went to Church where Pastor Don preached another one of his really good messages. Seeing so many old and new friends up at the Church here is one of my favorite parts of the whole week. I can't believe how blessed I have been to know so many amazing people who have dedicated so much of their lives to serving our Lord.

After Church, we grabbed a quick PB and J here at the hotel and then I was off to the races in clinic! I never have any idea what to expect there-- sometimes we've worked until after 9:00 p.m. seeing patients. Today there were only 14 or 15 that signed up, and I totally "struck out" with scheduling surgeries (only scheduled 2). I really got to see quite a few patients that simply needed reassurance that they did NOT need surgeries that had been recommended. These women were by far the happiest of the day as they left with a weight seemingly lifted from their shoulders.

A few other patients I was actually able to diagnose and help with creams or other medicines or just advice or education. So it was really a great clinic day although the patient-to-scheduled-surgery ratio was a little higher than most surgeons like it!

Please pray for our patients scheduled for tomorrow-- Elvia and Valbina. Also feel free to thank God for making it through customs once again without any hassles! I was able to bring in quite a few (like, at least 20) laparoscopic instruments for Tom to use-- they X-rayed all of our bags but didn't seem to have a problem with anything.

Here's some random shots from travel and our day today... just to add a little color to this post! Will try to keep you updated tomorrow. Thank you all again for reading and praying with us.

May 2011 - Day 5/6 - By Dr. Chris DeLuca - "Yay, An Airplane Trip!"

2011-05-12T13:47:00.000-06:00

Well yesterday was a lovely quiet day! We got up and rounded on our patients and then really didn't have much to do. Went through all the supply boxes and donated things and made some sense of them and tried to clean up the clinic room a bit. Pat went "shopping" in my bag full of anesthetic supplies and was very grateful to OMH for all the recently expired goodies (ET tubes, LMAs, epidural supplies, etc)! I think perhaps I am going to start a similar "give away" box in L&D and OOB for missions because that system obviously is working great in the OR.

Got to then get some lunch and spend a little time in the market here in Chichi and then actually went back to the apt, packed up, and got a little nap in! NIce treat! Skyped with my handsome fiance for a bit then headed back to Buen Samaritano and watched Dr Hoak taken care of a walled off appy. Finished my day with a meal with 3 friends of Heidi's, Roy, Kathleen, and Jim, who I thoroughly enjoyed, and one more short talk with my honey before bed! We will discharge the last of our surgical patients today and catch a microbus to Quiche where Dwayne will pick us up in the Cessna and head to Canilla... yay!! We will get to spend some time with the Fickers and help them our tomorrow with one of their clinics, then it will be back home of Saturday!

Another great trip here, but there is always more to do, and more needed. Buen Samaritanos US machine, for example, was stolen recently... big old machine taken from behind locked doors... They are using and old borrowed Sonocyte now that really just doesn't cut it... anyone have an old machine they'd like to get rid of? If it is in working, or near working condition, it could certainly be used here... I'll be glad to help you get it here... just for starters, lets pray for a replacement for them, shall we? :-)

OK, off to start my day, hope everyone at home is doing great... see you all soon!

Chris

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May 2011 - Day 4/5 - Post by Dr. Chris DeLuca - "It's Not a Tumor"

2011-05-12T05:44:00.000-06:00

Or at least not a cancerous one probably... YAY! So good morning! Yay for God because the surgery we were worried might be cancer WASN'T! (At least I am about 99% syre pre-pathology results... and speaking of pathology results, anyone else ever seen an olive jar double as a specimen container? Love missionary medicine!) So did 5 cases yesterday, 2 of our own and 3 where I got to play general surgeon with Dr. Hoak (kinda fun!) One non-surgical consult only i the AM... apparently Mother's Day was yesterday in Guatemala and nobody fancied a pap for Mother's Day... crazy I know! ;-) All 3 of our post-op patients are doing very well... it remains to be seen how successful Tomasa's prolapse repair will be seen (may not know until well after we are gone) but we are still praying hard. We did decide NOT to reoperate... just trusting Him. Our first case was a nice mini-lap ovarian cystectomy that ended up being a little dermoid (cool but gross cyst with hair in it) so the correct call there. The one we were worried about, Manuela, appears to just have a HUGE cervical firboid that parasitized some nutrition from the uterine arteries. It was kind of a cool case, we got in to a MILDLY enlarged uterus sitting on top of a softball! Thankfully, the softball acted nothing like cancer... rest of the belly seemed benign, shelled out pretty easily once we took care of the blood supply... praise God for the gift of Dr. Tom Hoak who came down and dissected out our ureters and protected them from harms way after me a Heidi spent about 30 minutes trying to channel Dr Semer and dig them out... *lol* He was AWESOME! Enjoyed working with Him a lot! He is a great teacher and if God ever tells him he is done over here, he should ceratinly teach somewhere! Anyway, did lose a lot of blood, but by the grace of God, she is tolerating her anemia WONDERFULLY and should do great! I also did 3 cases with Dr Hoak.... a femoral and inguinal hernia repair (short and sweet) and an open cholecystectomy that ended up being a common bile duct resection and sphincteroplasty... something I'd never get to see at home... pretty cool!

So a good day yesterday, but another long one... been so happy for God's provision and grace, even if my feet and back are a bit sore! :-) Today whatever comes in we will see, will be our last consulta day and we'll have to see if anything surgical shows up. I know that Tom has 3 or 4 cases on the schedule so if there aren't Gyn patients, we may just help him out some. Tomorrow we will leave for Canilla to spend time with the Fickers, missionary friends of Heidi who I thoroughly enjoyed meeting my first trip here. We will probably do a clinic with them Friday then back to the States Saturday! This trip seems to be going by quickly... good and bad. Good because I certainly miss being around the people I love in the States, but bad because I truly enjoy it here when I come. Praying today for his favor and continued good recovery for our patients. Pray that we wouldn't miss opportunities to help these people, physically or spiritually! Thanks for the prayer! We can CERTAINLY feel it here! This doesn't work without it! Have a great day guys and God bless!!

Chris

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May 2011 - Day 3/4 - Post by Dr. Chris DeLuca - "Leaning on Him"

2011-05-12T05:43:00.000-06:00

Good morning all! Well for those who prayed for Heidi and Micah yesterday, Micah did SO much better... she was very good for our friend Aurelli and allowed Heidi to scrub 2 cases with me in the OR yesterday... in general seemed much more content so your prayers worked... THANKS! Yesterday was a very good, very productive day for the most part. Thanks to our other good friend Dr. Sherwood Pope (a family doc who works over at Aselsi, one of the other Christian clinics here in Chichi), we were able to turn NOBODY away for consultas despite a full OR day. He scrubbed the entire first case with me and portions of the second while Heidi did consultas downstairs.

First 2 cases went beautifully! Uncomplicated vaginal hysterectomy with repairs who should do wonderful, and a nice abdominal hysterectomy for fibroids that made this poor lady look NOT pregnant for the first time in years! :-) We started around 8:30 and had those 2 cases done by lunch. Broke for lunch and came back for another vaginal hysterectomy with repairs on a complete prolapse... (btw if you aren't interested in surgery details, now is the right time to skip to the next paragraph)... after 2 hours of patiently trying to work my way down into this inside out anatomy, we had gotten almost nowhere and the uterus (which we'd previously thought farily normal sized), wasn't descending at all. We decided to open the belly, do the hysterectomy abdominally, and then, since neither of us have any real experience the abdominal suspensions, to go below and finish the repairs from there. Get in the belly and its a 14 wk sized fibroid uterus... no wonder its not descending, it doesn't fit. What I had palpated before on exam was her 8cm elongated cervix... *sigh* So we get it out from above, but as we are getting to the bottom, we start looking for uterosacral ligaments to attach the cuff to and her tissue is so bad, we can't definitively ID them... meaning there isn't much to keep this little vagina from fallling right back out when we are done. We close the belly, go below, repair the rest of the vagina and close the cuff, trying to attach to what MIGHT be uterosacrals but knowing that is probably not the case, but finished the closure anyway, and 7 hours later walked out of the OR VERY frustrated. Praying that God finds something to supernaturally scar the top of the vagina in to keep it in place... we are considering going back in to the belly to try again to find some semblance of uterosacrals vs attaching it to the sacrospinous ligament below (something neither of us have technically done). Considered sacrocolpopexy, but again, not much experience between the two of us and its a risky surgery... just praying for wisdom whether re-operating is even the right call... Would LOVE intervention for this lady by my prayer warriors out there... her name is Tomasa.

Today we have 2, maybe 3 cases and some consultas possibly (there are always a few stragglers on Tues/Wed). Again pray for safety and wisdom in selection for our surgeries. And again pray for the Spirit to conitnue to move here. We have one lady who we are a little worried about cancer today, she could use lots of prayer today. Off to shower and round on patients now. THANKS for your prayers!!!! Love you all and will be in touch!

Chris

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May 2011 - Day 2/3 - Post by Dr. Chris DeLuca

2011-05-12T05:41:00.000-06:00

Well everyone home is up and about (and poking me on Facebook... Tony Schwering... *lol*) but I am just getting moving... 2 hrs behind here (I PROMISE I am not THAT lazy!). As usual today should be our busy day. Yesterday afternoon we saw 14 consultas, 7 of which were surgical (albeit one was an inguinal hernia that Dr. Hoak did :)). Productive day... We have 3 cases scheduled today, 2 vaginal hysterectomies with repairs (or vagathons as Heidi likes to call them), and a abdominal hysterectomy for a big firboid utures. Also scheduled 3 for tomorrow, one ovarian cystectomy, another abdominal hysterectomy for fibroids, and the slightly scary one, a abdominal hysterectomy to take out the girl parts and a soft a baseball sized mass next to her cvx that we are hoping is only a degenerated fibroid, but a little more worried is cancer... I've seen my share of Gyn Onc as a first assist in residency, but still not terribly comfortable with having to be one... praying for Gods favor in doing an adequate job if that is what it turns out to be. We did have one we couldn't fix... incontinence picture which was ? suspicious for a fistula between the bladder and vagina. Sure enough, when we put in the speculum, urine poured out and continued to pour confirm our suspicions. Dr. Tom Hoak (the general surgeon who is full time here and does a little of everything) is seeing her tomorrow to see if he can take a crack at it... hope he can, because there isn't much in the way of urology or urogyn here obviously... not a lot of options. I definitely don't know how to do it. Her story is sad... delivered a dead term baby at home after a prolonged labor, has leaked ever since... her husband left her as a result and now her brother cares for her. Pray that we are able to fix her issue, or find someone who can. More importantly pray that He start to heal the wounds this must have inflicted on her. We will probably try to work in a few more consultas between cases today as well. One interesting thing that I was asking Heidi about this morning... on the ladies we take care of, we ask them if they are in a church, if they know Jesus, and if they have accepted Him. Increasingly, the answer this time was "Claro" (meaning "Clearly" or "Of Course"). For the 42 y/o who was leaving in 3 months for a 4 yr missionary commitment to Spain (very cool by the way, I found her to be someone I may have been friends with in a different life (one that I spoke Spanish better in... *lol*)) I believe that very much... but sometimes it seemed to come to quickly. I pray that the Spirit is indeed moving here in such a way that people truly know and trust God, but I am nervous. Part of me wonders too if they feel like they need to say that to be cared for because we asked. That is OF COURSE not the case... God rejoices over the one returning son, the one coin found, etc... we would LOVE to opportunity to serve His lost sheep... just hope they understand that. Either way, will love on them and hope somehow through our inadequacies they will still see HIM. Part of me wonders if the Sunday Christianity that is so much a part of our home country (that requires little belief, little life change, and mostly attendance) has spilled over here... who knows I guess. Impossible to see in a 1 wk trip really, but praying for real, saving knowledge. ANYWAY, thanks for the prayers and love... Heidi said Micah did sleep a little better last night. Hopefully she will settle down some today too... she wanted to feed/be held almost continuously yesterday (and I just wouldn't do) which I know was frustrating for Heidi, but she handled it with SO much grace... hoping when my time comes I can find that patience... she definitely was the ultimate mom on MOther's Day, nursing, soothing, and doing consultas all at once. :-) So the OR starts up in an hour so I best be off to get ready! Pray for everything mentioned above and for a good day of patient care, that he would guide or hands and words as we take care of these ladies.... love to you all!

Chris

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May 2011 Trip Day 1 - Posts by Dr. Chris DeLuca

2011-05-12T05:39:00.000-06:00

Heidi is on this trip with her 6-week-old daughter, Micah. Those of you who have breastfed babies know that 6-week-olds are completely dependent on Mom 24/7. So it's very challenging for Heidi.

Because of this, we'll be stealing Chris' posts for this trip.
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Good morning again from Chichicastenango! Trip here yesterday was LONG but went easily. I drove from Seneca to Greenville yesterday after work... I think I know better to work the day before I go, but I was taking off a lot of time for the trip, and the wedding, and the Colombia mission trip with TCWC in July, so I was feeling kinda bad about leaving my partners that long, so I stayed. Got on the road at about 1:30... at about 3 I realized that my passport was still in Seneca... *sigh* So drove back and didn't get to Greenville until 10pm. Sat down to a LOVELY meal of mac and cheese (cooked by my favorite daughter to be), watched a little Modern Family, got a REALLY sweet (and completely unexpected) Mother's Day card from Ashley (its true, she is kinda a sweet kid)... and collapsed by 11pm. Woke up at 2AM with my neck in spasm and that was it for sleeping... *sigh* So about 3:30 we hopped in the car and drove to Raleigh and 2 flights and a long car ride later, made it to Chichi. All this to say that I was a bit tired yesterday and feel like it was a bit of an attack but prayerfully went to sleep and had A GREAT nghts sleep last night... SOOOO bring on the week. Heidi (the physician I join here who is an awesome OB/GYN) brought her beautiful little mini-me 6 wk old daughter Micah. Pray for Heidi... its so early right now and Micah isn't quite adjusted to the schedule here... I know she kept her up most of last night and wants to feed every 30 minutes or so which is very frustrating for Heidi who really wants to be able to get things done here. Pray for a cooperative little nina, but mostly for peace for Heidi that whatever Micah may choose, things will get done as God intends and he will provide workers if Heidi has to step away. Today we will head to the gringo church in a little over an hour and then after lunch start our consultas... pray for the women and families that we meet today, that we may be able to bless them physically, emotionally, and spiritually. Pray for the Spirit to move here in Chichi and to soften the hearts of those whose sight is blinded by the enemy. THANKS for your prayer support... I am faithful He will use this week to His glory and can't wait to see how! HAPPY MOTHERS DAY too to all the mom's out there... especially mine, Margaret DeLuca! Love to all of you!

Chris

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Days 5-6 from Dr. Chris

2011-02-11T16:57:00.002-06:00

Well, I have gotten a slow start this morning... kinda feelin' cruddy. Looks like I've caught a nasty little Guatemalan cold and spent most of the night up coughing and sneezing and trying to breathe... ugh. :-( So this mornings note may be a little short, but here goes...

We lose Matt today as he has to head back to the States for work... will be sad to see him go as he has been a GREAT help. Yesterday was slow... 1 surgery and 1 patient in clinic... and really wasn't a Gyn patient- she came in with abdominal distention... normal girl parts on exam but LOTS of ascites... US done with some input from Dr. Hoak looked like a GI tumor... ugly and she probably doesn't have a lot of time left. Cancer is such an ugly disease, but especially out here when they are SOOO advanced by the time you get them. Dr. Hoak (the full time American General Surgeon who also does a little of every surgical subspecialty from Plastics to Neurosurg) said that when he asks why they wait so long, they usually say, "well, I thought it would go away.." Anyway, she could use prayer... they did a paracentesis for some symptom relief but there really isn't much more here. Surgery went great at very least.

So today we go and round on our patient and then head to Aselsi, another local mission to help out with their free clinic... hoping I can remember my Gen Med stuff... :-) Tomorrow we will d/c our last lady and get a day to play tourist and head to Pananjel (sp?) which supposedly is a gorgeous little town on a lake. And then FINALLY home on Saturday... I will be ready... pretty tired and this cold is taking it out of me...

Continue to pray for the successful recovery of our patients and the patients we will interact with today. Pray for the health of our team... Brandi is feeling a little better but Victoria and Kent have had some GI stuff and I have this cold... we are all pretty exhausted. Thanks so much for the support... it means the world... God bless!

Chris

(And thanks again to Dr. Chris Deluca for letting me "steal" her blog posts from facebook and repost them here! --heidi)

Days 3-4 From Dr. Chris Deluca

2011-02-08T20:37:00.002-06:00

"Days 3-4"

Good morning to all! Well we are going into our 4th day here and a little tired, but for the most part doing well... starting to get used to the loud noises at night that our Guatemalan friends seem to love so much... *lol*

Yesterday went well, but a little slower than I would have liked. Our Guatemalan anesthesiologist (who is fantastic and wrote my post-op orders by the way... awesome!) showed up on Guatemalan time at 9:30 rather than 8 (actually not bad because I believe last time I was here there was one day it was around noon) so we didn't get started as quickly as I would like in the OR, BUT the cases we did went WONDERFULLY! Kent did my first case with me that was a decently extensive vaginal hysterectomy with repairs like he had been in the OR for years... someone needs to get that boy out of Emergency Medicine and into a surgical subspecialty quick! Got out of that just before lunch. During my cases my other 2 remaining med students had been in clinic getting histories and doing basic exams on patient so between cases, we squeezed in 2-3 patients for exams/plans. Not a lot of surgical candidates, mostly benign stuff... the only one we tried really hard to convince was a sweet old lady with pretty decent prolapse and CIN II on biopsy a year or so ago, that Heidi had attempted a pessary fitting on previously... we got a better pessary for her that she promptly declined, and then when we counselled her on surgery, she stated she wanted a few months to think about it... we did (I think, I hope) convince her to repeat her cervical screening and come back in May. Our second case was by far the most impressive case of prolapse I have ever seen... this poor sweet lady had apparently been dealing with it for about 15 years too... took about 3 hours, but I am happy to say, I think we got a GREAT result... Victoria also did a great job with the assist and a very tough case was made very reasonable as a result. I learned that gasas are lap sponges and that piencas campos are towel clips, however I still haven't figured out what sponge stick is after about a half dozen tries... *lol* Alma, our Guatemalan scrub tech does pretty well with "este, por favor" thankfully! We got out around 5 though from clinic which is pretty early and had an AMAZING dinner and a little ice cream for dessert... the little things in life. :-)

So for today, as always, pray for opportunities to share with and love on the ladies we will see today. Pray for more opportunities (and the RIGHT opportunites) to serve today as clinic was pretty slow yesterday. Pray for the lovely lady we are operating on this morning and the ones we did yesterday as well. Pray that each of us here would be CHALLENGED by this trip and come away knowing something new about the God we serve. THANKS for the prayer! It means SOOOOO much! God bless all!

Chris

From Dr. Chris...

2011-02-08T07:28:00.002-06:00

Thank you, Dr. Christina Deluca, for giving me permission to "steal" your blog from facebook for reposting here! You are such a blessing.

"Guatemala Day 2-3":

Good morning everyone! So up this morning preparing for what I expect to be a busy day... the operating room gets going this morning in about an hour and we'll be doing consultas most of the day today so I am mentally preparing for the crazyness with prayer and Scripture and physically preparing with large amounts of Pepsi Lite. :-)

Yesterday was actually pretty reasonable... we did 13 consultas, scheduled 3 very sweet ladies for surgery today, and were back in the apt by 7pm. We started off our day on a pretty sobering note with a patient with advanced cervical cancer... if you feel led please pray for her and her family as they knew their diagnosis and were very much hoping for a cure that our science cannot offer. She does know Christ so praise God for that, but it will be long road for them all and they will need people agreeing on their behalf. We also got a chance to see the second half of the SuperBowl with some other American missionaries here which was a nice break, although the "responsible" physician of the group (oops) may have left the keys to our apt IN our apt... allowing us to see the hoodlum skills of our group when we had to break in to my bedroom window and squeeze Brandi through when we got home... *lol*

Also got to enjoy a wonderful church service over at the "gringo church" as Matt calls it... God always has a good message in time for me and led me yesterday to Philippians 2:1-8 which reads, " If you have any encouragement from being united with Christ, if any comfort from his love, if any fellowship with the Spirit, if any tenderness and compassion, then make my joy complete by being like‑minded, having the same love, being one in spirit and purpose. Do nothing out of selfish ambition or vain conceit, but in humility consider others better than yourselves. Each of you should look not only to your own interests, but also to the interests of others. Your attitude should be the same as that of Christ Jesus: Who, being in very nature God, did not consider equality with God something to be grasped, but made himself nothing, taking the very nature of a servant, being made in human likeness. And being found in appearance as a man, he humbled himself and became obedient to death– even death on a cross!" I find myself way too often writing myself as the central character in whatever story I am in... as if His plan revolves around myself, my growth, MY glory... the pastor spoke about all of our need for a life of significance, the desire for a glory that nothing in this world can provide... sometimes my desire to serve on missions becomes just that... its only about me! It is one of the ways I try to prove that my life is somehow worthwhile and of value! But the truth is, the only reason I have value is because I am a beloved of God! It is only through Christ's death and resurrection and my subsequent ability to come back to that intended relationship with my Creator that I truly can find any real fulfillment and self worth! So this morning, I am personally praying for God to help me see past ME today...to help me to "in humility consider others better than myself". Thought I would share...

Looking for a busy and challenging day... if you are walking with us in prayer, continue to pray for our patients and their physical and spiritual well-being. Continue to pray for Brandi's health as she is still feeling pretty rough. Pray for our surgical team today and the women we will be operating on. And anything else that the good Lord leads you to pray about... we LOVE and NEED the prayer support for this trip to be successful! Want to give a quick shot out to Ashley Schwering who is SIXTEEN today!!! Everyone in Greenville give her lots of love for me today! Happy birthday Ash! God bless all!

Chris

February 2011 Trip

2011-02-07T17:02:00.002-06:00

It's really weird to be here in Guatemala without Heidi (Dr. Bell) but here we are. She's back in North Carolina working very hard to grow a "baby in her tummy" (Isaac's description).

Here in Guatemala, we are Dr. Kris DeLuca, med students Victoria, Kent, and Brandi, and your humble correspondent.

We flew in on Saturday, uneventfully (yay) and drove up the mountain to Chichicastenango, where we found our accomodations with no trouble at all. We were exhausted, so sleep came pretty easy.

Sunday morning was Gringo Church, Market, and then 15 patients. The first was a real downer - one that Heidi had seen before. She is a 30 year old woman with Stage IV cervical cancer that has spread to her uterus and abdomen. She can no longer pee, so we tried to insert a catheter, but it turns out that her bladder is empty - her kidneys have either shut down or been obstructed from all the swelling - she looks like a balloon... She's a mother of four (the youngest is 2) and will very likely not see Christmas. As you might expect, she was not terribly encouraged by our report that there's nothing we can really do for her except give her some pain meds. She is in a good church and we prayed with her and her family.

The rest of the day was a little more encouraging for us, though. We scheduled three "vag-a-thons" (vaginal hysterectomy with anterior and posterior repair) and an endometrial biopsy. We were also able to reassure a few very scared women that there is nothing wrong with them, despite the diagnoses of some local doctors.

We were even able to get out of clinic in time to catch the second half of the Super Bowl with a bunch of local missionaries.

Today, Dr. Kris and company did two vag-a-thons and saw another eight or so patients. Matt took the opportunity to run up to Quiche and check on the facial plastics team that is there now. While in Quiche, he got to see our good friend Malachi Courtney, who will probably come down to help out tomorrow.

We're all done for the day now and headed out to grab a bite to eat. I'll have to post pictures when I get back to the US since I'm on a borrowed computer, or you can check our Dr. DeLuca's facebook page for some pictures now...

Hasta manana!

Please Pray for Upcoming Trip!

2011-01-23T15:25:00.004-06:00

So there have been some developments in our lives that God is helping and teaching us to work through, and I felt compelled today (well, okay, actually several weeks ago... but finally got around to it today!) to sit down and write to our regular readers with an update on the February trip. We will be needing LOTS of extra prayers the week of February 5-12th this year as we face new challenges.

A little over two weeks ago now, life threw a little bit of a curve-ball at Matt and I at what we had hoped was a routine prenatal care visit and follow-up ultrasound. It seems our little girl is not growing quite as quickly as everyone would like (For you "numbers" types, she was just barely at the 3rd percentile for growth at that 28 week visit). We are not yet sure what this means, overall, and there is great likelihood that she is just bound to be a small baby at term. (Some of you remember how tiny her big brother looked next to the cat when we brought him home from the hospital at less than 6 pounds, although he was technically born at 6#8oz) I was advised by my prenatal care provider to slow down my schedule some at that time, and we are doing some weekly tests on the baby that she-- so far!-- had easily "passed". We will re-measure her growth this upcoming Friday, which is the first prayer request as we pray that she shows signs of continuing to grow even if she stays small for her age.

This "slowing down" has meant a couple of things overall-- First of all, I was taken off of the call schedule at work and am only working days now. Second prayer request thus is a prayer of gratitude to my colleagues who very graciously stepped in to cover these shifts with no grumbling, and that I will heal up nicely after delivery and be able to return some of those favors! It also means that Matt has taken on even more of the household responsibilities on his own so that the baby and I can rest as much as possible when I get home, and for that I also offer prayers of gratitude.

The biggest thing, though, is that we made the very difficult decision (for me at least!) that I should not plan to fly down to Guatemala for the upcoming trip in February, which lands around the 32-33 week mark of the pregnancy. This is a HUGE deal for me, of course, and at first was probably even more stressful than the thought of coming off the call schedule and figuring out what "slowing down" means! God, as always, has been incredibly faithful in providing people and resources to keep the trip going, though, and so the final prayer request is for them...

I had three medical students set up to come down with us, named Brandi, Kent, and Victoria. I have been praying for some time for them to have a meaningful experience both academically and spiritually, as well as for their safety in travels. Please join me in that prayer, and we will get pictures posted of them as soon as possible, as they are all still very excited about the trip!

Matt has really stepped up in a major way, with no hesitation whatsoever, saying to me as soon as we got the news that I wouldn't be going, "I can't operate, but I can go and handle everything else as long as we have a surgeon!". His willingness to go on the trip, translate, help with all of the logistics and safety, and (hopefully) blog while he is there and keep you all in the loop means the world to me. I am truly blessed with an amazing husband.

The biggest piece of the puzzle, though, was whether or not I could find a gynecologic surgeon to fill in for me for the week! Some of you may remember Chris Deluca, who traveled with me and operated during an amazing week when she was a resident in our program. She has a huge heart for missions, as do the other physicians in the private practice near Clemson, SC, that she joined after graduation. She had contacted me about going back down on this February trip and I was really looking forward to working with her again! I can't even imagine the increase in weight that I asked her to take on her shoulders when I asked if she would be willing to do the trip on her own. Imagine my relief when she responded with, "I know and have known for a long time that is where God wants me that week, and there must be a reason now that He wants me there on my own!" What an amazing faith she has. I am sure she will do an awesome job of taking care of the patients, teaching the students, and operating. I do ask for your prayers of support for her as she takes this on, though, as well as continuing prayers of gratitude for her service.

I pulled out some old photos from my trip with Chris to put a face with a name, so please let's let her feel our prayers for her as the trip approaches!

Home safely... but please keep praying!

2010-11-15T14:11:00.002-06:00

Sorry we are a little late with this update, but we did indeed make it home safely-- although quite late!-- on Saturday night.

Please continue to pray especially for those patients that we operated on this week who do NOT know our Lord and Savior Jesus Christ... If you want/need names, here is the rundown for your prayer lists:

From Monday, Satornina who had vaginal surgery

From Tuesday, Gregoria who also had vaginal reconstructive surgery

Also give thanks to God for the other five gynecologic patients that we operated on, who have accepted His salvation. Specifically I was uplifted on this trip in learning that at least two of our patients have accepted Christ through the Catholic Church here, which I generally do not hear any members of the Guatemalan Catholic Churches say. Many of our regular readers know that the Catholic Church here, unfortunately, has suffered really since the days of the Conquistadors from a lot of "syncretism" or blending/melding with traditional pagan religious customs... To the point that the MOST common answer that we are given to the question of "Have you accepted Christ as your Lord and Savior" from a person who goes to a Catholic Church here is, "No-- We're Catholic; we don't do that". Very sad and confusing... and so encouraging to know that maybe-- just maybe!-- there is a positive movement growing in that area here! Two patients don't necessarily make a whole trend, but I will continue to choose to be encouraged by it.

Until next time-- and until the world is reached,

I am signing off.

Thanks again to all of you for your prayers and support this week!

2010-11-12T16:54:00.002-06:00

Cyndi is showing off Angelica's MUSC scrubs! Angelica is one of the nurses that has been working with us in the OR for quite some time now and is being trained to eventually take over (most likely) as the head scrub nurse there...

Our clinic room... looks just like your OB/GYN's office, right? (Well, maybe except for the fact that they usually change the bed covering there more than once every two days or so...)

"Meet the Team", continued... (Sorry, these keep kind of posting in random order and I'm scared to mess with them once I finally got them up successfully!) This is Pat with Dr. Calvin Williams, his wife Latrice and daughter Brittany, from the St. Louis area.

Another couple of views of the operating room, for those who haven't seen it before...

I just talked to Cyndi a few minutes ago who happily reported that almost all of our patients have now gone home for the week post-operatively. We will keep an eye on one more (via telephone, local doctors and nurses, and--most importantly-- with the help of Dr. Tom Hoak) until we are sure her incision is okay and not getting infected. She is otherwise doing very well, though, and we expect a smooth recovery. Glory to God for the smooth recoveries that all of our patients have had so far this week!

Pictures Finally!

2010-11-12T15:49:00.002-06:00

The first picture is just a general favorite... Cyndi Lawton holding a baby for one of our patients on Sunday in clinic (only after "winning" the dash to help by outrunning Keith to the mom's bedside to help ;-) WHAT a sweet picture and a sweet baby...

The next one was supposed to be posted last Sunday or Monday, as a "meet the team" picture... Heidi Bell, Cyndi Lawton, Keith Nelson, and Pat Peabody (with a little cameo appearance by my three-year-old, Isaac, there in the front)

Here is one of us relaxing outside the operating room between cases with Dr. Tom Hoak.

And an "action shot" in the operating room-- fairly modern for local standards, but it probably looks a little bit different than any operating rooms any of our readers have been visiting lately!

And a view of the Hospital Evangelico El Buen Samaritano (The Good Samaritan Evangelical Hospital) which was our home base for the week...

Picture

Another (failed) attempt at pictures!

2010-11-12T03:43:00.002-06:00

Okay, okay... it took me being up in the middle of the night and not being able to sleep (yes, it is 3 am here...) AND Cyndi hinting that her family was continuing to ask about the pictures, so here they are finally! Thanks, Cyndi, for some great shots from the week.

I will report briefly that all of our patients were doing very well at my last checks on them, and I am grateful to Dr. Nelson and Dr. Lawton for finishing up rounds on them in the morning and likely discharging them all since I have come out to the Fickers's farm to fly out to do a little bit more jungly-medicine in the morning.

Also some quick follow-up on our cervical cancer lady-- she did go home yesterday after receiving a bag of blood from a family donor and feeling a bit stronger for it. Thanks again to God for her supportive extended family, which is all she has right now... may they continue to be a light to her in a way that we can not as we walk in and out of her life ever so briefly during such a difficult time. She really personifies many of the struggles of very short-term missions and it hits hard emotionally, but I thank God still for the constant reminders of how very, very blessed we all are to live such wonderful lives with our health, our homes, our supportive spouses, and our medical care system in the U.S.

Now I'd better get to pictures before waxing too political or being too completely cheesy (After all, it is 3 am and a blogger is NOT to be trusted at this hour!) so here goes... Enjoy!

(Okay, four hours later here... the internet connection is NOT cooperating for posting pictures, so it appears as if I have lied and let you all down again... SO sorry! Will try again this afternoon...)

A few more long but wonderful days!

2010-11-11T07:18:00.002-06:00

Well, I finally got a couple of pictures to post... but unfortunately I still keep forgetting to get Cyndi's camera card to get the better ones! She has really been the photographer of the week...

The first picture is of a couple whose mother we operated on earlier this week and sent home yesterday. She did great post-operatively, and the family was very supportive and gracious. They were also very nice to let us take some good pictures of them... I explained that I wanted the picture because the "traje" or traditional dress that they wear-- from their hometown area near Solola-- is my favorite in the whole country! Especially since the men are more likely to wear their traditional dress there. I wish we could see more of the men's traditional dress from other areas, but they have mostly been converted to used clothes from the U.S., sadly.

The next picture doesn't do the scene justice, but we really enjoyed a few minutes of watching these young Guatemalan kids playing with bubbles and Isaac. They were waiting on their mother, who I think was waiting to be seen by the local doctor, and had been sitting perfectly still and stone-faced for at least an hour before we remembered to break out the stash of dollar-store wedding bubbles that we had brought down! That certainly livened things up in the courtyard of the hospital, and brought quite a bit of joy to both us and them. They went through every bottle of bubbles I brought before the end... then it was on to Play-Doh! (Thanks, Tana, for sending down your Halloween leftovers...) I had almost forgotten how much fun-- and how cheap-- it is to give small playthings to children here. It is ridiculous to think that Isaac has more toys in his little backpack that we traveled down here with than many of these children will ever even see...

Yesterday's OR cases went very smoothly-- Three vaginal repair surgeries that Dr. Nelson and Dr. Lawton really did with minimal help from me (My favorite kind of day in the OR, for those of you who know me!)-- I learned some new tricks from watching them, and got to take care of paperwork and checking back in on patients and organizing and tying up loose ends and such, which was a huge blessing to me.

We also were asked to do an inpatient consult on a lady that one of the local docs had admitted the night before. In the interest of time I will spare the details, but suffice it to say that telling a 30-year old, mother of four, whose husband left her for another woman during her last pregnancy, that she has inoperable cervical cancer is NOT one of our favorite things we have had to do... Please pray for Juana to be able to get the care that she needs to survive for a while to take care of her children. She has accepted Jesus Christ as her Lord and Savior, thank God!, but her struggles here on this Earth are very significant right now. We are also grateful that she has a supportive family here with her. They were looking for family members that could donate blood to her to help with her weakness from anemia when we left yesterday without any complaining or arguing, which is a minor miracle down here... so please be sure to also thank God in your prayers for them and ask for their continued support and patience.

Now it's off to the hospital to see what else the day holds in store for us... We hope that the patients are doing well and that a few are ready to go home, and will continue to pray for their recovery and salvation.

Breaking my Promises...

2010-11-09T06:13:00.002-06:00

... to readers, because I don't have any pictures to post this morning! So sorry... I will try to get some up tonight. We have really, truly been so busy trying to make and keep as many promises to patients as we can that there has been very little time for anything else so far this week. This is, of course, good news, because it means we have been busy and able to (hopefully) help a lot of people... but please pray that our minds and bodies hold out for the week on little rest and lots of pressure.

Sunday was a huge clinic day, starting at about 1:00 in the afternoon after Church and not ending until about 10 minutes before 10 p.m.! Yes, we were tired... drained physically, mentally, and emotionally... but God is good and did give us the patience and wisdom to make what we hope were decisions pleasing to Him for each patient that came in. We saw 18 new patients, setting five of them up for surgery this week and several more up for other procedures that we got done in the office Monday. That may not seem like a lot of patients to many of our readers, but believe us when we say that though the numbers might not be impressive, the complexity of problems this time was unbelievable! I am so very grateful to have two other strong gynecologic minds with me on this trip-- I would really be struggling without their insightful help. Once again, God shows us sovereignty in sending the right patients to the right team, though... simply amazing.

So some of the more interesting patients so far...

Alejandra and Satornina both got their surgeries on Monday for problems with their uterus and/or bladder prolapsing or "falling out", after being nicely prepared pre-operatively either by me in May/August or by Dr. Tom Hoak in the months in between. Both surgeries went very well and we were pleased with the results immediately post-operatively. Both ladies looked great last night, and we are anxious to get down to the hospital to check on them again this morning.

Manuela is a lady that we will operate on today (It is about 5:30 am on Tuesday, for anyone wondering...) She came in yesterday, referred by Dr. Hoak to us, for a diagnosis of blocked ureters (the tubes that go down from your kidneys to your bladder) which are thought to be due to the very significant prolapse (It is turned all the way inside-out, basically, for the non-gyn people, and a complete procidencia for you others!) of her uterus. A urologist in Guatemala City recommended that she wear a catheter in her bladder to try to relieve the pressure until it can be fixed, so she's been walking around with that for over a month now. Despite our best intentions and hormone therapy, her tissues are still very weak to support most types of surgical repair, so today we have opted for a major abdominal procedure to try to correct her problems. This is a surgery that I have never done before so I will once again be thankful that especially Keith Nelson is here, since he has much more experience than I do with it! And again, thanks to God for His provision for her this month.

We also have two other surgeries scheduled for various levels of pelvic prolapse today, so it should be quite a long day in the OR.

Somehow we have also found time to see some ladies with problems other than these, and I remain very encouraged by the handful of women that come back to see me so often-- even though they still don't want surgery for their problems and I am doing little for them, they faithfully seek me out almost every time I am here. Definitely one of the best parts of the job, and one that makes me even more thankful that we have been able to have a continued presence and continuity here for the last two years now!

Thanks to all of you for your continuing prayers as we look forward to another long but hopefully fruitful day today. Our patients that we are operating on are averaging about 50% that know The Lord and 50% that do not, so please join us in continued prayer especially for those who do not know Him-- that they will see a little bit of His love in our hands and work and smiles and hugs and sign-language communication when we don't speak their language this week, and that they ultimately might come to know Him as we are so privileged to...

"Until the world is reached..."

Meet This Month's Team!

2010-11-07T06:48:00.000-06:00

Today was our typical looooonnng travel day from Greenville, NC, to Chichicastenango, Guatemala— praises always to God for safe and smooth travels! Today ended in a special treat for me, of course (that would be Heidi, for those of you whom we have confused over the years with mixed blog authorship!) in that I was reunited with Matt and Isaac after being away from them all week! They’ve had a great week out at the Fickers which I am very jealous of, but I am really looking forward to getting to work with Matt again a little more closely in here in Guatemala! It is sure to bring back many amazing memories…

So our group this time is a little bigger than usual, and I am feeling very blessed to be a part of it. I am travelling with Pat Peabody, who regular readers have come to know by now and who will be running anesthesia for us again. She is joined this time by a special surprise in the form of Dr. Calvin Williams, who joins us from the St. Louis area (a friend of the Ficker family and from their home church) with his wife Latrice and daughter Brittany. Cal is an anesthesiologist with a long-term interest in medical missions, and we of course pray that he has a great trip and wants to come back and help out with anesthesia plenty of times in the future. As most of you know, providing anesthesia for surgeries is a major expense if we don’t have someone with us to provide that service, so I continue to stand in awe of the way God provides in this and so many other areas.

Also travelling with me this trip are Drs. Keith Nelson Cyndi Lawton, both co-workers of mine in the OB/GYN Department at ECU. Dr. Lawton is in her last year of residency with us and will be joining a practice next year in her home town outside of Charleston, SC. Please pray especially for her as it is the first time she will be spending any significant amount of time away from both her husband and her one-year old son, Beau, since he was born. Dr. Nelson is a member of our faculty who has quite a bit of experience leading mission trips of his own, mostly to the Dominican Republic over the last several years. He and I work together on medical student education in the department, and he is also very involved in surgical education and administration of the residency program. He is highly regarded as one of the best surgeons in our program, and I look forward to operating with him this week! Many thanks to his wife, Megan, who is once again graciously staying home with their two children while he travels the world to help those in need.

Tomorrow we will start seeing patients in the afternoon and set up surgeries for the week, so we will see what the week brings our way! We will continue to pray that God sends those our way who we most can help, and that we are able to help each and every patient that comes through our doors even if they don’t need our specialized medical care specifically. We are looking forward to a great week, and will keep you posted! Pictures to follow, of course… We were all feeling a little more travel-weary than photogenic today…

Pictures as Promised

2010-08-18T11:47:00.004-06:00

Here are the pictures that I promised everyone that were supposed to go with that last post...

First is David and Juanito re-wiring the Dodge so that we could drive it in to Canilla with at least one functioning headlight!

Next is one of our ASELSI patients, with her sweet baby that she brought in...

Here is the front of ASELSI's beautiful facility there in Chichicastenango, for those of you who are less familiar with the area...

Again, you can read more about ASELSI at aselsi.org if you are interested... We have truly been blessed by the opportunity to work with them over the years!

Signing off now until next trip, which will be in November of this year.

Wrapping up the Week

2010-08-15T15:34:00.003-06:00

(OK, I will go back and try to re-post the pictures later; for some reason they don't want to upload tonight and I'm getting impatient to go ahead and post this! Sorry...)

Thursday was a very nice “blast from the past” for me this week—I did clinic at ASELSI (read more about their amazing work in Guatemala, if you want, at www.aselsi.org) with Dr. Sherwood Pope, his wife Areli, and my old friend and most excellent of translators, Cecilia or “Ceci” as we have always known her. She is the Quiche to Spanish translator that Matt and I worked with for two years there at ASELSI, and offered a scholarship to when she eventually became interested in going back to nursing school. She now has what is essentially the equivalent of an LPN (Licensed Professional Nurse) degree and has been able to increase her hours and earning potential with it. She is still a great translator, tirelessly educating patients without even being prompted anymore about hygiene, clean water, hydration, proper care of children, and much more.

Ceci and Areli both are showing great interest as well as skill with the ultrasound machine in pregnancy, so I got to be really in my element for a while and do some teaching! Areli has really been helping Dr. Sherwood quite a bit with the prenatals, and is becoming quite handy with the ultrasound machine. That’s something she probably never planned on using her degree in International Studies for, but I am continuously awed by her flexibility and patience. The first two pictures are of ASELSI's main building and one of our first patients and her baby.

In all, we saw about 50 patients between the three of us—I remained worried the whole time that David Ficker would call at any second and say that they were ready to pick me up in Quiche immediately (I was scheduled to ride out with him to Canilla and hated to think about making him wait for me…) Those of you who have ever either been to Guatemala or had many things scheduled on “FST—Ficker Standard Time” are of course now laughing at my seeming naivete in my concern! ;-) It was only after the obligatory seven or eight plan changes that we met up relatively smoothly in Quiche for the long ride over the mountains to Canilla.

I’ll spare you all the details of that trip (we managed to get there having lost only one lug-nut, having stopped only twice to check on the drive shaft, and to re-wire a headlight directly in to the battery so that it would stay on for more than a few seconds at a time after it got dark…), but it was even more adventurous than usual for that trip! Any of you who have known the “adventure” (read: sheer peril and terror) of driving that road during the rainy season in broad daylight will just have to imagine how fun it was after nightfall with no working headlights! David Ficker is truly an amazing mechanic and driver… and even provided for a photo op or two! The next pic is of him and Juanito, a friend of the family, rewiring the headlight—successfully, of course.

Late in to the night Thursday, we greeted a team from Real Life Missions out of Washington state who are there for the week. They are poised to do some great work, teaching and evangelizing in local schools and building a widow a new home out near one of the clinics. Friday was spent helping them settle in and just reconnecting with the Ficker family (check out their new website at adonaiinternationalministries.org). What an amazing opportunity to work with them again! There was even an afternoon beach volleyball game after the usual trek through the river to get to the court… THAT truly felt like home, sweet home again!

This morning we were able to see most of the prenatal patients who were waiting with the help of a local Peace Corps volunteer, Cali, who has also become a great friend over the last two years. My flight out was around ten this morning from Canilla, so we were actually hoping to get through them all before that… but we got of to a late start due to another unexpected change in plans, of course. When we opened the doors to call for the first patient, we were greeted instead by one of the nurses from the Health Center with a patient in her hospital gown that they were asking for help with. They had brought her over in the ambulance because she had reported laboring all night with no baby yet delivered. A quick review of her “prenatal records” (handwritten in the card that she carries with her from the Ficker’s clinic there) revealed that she was full-term and the baby had been in the right position at her last visit, so we hoped for the best as we put the ultrasound on! We were able to confirm a strong heartbeat, head-down or normal position, and about 5 centimeters of cervical dilation before they popped her back in to the ambulance and took her back to the Health Center where there is actually a doctor to attend her delivery. We heard she delivered about an hour later with no problems, so thank God for that.

I am now on the plane headed back to my true home, sweet home—my “boys”!! It has been a long week away from them like it always is, but I am forever thankful for the opportunity to remain connected to Guatemala and her people. Leslie is preparing at least one more patient for us for surgery in November—a lady we have known for a long time with a complete prolapsed of her vagina after a hysterectomy, which re-prolapsed after an attempted surgery many years ago. She has been miserable with this for many years now but has refused further surgery. Leslie mentioned to her that we might be able to help with a different procedure (essentially to close up the vagina completely—reserved for pretty unique cases, of course) and she is now actually considering this, so we pray that she will do well with this surgery in November.

Stay tuned for more updates, we hope, as our November trip draws closer as soon as this one draws to an end… We will continue to pray for Maria and so many others in whom we hope some seeds have been planted this week and over the years, and that God will continue to bless our feeble efforts in His Name in Guatemala and the U.S. Thank you all for your support and prayers over the years and during this week!

Clinic Day with Agape!

2010-08-11T19:06:00.002-06:00

Today was definitely a special treat-- I got to go out on the road to one of the remote clinics that Dr. Sherwood Pope and his wife Areli are now running with Agape in Action! They have been working down here essentially in the role that Matt and I played full time back in 2006-2008, and you can always read more about them at missionarydoc.com, nbri.net, or agapeinaction.org. They are a young couple, full of faith and patience and medical skills (Dr. Pope is a US-licensed Family Practitioner, and Areli-- although with no formal medical training-- is VERY good at picking up on small details from the patients during consults and picking up some ultrasound skills very quickly!) The first picture today is of us turning off of the main road from Quiche, which thoroughly disoriented me at first because I had no clue where we were! I didn't remember there being another tunr-off from that road, which is because it was never PAVED when we drove it for two years... A pretty good stretch of it now is although there is still a long way to go before it is completely paved out to where the Fickers live in Canilla... but time indeed does march on.

The next picture is of the Church where we set up our mobile clinic-- that's it, the little white speck in the middle of the picture! This picture is, unfortunately, taken from our "parking spot" where the truck could pass no further in the current road conditions. Rainy season has really been rough this year for ground transportation.

Luckily two strong-backed Church members came to our aid and lugged (and lugged... and lugged... and lugged...) our stuff down and then back up the hill on their backs! These truly are amazing people here. Areli and I between the two of us could barely make it with just ONE of these trunks on the way back!

About the time we were crossing over this "bridge" was when I figured that-- because I KNOW myself quite well, I should probably put the camera away before it went in the river or the mud where the rest of my body was likely headed...

Unfortunately, though, I forgot to ever get it out again to take any pictures during clinic or of the patients! Well, except technically the two guys carrying our stuff did ask for consults-- one said that his shoulders hurt a lot and feel tight all the time! Go figure. I tried massaging his back for him for a little while, but he said that hurt so we gave him some ibuprofen instead!

The patients we saw were pretty routine today for the most part-- lots of gastritis/gastric reflux, prenatal patients or women for pregnancy tests, body aches and pains, and kids with colds mostly. Please pray for our most interesting (and hopefully most fruitful) patient of the day, Maria Vicente. She had been in several times for aches and pains, ibuprofen and vitamins and such. Today, though, her chief complaint was that ever since a horse down by the river had charged after her a few weeks ago, she is very anxious and afraid all of the time. The translator was explaining to us that this animal has scared lots of people and runs a little wild, but after ruling out the possibility of prescribing a rope or chain to tie it up (a joke somewhat lost on the patient and our translator but nonetheless amusing to us!) we delved deeper into her issues.

Here in clinics, we have very little access to psychiatric medications generally speaking. This has led us over the years to probably a more effective treatment of anxiety and depression issues than I give many of my patients in the U.S., as we are left to witness to them of the only effective anxiety relief we know of-- the assurance of eternal life with our Lord and Savior by acceptance of Jesus Christ's gift of salvation for us. She was in the "Catholic" Church here (really often just a traditional Mayan religion, especially out in smaller villages) and claimed she had never even heard of Jesus Christ. Surely what we shared with her today and the prayer we prayed with her are just a tiny little "starter seed" planted, but we will continue to pray that it grows in her heart until she can share in the peace that we possess only through Him.

The area we were in today, called Tabil, is largely unreached by the Gospel in general and I am thankful for Agape's continued efforts there. Please pray for their continued strength, patience, and perseverance as they try to chip away at the darkness there one "Maria" at a time.

Tomorrow I will be back at ASELSI, another old "stomping grounds" from when we lived here, which will be another special privilege. I haven't even made it by there on most of my recent trips down here, so I am excited to see how much it has grown. I made Dr. Pope a deal that I would see all of the prenatal patients if he would see at least most of the men tomorrow, so I hope he holds up that bargain! Every now and then it's good to play the "gynecologist" card...

Two Days in the Life of Chichicastenango...

2010-08-10T16:40:00.002-06:00

Well, yesterday and today were fairly routine in terms of clinic patients-- today I actually saw almost exclusively prenatal patients, which has been rare up to this point! The most promising thing about seeing all of them, though, was that almost every one of them actually had received some prenatal care elsewhere also and were essentially here for an ultrasound. It was very encouraging that prenatal care as a general concept continues to catch on, and I gave them all copies of their visit/ultrasound results from today to take back to their other providers in hopes of more continuity of care.

I also saw several more of my own return patients, which I try to take as a good sign that there is growing trust in me and in our care here at the hospital. I was also able to pull several charts from patients that I had seen in May and referred back to Dr. Hoak for various reasons, and was very pleased to see that they had followed through and had their surgeries done.

I think the best and most exciting new yet, though, is what we spent about half of the morning doing today-- When I walked out from seeing my last patient in the stack, I met one of the nurses who was dressed in an OR gown, gloves and mask in the hallway with a broom. Intrigued by her attire, I of course asked what she was working on, and imagine my surprise to find out that she and three others were cleaning out one of the "bodegas" (storerooms). It wasn't actually a bodega, but more like a big hallway behind one of the bodegas that has been filled literally floor to ceiling with "overflow" junk over the years. They were all climbing in there and sorting through things, and actually throwing a large portion of it away! Those of you who know anything about Guatemala know that Guatemalans voluntarily throwing ANYthing away-- especially at this Hospital!-- is nothing short of a minor miracle. So I threw on a pair of gloves and did what I could to encourage their efforts... especially acting as a "consultant" to look at boxes full of junk disguised as donated medical supplies and equipment and determine whether it was anything that we could possibly ever conceivably need to use or not. The project didn't last long, but it did create a small mountain of trash that I think was later burned... The first picture below is thus of the only "surgery" that we did today-- a trash-ectomy!

The second picture is a new Guatemalan classic for me-- I always knew they could and would grow CORN anywhere here, but seeing it in a planter on the roof was another first for me! Just when I thought I had seen it all... But in all fairness, the rest of the world would surely think we were all even crazier for growing tomatoes upside-down on our porches, don't you think?!

The last picture is just something that amused me when I saw it on the Hospital wall today-- a poster advertising a Medical Conference coming up on "Cancer Treatment in the New Millenium". Apparently quite a few international docs are coming down to speak, including three from MD Anderson in Houston. What amused me, though, were the prices-- $250 bucks for docs from outside Guatemala, 400 Quetzales (about $50 bucks!) for Guatemalan docs! Those of you planning any international continuing education conferences any time soon, just be aware you're being gouged... but enjoy nonetheless!

Tomorrow's plans are still up in the air, depending on whether the Fickers are able to fly me out there or not... We will see what God has in store, and if I don't go out there then I may see if I can help Dr. Sherwood Pope and his wife Areli with Agape in Action or at ASELSI on Thursday or something... My father-in-law always tells me, though, "If you ever want to hear God laugh, tell Him about YOUR plans!"...

We will see what HE has in store for me the rest of the week.

Clinic Sunday!

2010-08-08T17:30:00.002-06:00

Today got off to a great start... after going to bed at around 7:30 p.m. local time last night, I was ready to roll when 7:30 a.m. came around! Finding out about the need to buy toothpaste after I woke up, though, wasn't on my Top 5 events of the day list... but oh well! Mission soon accomplished. You can't really throw a stick here without hitting some kind of "tienda" or convenience store, so it wasn't that big of a deal.

I then rushed out to market to do some "power shopping" as I didn't have much time before Church (or so I thought... see below.) and lots of gifts to buy! It's always fun to see what is new, and also what never changes... I am seeing a lot more local pride here in Chichicastenango in T-shirts and things for sale with the name of the town on them, which I think is pretty positive. I then ran up to go to one of my favorite spots on the face of the planet-- the "Gringo Church" that meets up at the Hotel Casa del Rey every Sunday! Except sometimes during the summer, apparently, when too many people are gone back to the U.S. to raise funding... oooops...

Anyway, that at least meant that I got to start clinic a little earlier and I got done at a decent hour, so life is good! I saw about 14 patients today, but 5 of those were return appointments that I had made either in February or May for myself! It is so uplifting and encouraging to see people keeping these appointments. Most of the rest were ones that Dr. Hoak had sent, and the others were self-referred. Only two seem to need surgery, and they are now set up for November! So, Keith and Cyndi, get ready to operate!! Hopefully more will come in tomorrow, and still more by the time November comes around. The first picture is a lady we will operate on in November, who needs a vaginal hysterectomy for a prolapsed uterus (or for you non-gynecologic types, "her uterus is falling out"!)

The second picture is another patient, who is talking with me through one of the translators at the hospital (Quiche-to-Spanish translator) about her symptoms. She turned out to have a very treatable infection, so we hope she feels better soon. We had a few more run-of-the-mill gynecology patients (discharge, painful periods, etc...) then two interesting infertility patients. One was a young couple, married for 2 years and in seemingly good health, with unexplained infertility. I have no guess as to why they haven't conceived, but they are quite bright and educated so we went through lots of education about calendar-keeping for her cycles, the most fertile days of the cycle, basal body temperature charting to track ovulation, etc... I hope to see them back in November. There are some drugs available and affordable here to help her ovulate if it doesn't look like she is doing so on her own, so we'll see! It was nice to be able to do some real patient education on a pretty high level with this young couple. You have to keep in mind that with many of my other patients, when they complain about their "period" or menstruation coming in some abnormal way, the first question I have to ask is what color it is!! Often they mean they have a white discharge instead of bleeding... so yeah, there's a big difference here.

The other young lady was very different. Married for 8 years with no babies, but did have one on her back that she had just adopted at least! I could take one look at her and diagnose her with Polycystic Ovarian Syndrome, but unfortunately I could also do a fingerstick blood sugar and diagnose her with full-blown diabetes! This is going to be a tough problem for her throughout her lifetime. I did my best to start explaining to her what diabetes is and what she needs to do about it, but I pray that she seeks more ongoing treatment like I asked her to.

The other two pictures are for those of you who may not have seen the Hospital here before-- The "Good Samaritan" Hospital is really a pretty nice facility. Those of you who know anything about Chichicastenango on Sundays know that I cheated and that these pictures were NOT taken today, of course. (Market days are impossibly busy and you can barely see the Hospital for all the street vendors!) We will see what comes our way tomorrow, but for tonight I will sit and enjoy my hot tea, a hot shower, and a nice warm bed! Ah, the difficulties of missionary life, right?!

Long but Smooth Travel Day!

2010-08-07T18:53:00.001-06:00

I am so thankful to God once again for safe travels and another opportunity to spend time with so many people in this land that Matt and I have come to love over the years through His grace and guidance! Today was a very long travel day, but I am finally here getting unpacked and settled in for a nice long night’s sleep, I hope! I left home at about 2 o’clock this morning, which is about midnight local time, and arrived here in Chichicastenango about 4:30 p.m.!

I realized too late—as in yesterday!—that I had left everyone hanging on the pathology results from the last trip and for that I apologize. I had heard from Dr. Hoak just a few weeks after returning home that all was well with all of the reports. Nohemi turned out to have a benign tumor after all, which is wonderful. It is such a blessing to have such great follow-up on pathology reports and how patients are doing after flying home again, and something that is really quite unique to the short-term trips that I do here as far as short-term missions go in general. For that I am truly grateful.

This trip is a little bit different in that I do not have any other surgeons or anesthesia help travelling with me. With Dr. Hoak also being up in the States with his family this month, we prayed very hard over what I should try to do on this trip and have felt like it is not my calling to operate any during this particular week. I am certainly open to the possibility of something more urgent than usual coming up, though, so please pray for wisdom and guidance as I evaluate the patients who come in this week.

The hope is to set up quite a few surgeries for us to do in November, when I am VERY excited that I will have one of my Faculty colleagues as WELL as one of the Chief Residents in our program joining me! That will be an amazing trip both from a medical/surgical as well as personal/spiritual standpoint, I hope! This trip is hopefully going to be a lot more about reconnecting with the people here—both the locals and the long-term missionaries—as time might permit a little more liberally if I am not in the OR until all hours of the day and night each day. My bags are packed with everything from charger cords left behind recently in the U.S. to silly toys and things for the Ficker girls to bags of excess toys to take out to remote clinics to eventually be given out at Christmas to small gifts for the Church members that I can’t wait to see tomorrow to vitamins and a few medications! If TSA looked through them, I’m sure they are still scratching their heads pretty good… There is, of course, also plenty of suture, other OR disposable supplies, gloves, masks, glucose test strips, and lots of other medical goodies that are mixed in there. And yes, they are bulky and heavy! They did, for the first time in a LONG time, wave me right through Customs today without X-raying my bags looking for things they didn’t want me to bring in for free, so that was probably the biggest blessing of the day!

Later in the week I will be going out to the Fickers to hopefully help them with a “jornada” or mobile medical clinic out in the jungle areas to the north of them—many of our regular readers will recognize the Zona Reina area as one they have been trying to reach for years now, and we are hoping to make a little bit more progress on those relationships this week, Lord willing.

Thank you all for your continued interest and support of our mission here. Please always let me know if you want to get more involved or if you have any questions! And thank you especially for your prayers for safety and wisdom this week. God bless you all!

Back Home Again

2010-05-20T17:55:00.002-06:00

Just a quick "wrap-up" note to let everyone know that we made it back home safely late on Saturday night-- Many thanks to Tom for driving Pat and Monica and Duane Ficker for flying me down to the airport Saturday on time and safely! I was so glad to be able to make it out to the Fickers on Friday to visit with them; please pray that they will continue to receive the support and guidance from God that they have faithfully relied on for more than 10 years now!

It is always good to be home, but it is also always sad to leave again... It is such an amazing thing to always have a return date already scheduled, though! All of our patients have done well so far post-operatively, and they will all follow up with Tom within the next few weeks. He will also be able to follow up on the pathology results from some of the surgeries we did, which is such a blessing! Please continue to pray that especially Nohemi's pathology comes back benign.

We are also praying very hard now for another surgeon that can accompany me on my next trip to Guatemala in August-- Dr. Tom Hoak will be in the U.S. during that time to get his daughter off to college. I am not sure that operating by myself with no back-up or anyone to bounce thoughts and ideas off of prayerfully will be the right thing to do-- Please pray for both guidance in this area if no one steps forward or for someone to step forward that can come help! We know He has a plan, and just pray that we are mindful of it at all times.

I pray that someday each of you reading this will have the opportunity to be blessed even nearly as each of us participating in these surgical trips has. I will write more when our August trip gets closer, or if we hear something back on pathology reports soon.

Thank you all for your continuing support and prayers!

Some Fun Before We Go...

2010-05-13T15:28:00.004-06:00

Oh, how nice it was to get everybody out of the Operating Room and all of the scheduled patients seen before noon today! Monica was nice enough to help Tom with a hernia repair surgery he had scheduled which gave me time to finish up the consult patients and be ready for our second case. She was a young lady with a breast mass that is almost definitely not cancer-- we were able to remove it under just local anesthesia, which she appreciated since she would like to be back at work as a teacher tomorrow!

All of patients-- thanks be to God!-- looked pretty good this morning when we rounded, and slightly better even this afternoon before we left the hospital. I will check on them again this evening, and hopefully send them all home tomorrow and not have to leave Tom stuck rounding on anyone.

We then treated ourselves to a nice buffet lunch together, which really was a treat considering how little time Pat, Monica, and I have had together all three of us at all! We picked up a few last minute "needs" in the market and this afternoon are mostly cleaning up and planning for tomorrow.

We are still praying for negative pathology reports (i.e., telling us it's not cancer) on Nohemi, Maria, and another Maria especially, so please keep those especially in your prayers.

We still don't have a straight story on the lady that came in "just for an ultrasound" and we found the postmenopausal ovarian mass, but we are fairly certain she does NOT know Christ (although she considers herself Catholic, her neighbors consider her also to be a "witch"-- and unfortunately the Catholic Church down here has suffered from so much syncretism that those two are not mutually exclusive anymore!) We also found out that her son actually owns one of our favorite restaurants in town, so we did ask her to kindly pay her whole bill and not just the tiny bit she claimed to be able to pay before she left. This she did, to her credit, without grumbling-- I guess she knew she was essentially "busted".

It is always frustrating to know that would certainly not have been the first time we were taken advantage of by people who really do have the money to pay for their services, but the "Serenity Prayer" has been the only thing that has ever helped me come to grips with that in my years here...

"God, grant me the serenity to accept the things I can not change, the courage to change the things I can, and the Wisdom to know the difference..."

I hope that my Grannie is looking down and smiling on me quoting those words I first learned from her needlepoint sampler that still hangs in her old apartment, as I struggle to truly rely on God's sovereignty even in our human need for his unending Grace at every level.

Amen.

Oh-- and the pics are mostly just for fun today... One is a "paycheck" from one of the patients, that brought us these beautiful plums from their tree (one of my all-time favorite Guatemalan treats!), one is of Pat feeding the Parrots at the restaurant (tortillas, of course! What else would a Guatemalan Parrot eat?!), and then there's the beautiful view out the back window of the resaturant (Try to imagine if that were a real waterfall and not just a "waterfall of trash" as one of our students once dubbed it ;-), and the other is just some of the patients waiting around to get well! Thanks be to God that they are indeed well on their way...

Operating and More...

2010-05-12T20:28:00.003-06:00

Well, last night we were too exhausted after a pretty grueling day in the OR to write anything, so here's a quick catch up... Yesterday was one of those days when we just couldn't get anything to go right-- From not being able to start our first OR case until nearly noon to having to stop and change the tube in the bladder out because the first one wasn't working to running in to more bleeding than we wanted to calling Tom because I panicked and thought I had cut in to the intestines to... well, you get the picture. The ladies who work in the OR thought it was a spiritual attack brought on by the fact that our patient practices some witchcraft, and I'm not at all sure I don't believe them!

Thanks to all of you who have been praying so faithfully for us, today was a million times better and one of the best days I've ever had down here! The patients from yesterday looked fantastic this morning, the one from Monday went home, there were only three consults waiting for us, and four good surgeries scheduled. For the first time this week, we actually got all the scheduled cases done today! Tomorrow should be a relatively light day in theory, so maybe we'll have time to catch up on odds and ends (and shopping, of course!) that have eluded us earlier in the week. There are several of the nurses at the hospital that want to talk to us about something or other so we can finally see them tomorrow maybe.

Today we have a few fun pictures to share also... One is of Monica receiving a random but much needed shoulder rub from a young girl who came with her mother for her consult today! Never mind that they had been waiting by that time a good five or six hours to even see us and we had relatively little to offer for their non-gynecologic problems-- The girl saw that we looked tired and took over trying to help US out, which is just another example of the spirit of the Guatemalan people we are so privileged to serve.

Warning: pictures that follow are not for those who really don't like gross stuff...

There are also some pictures of a great big uterus that Tom and I took out at the end of the day, which was actually a lot of fun considering how smoothly the surgery went. Also pics of Tom and I operating (Monica was nice enough to be operating the camera for this one) Monica got to be a little more involved on the cases today since they were going more smoothly, which was a blast for me (and hopefully for her, too!) to get to have her open up and close up her first surgery!

Thank you all for your continuing prayers-- We really felt them today in the operating room and in the Hospital in general and are feeling refreshed even after such a long day by being reminded once again how great our God is.

First OR Day-- So far, so good!

2010-05-10T20:47:00.003-06:00

Well, more or less good anyway... Always a few set-backs, but nothing that we won't be able to work out. Today started off less stressful-ly than I was prepared for, which was good and bad in a way-- only 8 total patients came for consults with us, when we were expecting more like 15 or so from what we were told of how many were turned away yesterday! I'm worried that people didn't bother returning, even though I tried very hard to explain to people in the waiting room in one long "speech" about how we would see everyone that showed up even if it was today or Tuesday... But we just have to continue to trust that God sent those that needed us and do our best to help those that come.

We scheduled three more surgeries today out of clinic, which we were able to mostly get done before we got started in the OR. Then Monica and Tom went up and did a prostate surgery (slightly outside the scope of most general OB/Gyns...) while I finished up clinic, which made starting our vaginal case much less stressful with no one waiting on us. The case-- a vaginal hysterectomy with anterior repair, culdoplasty, and perineorrhapy for a complete prolapse for you gynecologic types-- or what we often affectionately refer to as a "vag-a-thon" for the others!-- went quite well overall but was very challenging. We will pray that she recovers well and doesn't have her problems recur in the future-- her name is Maria.

Our third case today was supposed to be the lady we blogged about yesterday with the ovarian mass and no complaints, but her labwork showed that her hemoglobin (measure of anemia) was at about half the level it should be (7.3) and we needed to get some blood donated for her before we could safely start! The husband's blood type was not compatible with hers and they only have one son in the area whose blood type they don't know, so it was looking a little iffy for a while. Then the family members of the first lady we operated on offered to "donate" theirs for her (for a fee, of course... I stayed out of those negotiations!) and we thought we were back in business.

Then we got set back again by the laid-back culture of Latin America-- It turns out that the lab tech, who is of course the only one in the hospital who knows how to crossmatch the whole blood and test for HIV and Hepatitis before transfusing it, decided to stay "a few extra hours" in her home town a few hours away this weekend and wouldn't make it back until tonight. She is usually back around 3 or so on Monday, but not so much today... So to make a long story short, we managed to send the men up to another private lab in town with some blood storage bags we found in the lab here, where they donated and brought the blood back. It is now waiting in a refrigerator overnight until it can be screened and prepared tomorrow and this lady can finally get her surgery! Of course we already have a pretty full load for tomorrow, so we'll see how we end up getting through it all. Somehow we will manage with God's help; we always do.

At least we got to take advantage of our early evening by a nice dinner out with some other local missionaries-- thanks to Roy, Erna, Sally, and Ervin for such a great time with old and new friends!

Will let you all know what tomorrow has in store...

Pictures today are of Monica and Tom operating on a prostate, then the "obligatory" first uterus picture of me and Monica after her first hysterectomy that she scrubbed in on! There's also one of the upcoming women for surgery with her husband in the courtyard of the Hospital, which is looking a little better every time I come down. What a lovely place to be called to work...

Long Clinic Day

2010-05-09T22:26:00.003-06:00

First of all, a quick HAPPY MOTHER'S DAY to all of my favorite Moms out there... Hope you got a little more pampering than we did today! ;-)

Today was a great day, but quite long-- started out to market around 8 or so after going to bed around 8 last night, so at least we started out well-rested! Monica got to experience the market for the first time, and Pat was there to faithfully help shepherd her through and give her the personal shopping experience that only Pat can... Then we hopped up to Church at the Hotel, which was another great service as always. Then it was off to the races when we arrived to a "standing room only" waiting room at the hospital!

We saw a little over 20 patients today, which won't sound like many to some of you but it took us almost 8 hours... We write up pretty full histories and physical exams on them all and try to make sure they all leave feeling like it was worth their while to wait the 8 hours to see us, which is sometimes more challenging than others of course! Either way, it was more than I've ever seen in a day at this clinic by at least 25%, and we turned many away to come back tomorrow. So there's no telling what tomorrow will bring, but God will provide for whatever He sends our way...

So speaking of what He is sending, our most interesting patient of the day was the 9th one we saw-- she was the first patient we saw that literally had no complaints-- she just wanted an ultrasound to make sure everything was OK "before I get any complaints from anything". She literally repeated and harped on the fact that she had no complaints until Monica learned that word quite well in Spanish! So we figured this one would at least be quick and easy and we could give her what she wanted as we walked over to the ultrasound room. It got less quick and easy when we diagnosed an ovarian mass the size of a small orange (she is post-menopausal so this is particularly concerning) and set her up for surgery tomorrow! I am now quite suspicious after reviewing some blood work that she may have ovarian cancer. If she does, though, it will be picked up early and maybe even cured without further treatment. Those of you who know anything about ovarian cancer know that this is rarely the case, so praise God for sending her today! I do not think she knows Christ personally yet, so please pray that we can really use this opportunity to minister to her and lead her to Him.

Please also pray for a young lady-- in her 40's, I think-- who has inoperable cervical cancer and likely only a few months or so to live. There is nothing I can do for her but hug her, pray with her, cry with her and her husband, and give her some pain medication. As a physician, those are some of the hardest times. As a Christian, though, it was a huge relief to know that she knows The Lord and is planning to spend eternity with Him in His kingdom. We will see her there someday and it will be a joyful reunion.

If any of our old regular readers remember the young lady that we tried so hard to help with her breast cancer a few years back (Maria was diagnosed while both pregnant and breastfeeding-- no-showed her mastectomy, tried some "faith healers" and such then finally did go to The City to get treatment but way too late...), we saw her family in the market today and they seem to be doing well. The first picture is a picture that I took of her husband's cell phone-- He has her picture as his home screen, which I thought was a beautiful reminder of her this Mother's Day. I get to see one of her daughters and her husband almost every time I come down, which is a great privilege in my travels here to have such continuity with a family.

We also scheduled several vaginal hysterectomies for prolapse, and a bladder evaluation (cystoscopy) for a lady with no prolapse but lots of bladder complaints and blood in her urine that is unexplained. I'll save some of the other clinic details for tomorrow or the next day; I guess y'all get the gist of it by now... the other pictures are some of the ladies we will be operating on this week, and the last one is just for fun, showing the "glamorous" side of gynecology which Monica snapped when I had stepped out to wash some speculums!

I did have at least three patients today that I had given appointments to come back and see me myself, which is always exciting-- one post-op from February and two other follow-ups for an abnormal pap smear and fibroid uterus. It is always wonderful to start those relationships and be able to provide continuing care, even when you're only here every three months! What a privilege, and what a wonderful way for God to prove just once again how good He is...

Quick Update Before BED!

2010-05-08T18:54:00.004-06:00

Just a quick note to those of you out there reading that we are here safely for the night.

GOD IS GOOD.

Tomorrow will be another long but exciting day, so we are pretty much tuckered out and ready to turn in, but I thought I'd post a quick photo of Monica and Pat (they asked me to remind everyone that this is around 5:00 a.m., after getting up to travel starting at 2 a.m.-- they weren't exactly thrilled with me for taking it, but I think they are beautiful! ;-)

Monica is on the left, and Pat is on the right... just to put "faces with names" for those of you praying with us this week... Good night!

Ready for Take-Off!

2010-05-08T03:11:00.003-06:00

Just a quick update now from RDU airport, where we have arrived safe and sound, with all luggage checked through and no issues so far! To introduce you to the "team" for the week, it's me (Heidi, OB/Gyn), Pat Peabody (a CRNA or Nurse Anesthetist who will be running anesthesia for us and saving us TONS of time and money-- this is her third trip down to Guatemala with us and she has become quite the tour guide!), and Monica Horne, one of the Certified Nurse Midwives on ECU's Faculty with me-- her first trip out of the country ever so please pray for a good experience for her especially! I am excited to have her helping me out in both the clinic and the operating room this week, and you never know what God will send us in the way of babies needing to be delivered since I'm bringing an expert with me... It really does tend to work that way.

Please pray for safe travels and some rest for us today-- we all got up before 2 a.m. to get here to the airport! Also pray, as always, for the patients that need to be seen to show up and that each patient walks away with what they need or what God wanted them to have from us this trip...

Thanks and God bless you all! We are boarding now so I'll try to update again probably tomorrow night after a full day of Church and clinic...

Preparando

2010-04-19T13:50:00.003-06:00

It's amazing how time flies. It seems like Heidi just got back to the US from her last trip to Guatemala and it's already time for another one.

The team this time is Heidi, Pat, and Monica. Pat has been several times already but this is Monica's first time. Please pray for their preparation and safe travels.

Plane tickets have been purchased and a packing party is imminent.

We'll post more details as we get them.

Back Home Again To Reflect and Give THANKS

2010-02-18T16:56:00.003-06:00

Well, we didn't manage to get a blog post up Monday like we tried, but hopefully we can still go with "better late than never" for the follow-up?!

Anyway, we've all been back in the full swing of things in our clinics and at the hospital, so Pat and Carrie and I have seen very little of each other this week. I know they have both had some opportunities to share some of their own stories from Guatemala last week with colleagues and friends, though, and for that I am always thankful.

Our week finished up relatively without incident-- Glory to God for seemingly very safe healing of all of our gyn surgical patients, who all went home on Thursday! Thursday we had another few general surgeries-- a gallbladder and two biopsies on possible enlarged lymph nodes in a brother and sister from the same family. We also did a more involved case on an older gentleman that Tom had been observing for a day as an inpatient, who had come in with severe abdominal pain overnight on Tuesday. He was finally starting to convince us that surgery could help, and we were glad to find out upon operating that we were right! (well, okay, "we" is really just Tom; Us gynecologists don't spend a lot of time on the men's ward usually!) He had what looked like a pretty long-standing appendicitis, so Tom and Carrie cut out that section of his intestines to cure him of that. He will have a large surgery to recover from, but should be feeling better soon. This is the type of patient who could truly die if it weren't for life-saving surgery, and we are always grateful for God's faithfulness in providing for his children.

Without your prayers and financial support, people like this do get turned away from many other hospitals-- or delayed long enough in the government hospital that they get too sick to operate on or die anyway! I thank God regularly for His provision, and for people like Tom and Jana who devote their lives to caring for His children. We look forward to another great trip in May, so please stay posted for more on what we are doing.

Oh, wait-- Almost forgot to explain the pictures today... The first is a relatively rare shot of a Mayan lady smiling! (Smiling in pictures is not a cultural norm here, generally...) She was one of our vaginal hysterectomies from Tuesday, and we were thrilled to see her up and about and looking so well. She is pictured with several of her family members and friends who were there to support her. The one here at the end is of a young lady who delivered her baby overnight at the hospital. They called Carrie and I to come evaluate her because they thought she might need a C-section, but the baby delivered within the five minutes that it took us to get down to the hospital! We were able to print a copy of this out for her, which is a rare gift for the poor in a developing country and brought a lot of smiles to the family's faces. What a privilege to ever be a part of something like that!

Finally Home

2010-02-14T22:17:00.002-06:00

Snowmaggedon, Snowpacolypse, whatever you want to call it - it managed to affect life not just in the United States, but also in Central America. No, they didn't get any snow, but the airplanes that come to Guatemala to bring people home DID have to deal with the snow.

Heidi, Carrie, and Pat arrived at the Guatemala City airport in time for their 1:50pm flight back to the United States on Saturday but their plane didn't. It was coming from Atlanta (in order to return to Atlanta) but was part of the biggest cancellation of flights since 9/11 and was about six hours late.

Of course, with that delay, the girls missed their connecting flight and ended up spending the night on the floor in the Atlanta airport. They were re-booked on a flight for Monday but all needed to be at work on Monday. So they put their names on the standby list, tried to rent a car (which wouldn't be available for 12 hours), and even explored the option of having someone drive in from North Carolina to get them.

But God smiled on them and they were able to get on the first morning flight out of Atlanta and arrived in Raleigh at 10:05am - about 10 hours after their originally scheduled arrival.

With the exception of the more-eventful-than-usual return flight, it was a hugely successful trip and we'll post some more stories and pictures tomorrow. Thanks for all the thoughts and prayers.

When you are considering your giving for this year, please keep this mission in your prayers. We are currently trying to raise funds to help pay for all the surgeries we do in Guatemala. Obviously, the surgeon does not collect a fee, but the hospital does. The patients have to be fed, given medicine, put in a bed, and given nursing care. The average cost of a surgery is $200-$300. The patient contribution probably averages around $10-15. And while the balance is pretty inexpensive by American standards, operating on 10-12 patients per trip multiplied by four trips a year leaves us with a hefty bill.

The members of the team all travel to Guatemala on their own dimes - and most of them use precious personal vacation time to go. If you feel led to contribute, know that 100% of your donation goes directly to patient care. There are no administrative expenses, no doctor travel expenses, no candlelit dinners, etc. Every dime goes directly to helping some very needy patients. And your contribution is fully tax deductible through Agape In Action, a 501(c)(3) organization.

And if this is not where God is calling you to contribute financially, we still appreciate all of your prayers. We can't do our work without those, either!

Welcome, Baby Anna!!!!

2010-02-11T07:12:00.002-06:00

Thank GOD for the safe arrival of beautiful baby Catherine Anna Ficker this morning at around 6 a.m. (also, about ten minutes after safe arrival at the hospital in Guatemala City!!) God is sooooooooooooooooooooooo good! More details later... It is really not my story to tell, but please when you talk to God today, thank Him again for his sovereignty, love, and protection of his precious children down here...

More Operating Time...

2010-02-10T17:47:00.003-06:00

Wow, God really kept us busy yesterday, so we're really glad we got a little bit of a break today! I don't know if the time stamp on this thing works, but it's about 5:30 p.m. and we are essentially done for the day, after a nice lunch and even a little market time...

We did have several consults to do today on clinic patients, and Carrie and Tom stayed scrubbed in to a particularly tough gallbladder case for about 5 hours!! Unfortunately, the other patient we had scheduled for today did not show up, and she is the one who probably needs her surgery the most! Please pray for Julia, who needs surgery for about a 10 cm mass in one of her ovaries-- pray that it is not cancerous, and pray that she gets the surgery that she needs soon to know for sure! Her husband is away working down near the coast right now (cutting sugarcane, most likely...) and likely did not give her permission to have her surgery without him here. A very sad state of affairs on many levels, and one of the realities that many Guatemalan women live with.

We do have good news, in that all of our post-operative patients seem to be doing well overall! Yesterday we operated on three ladies who needed various kinds of hysterectomies (for you OB/Gyn types out there who are interested, a TAH s/p 3 C-sections, a TVH with anterior repair, culdoplasty and perineoplasty, and another TVH with culdoplasty, perineoplasty, and a prayer that it holds since her tissues were too post-menopausal to do anything more substantial!) The second case took much longer than we had hoped but so far the outcome has been good and that's what really matters this week. In the long run, of course, we just hope that they will feel the love of Christ while they are here and know that it is only because of this that we are able to help them at all...

Today brought an interesting "mystery" story our way from clinic-- A lady who is around 49 years old, who came in stating that she had a hysterectomy last September done by some visiting North American doctors down in Antigua, Guatemala. She says she had her surgery because of some heavy bleeding she was having, and that they told her they also took out both ovaries. She was doing well until January 1st, when she started bleeding again like she was having another period, which has kept going through today! She brought in a pathology report with her name on it that said her uterus, tubes, ovaries, and cervix were all sent to pathology and that she had a cervical cancer found on pathology! Luckily, the cancer was small enough that the surgery should cure it permanently.

But imagine our surprise when we went to examine this lady and found that she has a cervix, a uterus, and at least one ovary still intact inside!!! Hmmmmm... where to start?! The patient strongly believes that she had her uterus removed, but was unaware that the pathology report (which is obviously NOT hers as she still has her cervix intact!) read "cancer". So now we have TWO problems-- Someone DOES have cancer, DOES need to follow-up with regular pap smears and doesn't know it! And THIS lady... well, has a uterus, what appears to be a complex cyst in one ovary that probably should come out, but unfortunately also has very uncontrolled diabetes making us more than a little hesitant to operate on her just to find out for sure what's going on!

I tried calling both the pathology lab and the Hospital where the surgery was done (both generally quite reputable places down here...) and talked to very nice people who promised to call back soon when they found some information but whom I have yet to hear from. Maybe tomorrow we'll hear something, but I won't hold my breath! I checked some lab work to make sure she's not anemic, biopsied her uterus, did a pap smear, and then sent her with some paperwork to try to get a CT scan a little ways up the road to get a better picture of what's going on with this ovary of hers! Tom is nice enough to follow all this up in a few weeks, and we gave her a lecture about controlling her diabetes better in case she needs surgery, but who knows where it all will lead?!?! I'll call the hospital again tomorrow and see if I get any further...

Speaking of tomorrow, just a few quick general surgery cases (gallbladder and two lymph node biopsies), and hopefully we will send almost all of the patients from this week home. Then the girls will surely hit the market hard again, assuming that we don't have another 20 clinic patients to see!

A few random pictures today... The first is of Carrie with the family (or maybe the whole village, it would seem!) of the first patient we operated on yesterday-- Yes, that is the lady's uterus that her husband is holding in the basin there! They like to see the "parts we took out" here after surgery... Usually a new cultural experience for most people that come down here!

The second is from inside the hospital, a nice view of the courtyard that everyone enjoys and takes good care of...

Will try to bring you more stories tomorrow!

In the Operating Room

2010-02-08T20:00:00.004-06:00

Thought I'd start out today with a precious picture of our youngest patient today-- It took forever to get her to warm up to us and smile (bubbles are universal, though!) but sooooo worth it! Dr. Hoak repaired a hernia for her with Carrie's help this afternoon, so don't worry; we're not going around taking out EVERYONE's uterus around here! ;-)

Aura (the beautiful little girl above) was actually the third surgery of the day, preceded by two women who needed surgery to repair prolapsed uteruses (?or is it "uteri"? I've never known how to say that! Guess they don't teach everything in "Gynecology School", as my husband calls it...) Carrie did a beautiful job with these two vaginal surgeries and gained some valuable experience that she hasn't had much of in the U.S. recently while busy practicing robotic surgeries instead! These women's lives, with God's help, will be changed dramatically by the relief of their symptoms, and our prayer is that that Rafaela (our second patient today) will come to know Christ eventually through our work here.

The first patient, Paula, was a little bit of a "breath of fresh air" for our friends the Fickers, who recommended she come to see us here and were pleasantly surprised when her Pastor stepped up from her very small little village and said HE would take her! This is about a 2.5 hour trip for them, and he is planning to come get her on Wednesday when she is discharged, too. I called on his cell phone after the surgery to let him know she was doing well, and he asked if I could give her the phone so he could speak to her, too! What a wonderful example he was for so many... A true shepherd to his people and a huge blessing to her.

The third picture is of Carrie and Tom doing a gallbladder as the last case tonight-- This lady may also need a hysterectomy in a few more months, but we are going to try to control her symptoms with medicine first before doing another surgery.

The last picture is one of my favorites of the day... Pat finishing up the anesthesia for the little girl Aura...
We also saw a few more patients in the clinic in between cases... Scheduled a couple more cases for the week and were able to provide some reassurance to a few other ladies in need of it. Lord willing, we will be operating all day tomorrow on three tough cases and then we'll see what God has in store for us on Wednesday and Thursday!

Long Clinic Day!

2010-02-07T20:59:00.003-06:00

What a great-- but LONG-- day today!

Started off with market around 8 a.m., which Carrie got to experience for the first time but Pat's an old pro at by now! We then headed up to Church with the other local missionaries at 10, where we heard an amazing sermon on suffering and God's ultimate plan based on the raising of Lazarus from the dead. Then a quick (but really yummy!) lunch at a local restaurant that Pat has been talking about since the last time she left I think...

Then we ran over to the hospital to start seeing patients... 16 total came in, and we scheduled 5 surgeries for this week as well as some that want to come back later in the year for surgery. It's always wonderful to see patients back for a final post-op visit, so picture number one is a lady that I did a vaginal hysterectomy on back in November who is doing GREAT! Please pray for her, though, as she has not accepted Christ as of yet despite her family's efforts to convert her. She is in good health overall but getting on in years and I fear we are running out of time... It was nice to see her back to be able to show her some more of God's love for her today, though, and we just keep praying that our seeds we are planting will one day grow in to a beautiful relationship for her. She is pictured with her daughter. Her name is Manuela.

The next picture is just of me getting ready to start for the day, but it shows our trusty little clinic room, which is actually decently well-equipped with an exam table, light, and lots of supplies we have brought in over the years. Thanks to Carrie for being my photographer today; hopefully tomorrow we'll get some pictures of her and Pat up!

We also saw an assortment of ladies needing hysterectomies, or who needed reassurance that they did NOT need surgery for their tiny ovarian cysts that some of the local doctors want to make money off of. That is an unfortunately common thing here. We also saw a lady with a 10 centimeter ovarian mass that DOES need to come out (pray it's not cancer!), a lady who needed follow-up on an abnormal pap smear which we were able to help with, and a couple of ladies with pains that we aren't really able to explain. At least we were able to offer reassurance that they don't have anything terribly wrong with their uterus or ovaries, though!

After we had seen about 10 of our 16 patients, the local doctor called to see if we could help in the emergency room because there was a breech baby they were trying to deliver! So Carrie and I rushed over to see what we could do... Unfortunately, the young girl had tried to deliver at home and the baby's body had been delivered for quite some time before she arrived at the hospital. We were able to get the baby delivered safely for mom, but it was obvious that the baby was not alive at all even upon arrival to the hospital. How amazingly sad to have to tell a teenage girl that her first baby is a stillborn... and all for lack of delivering where there is a doctor trained to help! I don't even know the young lady's name, but I'm sure God will know who you are talking about if you send up prayers for Him to help heal her heart from the ache it must be feeling tonight.

Tomorrow we will operate on at least two ladies who need vaginal hysterectomies, and see what else God sends us! Hopefully we will get a good night's sleep tonight and be ready to go tomorrow... There are also currently 2 surgeries scheduled on Tuesday and one on Wednesday. I'm sure others will show up, though!

Safe Arrival!

2010-02-06T19:55:00.002-06:00

Thanks in large part to lots of prayer coverage, we have arrived safe and sound in Chichicastenango! And the best news is that we didn't have any medications or other supplies "held" (i.e., stolen) in customs, which is becoming a bigger and bigger issue with entry in to the country with any medical supplies lately... Kudos to Pat for being organized enough to get all of her meds listed and approved in advance, and many thanks to Don Tono, the administrator at the Hospital Buen Samaritano, for getting the paperwork done! That's a huge load off of our shoulders already...

Today has been a long day (We left home about 2 a.m. local Guatemala time and it is now 9 p.m.) so this will be a short post, but wanted to thank you all for your well wishes and prayers during this week. We will get up tomorrow morning and probably hit the market for a little early bird shopping before heading up to Church. Then as soon as we can, we will start seeing patients until we are done! We hope for a good turnout, of course, but always pray also that God will never send more than we can handle.

Ideally, we would like to see all of the patients first tomorrow and then just schedule the surgeries that are needed for the rest of the week and not have to try to rush to see patients between surgeries later in the week... But we know that's not always going to work perfectly, so there will be plenty of work to do all week and we will need to pray for lots of patience especially the first few days. It is so tough between surgeries when you have time to see maybe one or two patients before they are calling you back to the OR-- the next patient in line always looks so crestfallen when they realize you are leaving again for what could be another several hours before you can come back down to see them. Luckily for us, Guatemalans are generally a lot more patient than we North Americans are...

Will try to post some pictures tomorrow, of course, so please stay tuned!

February 2010 Trip

2010-01-28T14:26:00.006-06:00

Yes, several months have passed since our last blog and a few trips. The second week of the second month of each quarter is the scheduled trip from Greenville, NC to Chichicastenango, Guatemala. (February, May, August, and November).

Heidi has been fortunate enough to have some wonderful experiences her last few trips and has been able to perform some badly needed surgeries, as well as transport some critical supplies. Thanks to the generosity of many in Matt's parents' church in Michigan, literally thousands of diabetic test strips have been sent. A couple ministries were even on the verge of discontinuing treatment of diabetics for lack of strips but God always comes through and we're thrilled when He uses us as His "boots on the ground".

The next trip is scheduled for February 6-13, 2010. Traveling with Heidi will be Dr. Carrie Ballard, another ECU faculty member, and Pat Peabody, a nurse anesthetist who made her first trip to Chichi last May.

In her last two trips, Heidi has been very encouraged by the fact that she's given some patients pre-surgical courses of treatment that they've followed and returned for surgery, she's seen several return patients, and it seems like word has gotten out that this doctor who says she's going to come every three months is actually coming every three months. She's also had an opportunity to operate with and assist Dr. Hoak which is both helpful to him and educational for her.

In the August 2009 trip, Heidi was accompanied by Dr. Chris DeLuca, a chief resident at ECU. Below is a picture of Chris with a few of their post-op patients eating breakfast.

Next is a picture of Heidi, Katie Ficker, and Duane in Zona Reyna (yes, she had time for a short trip out there) to see over 100 patients with Katie and Chris.

The next picture is inside the clinic building there. There are no roads to this village. Visitors must either come by bush plane or walk a LONG day over a mountain. It's so steep that horses can't even make it, so everything would have to be carried in on your back. Thank God for airplanes! Only a few residents in this village speak Spanish (everyone else speaks K'ekqchi) so translators are needed for every single patient. Typically, the medical people will see patients, the rest will evangelize or help with projects that need to be done and keep an eye on the sky. It takes two or three trips to get everyone in and out and if the weather starts to turn bad, Duane has to start ferrying people home or risk getting stuck in the jungle all night with no power (don't laugh, it's happened!)

The last picture is of a beautiful rainbow they saw on the way back to Canilla Intergalactic Airport. It's an awesome reminder of the promise and the faithfulnessof God.

Surgical Trip

2009-05-14T16:21:00.002-06:00

Wow, where to start? I probably should have started blogging a little earlier this week as I am somewhat out of practice with blog-writing! We (Heidi and some friends from work) have been down here in Guatemala operating at the Hospital Buen Samaritano in Chichicastenango all week. We are hoping that this is the first of our quarterly trips down here, and are praising God today towards the end of the trip that everything has gone well!

We were not sure what to expect-- how many patients, how our transportation would be arranged, how much help we would have, whether we would spend the whole time at the hospital, etc..-- when we got here, but we did know that God already knew and that was enough! He has been faithful-- as always-- in providing for His people here in Guatemala. This week, specifically, He also provided three women who had never done missions in Guatemala with a wonderful experience. We are praising God that everyone is already talking about when they can come back!

Our first picture is of our team-- We are in front of the fire at the Hotel Casa del Rey here in Chichi, and from left to right we are:

Erin Hartwell, a fourth year resident at ECU in OB/Gyn, who Heidi has enjoyed working with since September. She had the chance to not only do some great gynecologic surgeries, but also some general cases with Dr. Hoak that she would never get the chance to see and do in the U.S. Heidi is sitting beside her, of course.

Pat Peabody is a CRNA (Certified Registered Nurse Anesthetist) who tirelessly ran anesthesia for us this week. Heidi has also had the great honor of working with her at Pitt County Memorial Hospital since September. It took a little less than a week of working with her before Heidi was hitting her up to join us on a Guatemalan trip, and she has held fast to her promise to do so!

Patty Palmer is a circulating nurse in Tulsa, Oklahoma, who actually arranged to come down here through Sharon and John Harvey at ASELSI. We quickly snagged her up and adopted her on to our team, and she was a true God-send all week! She helped with everything from prepping and transporting patients to getting hair out of Heidi's eyes during an operative case, and even found time to do some classes for the nurses there at the hospital about how to use the new autoclave for sterilizing instruments properly. She is also to thank for many of the great pictures that we have from the week.

The next picture we just had to include for our old regular readers... Some of you might just recognize the lady in the sharp-looking nurses' uniform as Cecilia ("Ceci"), our translator from ASELSI! When we found out over a year ago that she was interested in putting herself through Nursing School, we offered her an informal "scholarship" to do so. She is now just about a month away from her degree (equivalent, basically, to an LPN in the U.S.) We are so proud of her! She is truly a success story out of the ASELSI mission... a single Mayan mother with a professional degree? What an unheard-of and wonderful bit of news!

Now on to the patients, finally! What an interesting week... that has left us full of prayer requests to post! The first picture here is of Heidi and Erin posing with the uterus they took out Tuesday night. The normal uterus should be less than the size of a fist, just for a frame of reference... This lady should be feeling much better from here on out.

And here is our BIGgest prayer request from the week. The picture below is of Heidi, Erin, and Tom Hoak operating on our patient Petrona. She was diagnosed with cervical cancer by Tom recently, and we attempted to do a curative surgery on her this week. We knew that none of us is truly qualified to do this kind of radical surgery, but we also knew that this lady would NOT get any help from anyone here otherwise. Dr. Hoak has enough experience with the Guatemalan medical system now to know that there was essentially no chance of her getting a safe surgery here-- if anyone would even operate at all. The other option-- radiation-- is something she will not be able to afford, most likely. She refused to even go to The City to explore that option, so we all spent lots of time praying over her and agreed that surgery with us was the best option. God provided a peace with this decision, and we proceded with as much love and patience and diligence as we could.

Seven hours in to the surgery, however, we eventually encountered a stumbling block that we could not overcome. (For the medical folks, her left ureter was completely encased in tumor, which we did NOT expect from our clinical exam. This makes her an inoperable Stage IIIb cervical cancer) We could not safely remove the tumor, and had to terminate the surgery. Her only option now is to go to Guatemala City and try to get radiation, which she is unlikely to do. So the other option is praying for a miracle, which we invite you all to join us in. Either way, we hope that she felt the love of Christ that we tried to show her with our efforts.

The last picture is of a little 3-year old boy that a team from ASELSI actually brought in to the Emergency Room after finding him on a home visit that they made. About 10 days ago, he stuck both hands in to some boiling liquid and severely burned them as you can see. The family had sought no medical care to date, and it is really quite lucky that he has not become severely infected. Tom, Pat, and Erin took him to the operating room and cleaned his wounds under anesthesia. Tomorrow they will do a skin graft to try to save some function of the right hand. ASELSI will follow up with physical therapy, and the whole thing will hopefully be a wonderful testimony of how God can really work in people's lives when we all work together for His good!

Please pray for the rapid recovery of Hugo Emmanuel. He will be hospitalized for a while here, but hopefully will continue to do well.

Today Erin and Heidi were supposed to go out to the Zona Reina with the Fickers, but that trip was cancelled due to some forgetfulness on the part of the community leaders where we were supposed to go! Bummer, but at least it gives Erin something to look forward to when she comes back!

Tomorrow Heidi will get up to Quiche where Duane has generously offered to come pick her up to spend the day and night with the Fickers. It is hard to imagine a trip to Guatemala without seeing them, but the logistics proved to be a little challenging this time with no vehicle. We will all meet up back at the airport Saturday morning (Thanks, Tom and Jana, for offering a ride to Erin and Pat!) and fly out...

We have missed our friends and families this week, but are truly blessed to be a part of God's continuing work here in Guatemala. May He continue to bless you all and all of his people here in Guate!

Merry Christmas

2008-12-30T07:43:00.002-06:00

Merry Christmas, everyone!

The two main holidays in the Christian world are Christmas and Easter. One because it celebrates Christ coming to be with us and the other because it celebrates the accomplishing of his mission.

This season, we celebrate the fulfillment of a promise. God had been promising his people for thousands of years that he would send a messiah. And in a tiny town in modern-day Israel, that promise was fulfilled.

It's a reminder that ALL of God's promises are fulfilled - in His time. That's why this is often called a season of hope. See, another one of God's promises was that Jesus will come back in the same way the disciples saw him leave. So, like the old testament Jews waited for Jesus to come the first time, we now wait for him to come back.

In the meantime, there is work to do.

Agape in Action is very excited about the next chapter of our story in Guatemala. Dr. Sherwood Pope and his wife Areli will be moving to Guatemala in a matter of days now. Please keep them in your prayers.

Also, since Agape in largely funded through investments in the oil and gas business, and you may have noticed that oil prices are dropping, please consider a financial gift to the ministry. Less money at the pump in our case means less money for missions. So maybe a bit of what you're saving could be put to good use???

Just a thought.

We pray you have a blessed Christmas and New Year!

Happy Thanksgiving!

2008-11-30T11:58:00.002-06:00

It was a pretty typical American Thanksgiving week for us. Busy, busy, busy!

Heidi, being junior faculty at the hospital, was blessed with a 24-on, 24-off schedule for the week. The trade-off is over a week off at Christmas, though, so no complaining here!

Matt played Wednesday-Saturday nights, so we spent a few nights at Heidi's Aunt Mary Ann's house to celebrate Thanksgiving with her and to have a place for Isaac to stay while Daddy was out playing "rockstar".

God continues to smile on our end of the ministry here in North Carolina. We have a very different role now, but we're still working for the kingdom. Heidi has been busy collecting "trash" from the hospital. Yes, it's hard to believe, but we Americans throw away a lot of stuff that can save lives in other parts of the world.

We are using the attic in our house as a storage facility for these donations and will start working on a plan to get these things into the hands of the hospital folks in Guatemala.

And to echo our last post, during this time of worry and fret here in the United States, please remember that we are still the richest country in the world. Our bounty is so ridiculous that the obesity epidemic is the most pronounced in our poor population. Not too many other countries in the world worry about how fat their poor people are.

Please, please, please, keep giving to missions, especially when times are tough here. If they're tough here, they're even tougher everywhere else. Just a few dollars a month can make a huge difference in the third world.

And if you're looking for a place to send money, Agape In Action sends 100% of all donated money directly to the mission field. NO administrative expenses are taken out - those are already covered from their business ventures. So you can know that every penny of the money the Lord has led you to give ends up in the hands of those who are spreading the gospel.

Also please keep Dr. Sherwood Pope and his wife, Areli, in your prayers. They are preparing to move to Guatemala to take over the medical mission there and do amazing things with it. They are young, energetic, and spirit-filled, so you can only imagine what God has in store for them. Please pray for an easy, uneventful move and for God's revelation to be clear to them.

Guatemala Trip Scheduled

2008-10-30T05:04:00.002-06:00

Ironically, sometimes things move a little slower here in the US.

It's taken us a little while to get our feet on the ground here in North Carolina and now we are ready to schedule our first round of return trips to Guatemala. It looks like it'll be the second week of the second month of each quarter in 2009. Our time will be spent in clinic and in surgery, God willing, along with bringing and delivering supplies to other missionaries in Guatemala.

And, of course, Isaac needs to visit his "big sisters", Abby and Grace, in Canilla. Now that he can walk, he might be able to defend himself a little better. But what are big sisters for, right?

With the tough economic times here in the US, sometimes it's hard to remember that we are still, far and away, the richest people in the world. If you get sick, you have almost immediate access to world-class health care. Gas costs way less than a day's wages per gallon. Meat costs less than a day's wages per pound. You are probably feeding fewer than 10 children on more than $15 a week.

Even if it means cutting back on "necessities" such as that extra package of channels on your satellite TV, eating out twice a week, or even buying brand name detergent, please remember the missionaries around the world in your weekly or monthly offerings.

We are hearing incredibly sad news that missionaries in Guatemala and around the world are suffering due to huge decreases in giving. Know that the work of God must continue. Souls are being saved in distant lands - places where the name of Jesus has never been proclaimed - through the work of missionaries. We understand that during tough economic times, sacrifices have to be made. But please sacrifice in your own life and not in the lives of those so much less fortunate than ourselves.

You can't out-give God. Give Him an opportunity to prove it to you. Please keep giving to missions, especially during these times.

Also, check out our new link on the right - to the Fickers!

Nueva Santa Catarina - And A New Doc!!!

2008-09-29T11:40:00.004-06:00

Sorry again for the long delay in posting. Life in the US moves at a little different pace than life in Guatemala...

We got a call from Aaron and Katie last week around 8:30pm. They were on their way home from clinic in Nueva Santa Catarina. This was one of our "solo" clinics that they are covering for us now.

They had between 60-70 patients - about double the normal load there - but were able to see them all and get them taken care of.

Just a quick note to those of you who are still following.

We are so thankful to God that He has provided a replacement for Heidi and Matt. Many of you close to the mission already know, but Dr. Sherwood Pope and his wife Areli will be moving to Guatemala in January to take over the reins for Agape in Action.

Dr. Pope is from Michigan and his wife is from Mexico City. We prayed for them long before we knew who they were and we will continue to pray for them now.

Please check out their current website at http://www.missionarydoc.com and keep checking here for updates!

Safe and Well in Guatemala

2008-09-19T11:35:00.003-06:00

We got news today that Don Allison and John Villanueva made it through to Guatemala.

Apparently, as usual, they had some adventures, but nothing too terribly scary.

They split up once they made it into Guatemala. Don went to Guatemala City to pick up his family at the airport and John went to Quiche to spend the night at the dorm. They should all arrive in Canilla later today.

Ike Invades Houston

2008-09-12T17:53:00.002-06:00

To anyone not familiar with Houston geography, all of our support team is directly in the path of Hurricane Ike. To the best of our knowledge, everyone is evacuated.

While Ike will not "make landfall" until the middle of the night tonight, Galveston and the surrounding areas started flooding this morning - more than 12 hours ahead of the full force of the storm.

Houston and all surrounding areas will be subject to severe flooding and crazy high winds. Almost everyone will take some type of damage.

Please keep the Shaws, the Leathermans, the Villanuevas, and the Allisons in your prayers, as well as the rest of the Houston metro area.

We'll post more details as we get them.

Slight Change in Plans

2008-09-08T13:12:00.002-06:00

Matt flew to Atlanta this past weekend to attend the wedding of a friend he used to play with. It was beautiful! Many congratulations to Jared and Heather!

After the wedding, he flew to Houston to meet up with Don Allison and prepare for the drive through Mexico. There had been a slight paperwork mix-up, though, that generated a few problems.

Without getting into all the details, there is a waiting period of 72 hours from the time the US Customs Department receives your vehicle title until you can cross the border. Because of our mix-up, we won't be allowed to enter Mexico until Thursday.

It's about 28 hours of driving from the Texas-Mexico border to the Guatemala-Mexico border. If we crossed into Mexico by noon on Thursday, drove all night Thursday, and nothing went wrong (yeah, right), we would arrive at the Guatemala-Mexico border just as it was about to close for the weekend. Matt's flight out is set for Monday morning. There's virtually no way he could make that flight. So if the guys encountered more than a one hour delay in the entire trip, they would be forced to sit in a Mexican border town for two days, miss Matt's return flight home, and generally be miserable.

So we came up with Plan B. John Villanueva to the rescue (again).

John is vacationing in Chicago right now. He flies back on Wednesday. On Thursday, he and Don will drive to the Texas-Mexico border, fill out all of their paperwork on the US side, spend the night, then cross the border Friday morning. They have all weekend to make it to the Guatemala border (which means they'll get some nice time on the beaches of Tampico and Veracruz), then they can enter Guatemala on Monday. Matt will simply return to North Carolina tomorrow.

So, it looks like God knew what he was doing when he had John ride down with Matt in January. John will get one more trip added to his "experience list" and Don will get the help he needs. Additionally, the Fickers will get the 4-wheeler they've been waiting on for a couple of years.

About that 4-wheeler. In the area of Guatemala where the Fickers live, the "roads" are often impassible by car. So a 4-wheeler or dirt bike is needed. They have a couple of small 4-wheelers and several dirt bikes, but to really haul any medical equipment or accomplish a medical evacuation, a larger 4-wheeler is needed.

They have a big Honda Foreman 4-wheeler but it has almost 20,000 miles on it (and not easy miles, either!) It's becoming a bit inconvenient to keep it running as all of the parts have to be imported from the US. This 4-wheeler we're bringing down to them is a nearly new Foreman that has 4 wheel drive. So it'll be even better than the one they already have. Now they'll be able to get supplies and people to even more places than before!

It's important to remember that even when things do not seem to be working out the way you're hoping they will that God is always in charge. He will never close a door without opening a window....

If you're not watching the news, there is a hurricane drawing a bead on Houston as we speak. All of the fundraising staff here and their familes will probably have to evacuate. This includes John's wife and two kids (while he's on a trip to Guatemala). So please include all of them in your prayers.

We'll ask for prayers for the following:
* A safe, expedient, hassle-free and uneventful trip to Guatemala for John and Don
* A safe and easy evacuation for the Leathermans, Shaws and Villanuevas
* No damage or major inconvenience from the hurricane
* A safe trip back to North Carolina for Matt

Guatemala News and Trip

2008-09-04T19:39:00.003-06:00

Sorry it's been awhile, but we've been busy here in the United States.

Heidi officially started work this week. She has a new office, phone, pager, schedule, etc. Matt's mom and dad are in town for a few weeks to help out with Isaac because Matt leaves in the morning for Guatemala (with one side trip).

We heard back from Aaron and Katie. They went to Chicabracan on Monday to cover our clinic there. It's so nice to know that our patients have not been abandoned, but are in outstanding hands. Katie took the first two pics below (of patients of ours) so we could see how they're doing! Thanks so much, guys!!!!

We also got an email from the group in Houston with a funny story about how they managed to squeeze a 4-wheeler (and a big one at that) in the back of the 4Runner. It involved planks, trees, and a few concrete blocks. You don't want to know the rest. The other three pics below are of the legal portions of that process.

Anyway, Matt flies to Atlanta tomorrow for a friend's wedding, then to Houston on Sunday. He'll meet up with Don Allison, pick up the 4Runner (with a 4-wheeler inside it) and drive to the Texas-Mexico border. They'll spend the night there and hit the border first thing Monday morning.

If all goes well (and it never does), they'll arrive in Guatemala on Wednesday. Matt will hang out a few days, then fly out of Guatemala City on Monday, arriving in Houston that afternoon. Then he flies back to North Carolina on Tuesday.

We'll try to post some stories from the road once he gets to Guatemala. Hopefully, the trip will be so uneventful that there will be nothing to tell.... But probably not.

New Mexico - Then North Carolina Again

2008-08-24T15:43:00.003-06:00

Wow. A lot has happened in the last two weeks.

We went to Albuquerque, New Mexico to visit Matt's cousin Michelle and her family -including her son, Luke, who turned 2 while we were there. Isaac and Luke got along GREAT!

Here's a video of Isaac and Luke playing with Luke's new tractor.

Then Heidi and Isaac came back to North Carolina to get the house ready for move-in. Matt went to Michigan and came drove back to North Carolina with a new car, courtesy of Matt's mom and dad.

Matt stopped off in Salisbury at Heidi's dad's house and picked up all the stuff we left there - some from Houston a few weeks ago and some we left there before we went to Guatemala. Many thanks to Heidi's dad for storing all that stuff and for helping us get it all to Greenville (our new home).

We moved all of the UHaul stuff in on Monday and Tuesday, the moving van came on Thursday, and by Friday we were "functionally" moved in. Decorating will still take some time.

Saturday was the annual Luau at Heidi and Todd Durham's house - and we got to have lunch with our new landlord. We found the house we're renting on the internet (imagine that) and had never met Chris, other than by email.

And in ACTUAL news, Isaac is now walking. He also learned how to clap this week...

Here's a video of him walking.

This coming week is more "move-in" stuff, then Matt starts his journey back to Guatemala (via Atlanta where a friend is getting married).

If you'd like to know more about the trip back to Guatemala, please read the Allison family blog at: www.allisonfamilyinguat.blogspot.com

Okay, gotta run! Isaac's walking now so he's a lot faster than he used to be!

North Carolina

2008-08-10T05:40:00.003-06:00

We're back from Beach Week and on our own computer now, so here are just a few of the many pics we took.

Isaac took his first steps on 8/8/08 - while Daddy was running an errand. He hasn't really walked since - he still prefers to crawl - but "the step" has been taken.

We're in Durham, NC with "the other Heidi" for a few days, then we head to New Mexico to visit Matt's cousin Michelle and her family.

Then Heidi and Isaac return to NC and Matt goes to Michigan for a few days.

We take possession of our new rental house on August 18.

Then on September 8, Matt and Don Allison begin their drive through Mexico to Guatemala. Matt will fly back a week later - assuming they've made it there by then.

Pics 1-3 are of the beach - duh. And the last one is of Isaac at a Durham Bulls game - his first baseball game. He loved it... er... we mean that he loved the ice cream...

Beach Week!

2008-08-03T08:39:00.002-06:00

As you can tell, our posting will probably be a little less frequent for a bit now.

Matt and Martin spent a few days in Houston, each taking care of some personal business. Martin actually spent a day working on the 4Runner, changing out some things that we knew were ready for that.

Thank God he suggested that we change our water pump and timing belt. Even though the truck only has about 67,000 miles, the timing belt was not going to last much longer! But there's a new one on there now and we're good to go.

Wednesday evening, we loaded up a Penske truck with Matt and Heidi's stuff and a bit of Natalie Shaw's stuff and headed out. We got as far as Baton Rouge and spent the night. In the morning, we resumed our drive. By dinner time we were in Greenville, SC to drop Natalie's stuff. By 10pm we were in Salisbury at Heidi's dad's house.

The next morning, we grabbed some breakfast, unloaded, returned the truck, then got Martin to the airport for his flight to Providence where he's picking up a truck and a couple dirt bikes.

Then he's driving to Cincinnati to pick up another truck, then to St. Louis to get another dirtbike, then it's to Guatemala again (via Houston). He's got a grandbaby on the way, so he's interested in getting home.

Update: please keep Martin in your prayers. We got a call from someone this morning saying that they found his cell phone in a BP station in Ohio. Martin now has no way to get in touch with anyone, as most of his numbers are in that phone. He doesn't really speak much English and really hesitates to impose on anyone, so we're a little afraid he's just going to skip a necessary part of his trip to get back to Houston as to avoid asking for any help.

Anyway, we're now at the beach - at Heidi's aunt's beach house (the same one where we got married) in Atlantic Beach, NC - for the whole week.... Isaac is playing with about 10 or so of his cousins and having a ball!

We don't have our computer with us, so we can't post pictures, but we'll try to do that this weekend....

Also keep the Fickers in your prayers as Leslie and Hannah are probably alone in clinic in San Andres this morning with well over 100 patients outside the door...

Houston, Texas!

2008-07-27T23:07:00.002-06:00

Matt here -

My previous record for iron-man driving was from Houston to north of Boston. Just over 30 hours. Broke that this week.

We left Quiche at 4:00am on Friday. We arrived at our hotel at 12:30am on Sunday. With the exception of some silliness at the borders, all of that was driving. Martin and I each got maybe a total of an hour of sleep - most of it in 2-3 minute chunks. Amazingly, we never had a driver who was tired to the point of considering a stop.

And, (those of you who know me will not be surprised by this), I handed over the wheel from 10pm to 2am on Friday night and from 6am to 8am on Saturday morning. The rest of the trip was all mine. The 10-2 stretch was some of the most difficult driving, though. In Mexico, when it's dark, it's DARK! It was on bad, pothole-filled, windy, mountain roads and it was raining pretty hard. Good job, Martin! Not an easy task.

Anyway, the silliness at the Guatemala-Mexico border started thirty minutes into Mexico on our first attempt to enter. We crossed the border itself in about 20 minutes and started driving. At the first checkpoint, though, they told us that the truck did not have permission to be in Mexico. It's titled to John Villanueva from our support group and the notarized letter he sent (in English AND Spanish) was not good enough for them.

So we had to drive back to Guatemala. Martin went to an attorney friend in the border town to get some type of official seal on the title itself with a note on it (and an expertly forged signature) giving us permission to drive through. The attorney in the border town wouldn't touch it. So he took a taxi to the next town up the road - 30 minutes up the road - and found an attorney there who said he would, but he wanted a copy of John's passport.

So we called Houston and got a copy faxed down. We have John's wife to thank. She drove home from her job, got John's passport, then faxed a copy to him, which he faxed to Guatemala (John lives a long way from work - especially in Houston traffic.)

With the copy and about three phone calls, the attorney had all the info he needed. Then he decided not to put his seal on it. Luckily for the attorney, one of the commandments specifically prohibits what Martin WANTED to do.

Figuring that the law of averages had to eventually go our way, especially with two honest attorneys in a row, he tried a third. BINGO! Signed, sealed, and delivered, we were on our way again.

From the time we left the checkpoint the first time until the time they let us through the second time, we lost six hours. The kicker was that they put a sticker on our windshield that basically serves as the vehicle's visa. The sticker has to be removed by a certain office in Mexico to show that the vehicle has been in Mexico for less than the 30 days it's allowed. This office has hours and they do not include any hours on Sunday. So if we don't make it to Texas by Saturday afternoon, we're stuck in Mexico until Monday morning - which isn't the end of the world, but it ain't exactly heaven on earth, either.

So we drove.

And drove.

And drove.

Martin has been through Mexico more times than he can count. He knows a good way to go. One with hotels and restaurants all along the road. But Aaron Ficker had given us some notes to come down with and Martin hadn't been that particular way for many years. Hoping it would be better than his way, we tried it.

Aaron, the next time you see Martin, duck. Something might come flying at your head kinda fast. ;)

Not one hotel, not one restaurant. And by the time Aaron's route joined back up with Martin's, it was after midnight. At this point, let's just keep driving. Besides, we're faced with the knowledge that if we stop, we're stuck here until Monday. So we either push through or we completely hang back.

As a side note, the 8-9 Mexican police and military checkpoints are more than just a little annoying. The truck was immaculately packed as to avoid bumping, banging, clacking, smacking, chattering, annoying noises, and damage. At least it was until the first checkpoint when an 80 pound dog jumped into the truck, climbing all over my instruments and studio gear. In subsequent checkpoints, nearly every item we loaded was removed, opened, inspected, and put back in a place other than the one it came out of. At least the soldiers and police were friendly. Helpful, no. Friendly, yes.

Finally, we arrived at the Texas-Mexico border. Five minutes after the office closed to take off our visa sticker. And no help from the guy in the office, either, other than the advice to drive to Matamoros, an hour away, for the use of the 24 hour desk there (which might have been useful information the day before).

So we drove to Matamoros, eventually found the place we needed to be (an adventure on its own) and got permission to leave Mexico. We sat in a really slow and long line to get to the Texas side of the border, then were told to leave the vehicle until Martin could get his permission slip to enter the US.

Just in case you're wondering why people sneak into the US instead of securing visas, read on. Let's skip the part about how hard it is to get a visa. Martin has a visa. He also has a 28 year history of passing in and out of the US. He has never had a ticket here. He has never violated his visa, not even by one day. But every time he arrives at the US border, even with his visa in his hand, they reserve the right to refuse him entry to the country for any reason or no reason at all.

We witnessed a very nicely dressed (and obviously quite wealthy) Costa Rican family get denied entry to the country with basically no explanation. Dad was furious, Mom was bawling, and the kids were just confused. One look tells you that these people, arriving in their Ford Excursion, are not interested in picking tomatoes for $5 a day. But denied they were, and headed back to Costa Rica. If you don't know how stinking far that is, allow me to tell you that no amount of money you'll ever have in your possession will ever convince me to make that trip. And I LIKE to drive.

Anyway, after three hours of waiting, Martin was granted passage into the US. Then the truck was granted access (keep in mind that we could have made the entire trip, both been given permission to enter, and been told that we'd have to go the rest of the way on foot).

By now, it was after 9pm. We had been awake and either driving or waiting on border officals for 40 hours (counting the time change). Then we find out that the hurricane that just came through knocked out a bunch of peoples' power and that there isn't a hotel room to be found in Brownsville, Harlingen, or anywhere within two hours. And there MIGHT not be one after that.

So we drove. There's one more checkpoint inside the US - an hour or so inside the border. We passed through there without incident and arrived in Kingville around midnight. 43 hours after starting. There were two rooms available in the whole town (we checked) and they were both at the Quality Inn.

I asked how much it would be for a room and was given the "fijese" look. (In Spanish, "fijese" basically means, "you're not going to like this, but...") The guy behind the counter told me that because they only had two rooms left, it was going to be.... $68.88. After making sure it wasn't $568.88, we took the room.

Did we want two rooms? Duh. And at that price, it was tempting, but you don't want to take the last room in town, knowing that some poor soul might be just as tired as you and only five minutes behind you on the road.

On that note, a very special thanks to Quality Inn for not ripping off two obviously very tired and desperate guys, one of whom doesn't speak English. And with all that, the price on the back of the door (the one that's the maximum they're allowed to charge) was $145. Good citizens, those. That's the Quality Inn in Kingsville, Texas. If you ever get a chance, give them your business.

Nine and half hours of sleep later, we got on the road again, enjoyed a really nice breakfast at Denny's (except for the part when the waitress dumped my entire Diet Coke in Martin's lap) and got to Houston just in time to eat a really nice lunch at Olive Garden with Martin's two sisters.

Right now, I'm upstairs at Russell and Bethany Leatherman's house. My sleep schedule is a little goofy right now, so I'm not even really tired, but here's my anticipated schedule this week.

Monday - Martin comes to the Agape In Action offices in Porter to meet the crew. Pending approval from John, he'll take the 4Runner and do some scheduled and preventative maintenance on it. I'll introduce him to Chik-Fil-A for lunch, and then try to find all of our stuff here in Houston. That way I'll know what size moving van to rent.

Tuesday - Drive to Louisiana and hang out with Trip. After Trip adds all the parts we need to the songs I recorded, we'll do a final mixdown. Then he'll get the semi-finished product and can master it at his leisure. We'll pass out and I'll head back to Houston on Wednesday.

Wednesday - I'll rent a moving van, load it, and, with any luck, Martin and I will head to North Carolina.

Martin got introduced to Cajun music on our trip (it's a long trip) and fell in love with it. Since we have to drive through Louisiana anyway, we'll see if he likes crawfish, too.

We'll drive all night and hopefully arrive in Salisbury, North Carolina on Thursday. We'll sleep, then get him on a train or a bus to Providence, Rhode Island where there's a truck and three motorcycles waiting for him to drive them back to Guatemala. Please pray for him during his travels. He's away from his wife and daughter (who is about to have his first grandchild). Oh, and the drive through Mexico really stinks. It's manageable, but it's not the kind of thing you do because you're bored.

Heidi and Isaac fly to North Carolina tomorrow. It's an all day affair, what with the plane changes, layovers, and what-not. Pray for them to have safe and easy travels, with a well behaved little boy and a complete lack of stories to tell. I have enough for both of us.

Mexican Progress?

2008-07-25T21:01:00.002-06:00

Just a quick update for tonight... and a plea for continued prayers for Matt and Martin as they drive the 4Runner up through Mexico. They had an adventurous day today... which is really not quite what you're hoping for when driving through two underdeveloped countries to get home! Many thanks to John Villanueva and his wife for getting a copy of his passport faxed expediently to Guatemala... long story.

Long story short though, they lost about 6 or 7 hours running around trying to get a lawyer here to do enough paperwork for them to appease some Mexican officials-- It is very frustrating to deal with Mexican officials, who abide by no rules and with whom we as American citizens truly have no rights. Now is not a time for a political rant about the treatment they demand for their citizens who are illegally in our country, but suffice it to say that driving through a place where you truly have NO rights is quite frustrating and scary. Feel free to take this opportunity to thank a Vet in your general vicinity for your rights and your freedom...

Anyway, we have not heard from Matt and Martin since around 1:30 this afternoon, so we are hoping and assuming that "no news is good news" and that they are well on their way through Mexico. It is difficult to call from there, so "no news is good news" was the agreement. As we said before, continuing prayers are appreciated.

On the Guatemalan front, Heidi and Isaac continue preparations for the trip north. Help from several members of the Savior's Sons team (from The Woodlands United Methodist Church) is, as always, greatly appreciated. A few of them stayed behind to help with Roy's addition on the house, but have also spent countless hours now on home improvement projects here as well as helping Isaac and Heidi get the house ready for their prolonged absence! God is truly The Great Provider, as He has proven yet again with His provisions for our move home.

Thank you all again and again for your prayers and support over the last two years. Please be aware that we all serve a truly awesome God! Blessings to all... and good night!

Last Day for Matt

2008-07-24T07:29:00.002-06:00

Today is Matt's last day in Guatemala.

Yesterday, we spent a good part of the day packing. Matt went to Martin's with the 4Runner to get new brakes put on the front and to adjust the ones on the back. We're hoping not to use them too much, as we'd like to make good time through Mexico, but since Martin said he couldn't make the horn any louder, we worked on the brakes.

David, Craig, and Juan are still here working on Roy's roof. And Roy and a few of the guys are coming over this morning to help some more.

Then tonight, the rest of the team comes in. It was a bit of a surprise visit, brought on by some other circumstances, but we're always happy to have them!

At 3:45am, Matt will roll out of bed and meet Martin at 4:00 to head towards the border. We're hoping to be there about the time it opens, cross in around an hour, then make it to Veracruz, Mexico to sleep.

With any luck, we won't run into too much hurricane devastation near Brownsville. We cross the border about 20 miles inland, so we're hoping for smooth sailing... Well, maybe a water analogy isn't what we're looking for here.

In all seriousness, we pray for all the people in that area. We know firsthand what it's like to deal with hurricanes and to come home to find your possessions soaked and destroyed. No fun. So while it may be a minor inconvenience for us, for some, it's all they have.

Also, with any luck, Matt will be in Houston in time to go to church at the Woodlands Methodist Church on Sunday. Then it'll be some errands in Houston, some studio time with Trip during the week, then rent a UHaul and head to North Carolina.

Heidi and Isaac will ride down to Guatemala City with Roy on Sunday and fly out Monday morning - to North Carolina. Her dad will meet them at the airport and they'll have a week at his house, then head to Atlantic Beach for a family week there. We're hoping Matt will arrive in time to ride down with them.

After a week on the beach, we fly to New Mexico to visit Michael, Michelle, and Luke - Matt's cousins.

Then Heidi and Isaac fly back to North Carolina and Matt flies to Detroit to supervise the packing of our stuff there. A moving van will take it all down to Winterville, North Carolina, where we'll be renting a house for a bit.

Around September 1st, Matt's parents will come down to hang out with us for a few weeks. On September 4th, Matt flies to Atlanta for a friend's wedding, from Atlanta to Houston to meet Don Allison, and then they drive back through Mexico to Guatemala.

Don and his family are moving to Canilla to work with the orphanage in San Andres and with the Fickers. Don's never been through Mexico and Matt will be a third timer by then.

After all that, it'll be time to try to settle into a new life. (Did we mention that Heidi starts work at East Carolina University on Sept 2?)

Heidi did her undergrad work at the University of North Carolina-Chapel Hill. She then worked for a year as a pharmacist at ECU, then went to medical school there. After four years in Houston and two in Guatemala, she's heading home to be on faculty at ECU.

God has provided a wonderful job for us in a beautiful town, much closer to family and friends and we are very thankful for it. While we will miss Guatemala every day, we will stay in touch - often through our quarterly visits here with Heidi's job. (It's nice to negotiate things like that, isn't it???)

This will probably be the last post for a little while, as we'll be scattered all over for a few days. Thanks to all of you for your readership, your interest, your support, and MOSTLY your prayers. This has been a life changing experience for us and we urge you to follow God's call for you in your life, too. It is ALWAYS better than anything you could come up with on your own!

Last Clinic in Guatemala

2008-07-21T22:09:00.002-06:00

Unless God has something completely unexpected up his sleeve, we did our last clinic in Guatemala (at least on this go-round) today. We were in our solo clinic in Chicabracan. The next time anyone is there will be on September 1 (thanks Katie!!!).

Two of our patients actually broke down and cried. Isaac cried, too, but for different reasons. It's a good thing, for him, that we're leaving at this point. He's pretty much "all done" with clinic.

Luckily, there weren't too many SICK (read: contagious) people there today, so Matt took Isaac outside for a little while and let him play with some of the patients. They love his blue eyes and his waving good-bye and his game where you tell him to say "mama" and he says "papa", then cracks up laughing. We can see that...

Meanwhile, Duane, Aaron, David, Craig, Joe, and Juan all came over to the house to work on the roof on the addition. It's nice to still be able to see them, and to be able to return a meal. We've eaten so many meals at their house that it's a privilege to serve them every now and then. David, Craig, Joe, and Juan are spending the night tonight and will be back to work in the morning. The goal is to have the house dried in by Friday so Roy and his guys can start running heater duct.

After lunch, we drove to Nueva Santa Catarina to meet with the Savior's Sons team, then to their hotel in Totonicapan for dinner. Thanks for dinner, guys!

After dinner, they prayed for us and for our trip back to the US (which they are helping to answer their own prayer by carting a bunch of our stuff back for us).

One very special member of that team is Dr. Street. It was SO nice to be able to see him and we got a really neat pic with him and Roy...

Tomorrow we'll be here at the house, helping the boys, and starting to pack some.

Last Weekend in Canilla

2008-07-20T17:23:00.004-06:00

Of course we mean that it was the previous weekend in Canilla, but, unfortunately, we also mean our final weekend with the Fickers in Canilla. Very sad.

It's been two years, which means we've spent somewhere around 100 weekends there. If you count extended visits (planned or otherwise) and the times we've spent together during the weeks, we've spent nearly half of our two years here with them. Certainly enough to really feel like family. So it's hard to leave.

We did get a minor adventure on the way out, though. It was mostly smooth sailing all the way through San Andres. The roads are a long way from good, but since there was less rain than usual during the week this past week, they were at least passable. After the 3/4 point, though, we came up on a line of cars that were not moving. A short inspection showed that a big truck was buried all the way up to the frame in mud on one side of the road and the people who were trying to get past it on the other side of the road were not having much success.

Matt parked and walked up to see if he could help. What he found was that all the way on the right hand side of the road, it was muddy but more or less solid. In the middle, it was over a foot deep of just slime. The problem was many-pronged.

First, there was a crowd of Mayans standing around - most of whom do not own cars and have no idea how to drive - who were offering advice.

Second, the pickups that were trying to get through were not four wheel drive. Guatemalans, for some reason, really hate running their trucks in 4x4 mode. They feel like they're wasting gas or something. Yes, we're paying about $5.50 a gallon here, but tires are expensive, too. And when you have to rev like crazy and smoke your tires to climb a rocky hill, you might have saved a dollar on the trip up to that point, but you just spent $10 by refusing to lock in. But we digress.

Third, again, mostly for fear of breaking something, most Guatemalans, when presented with a muddy patch of road, will inch into it as slowly as possible and as soon as they start to bog down, they shut the whole engine off. This leads to a lot of stuck Guatemalans.

Matt watched for a little while and helped shovel some loose dirt into the muck, but mostly observed while a few people tried to get through - all unsuccessfully - and had to be pulled out by a crowd of 30 or so people and ropes.

After one particularly pushy Latin guy cut in line in front of us (in a Nissan, 2 wheel drive, automatic) and remained stuck for about 40 minutes, all the while shouting instructions to the Mayans on how to pull him out, Matt offered a better suggestion.

Why doesn't everyone get out of our way, let us drive through (which we're pretty sure we can), then we'll help pull the rest of the cars through when they get stuck? So that's what we did. Turns out you just need 4-wheel drive, good tires, some technique, and some guts. Below are four videos Heidi shot while Matt was pulling cars through. Yes, the last one is a LandCruiser, which had no business being stuck, but apparently nuns aren't the gutsiest drivers in the world. Plus, if you look closely, you'll notice that they're not even in 4x4 mode!

Anyway, our trip to Canilla took about 3 1/2 hours, instead of the normal 2, but we got some good movies for our trouble!

Clinic was relatively routine. We got to meet John and Alex, a father and son from St. Louis who were down to help out. Also, our friend Adrienne was here for her yearly visit. Martin and Gloria surprised us by driving out to share lunch with us and to say good-bye (even though Matt and Martin will get plenty of quality time later this week as they drive through Mexico together).

We also got to go down to the river for our last sand volleyball games together. Driving through the river was less challenging than last week (it rained less this week). Last week, even on the big 4-wheeler, your butt got wet riding through... Yeah, pretty deep!

We had a really nice worship service last night (thanks, Craig and everyone else) and got up this morning for breakfast and more clinic.

Heidi had a pretty funny patient today - perhaps her funniest of our entire time here. A 40-something-year-old man came in complaining of a problem with his hip or rear. He pulled a wilted plant out of his man-purse and handed it to Heidi. Eventually, the story came out that he had used a plant like this, well... like toilet paper about a year ago. It gave him a wicked rash. He came to clinic, we gave him some cream, and it went away. Just last week, the rash "came back". Knowing how much Heidi likes patients like this (there's a reason she's a gynecologist), she asked Katie to help her with the physical exam - after discarding the plant and washing her hands VERY thoroughly!

The end is a little anti-climactic. It probably wasn't another plant rash - maybe just some dry skin or something - but how great is it to HAND your doctor the plant that gave you some butt-rash last year? Leslie picked a bad time a few minutes later to ask Heidi if she was sure she wanted to leave...

Anyway, tomorrow is our last clinic here in Guatemala (as far as we know). We'll be out in Chicabracan. Then we'll drive to Totonicapan to have dinner with the Savior's Sons group. They were here at the house last night and we missed them (we were busy playing volleyball - all work and no play.... you know)

So please enjoy our videos and pictures... Oh, one picture that probably deserves explanation. You'll guess which one. That thing is part of one of Heidi's favorite trajes (traditional dress for women). The girls went to market in that village and bought one for Heidi as a going away present...

P.S. Okay, the videos embedded, but in low-quality. If you want to see the higher quality videos, go to youtube.com and search for "Pulling out trucks in guatemala" or something like that...

Busy Week

2008-07-18T10:16:00.004-06:00

WOW! Is it possible that Matt drives out a week from today??? Time is flying. And we still have so much to do...

David, Craig, and Juan came over on Monday to start the welding work for the ceiling and roof on the addition. They stayed and worked here for four straight days. The ceiling joists are completely done on Roy's side and the roof joists are about half done on that side. A few more days ought to finish it. See pics 1&2...

We had clinic in Chujuyub on Monday morning. Our friend there with the key was over an hour late showing up. We had a ton of stuff to do back in Quiche in the afternoon, the roads were horrible (we barely made it to clinic - lots of trucks, even 4x4s, were turning around and going back or getting stuck) and it was raining like crazy, making us wonder if we could even get home. So we set up outside the building and started doing clinic out there. See pic 3.

Somehow, the roads managed to IMPROVE with all the rain. We actually had less trouble getting home than we did getting to clinic. Go figure.

Tuesday, we had the wonderful privelege of visiting Vina Studios in Solola. John Henderer, one of the guys working there, had called Matt a few months ago and we started talking about trying to get together. Unfortunately, between our schedules, we didn't get a chance until this week. They are doing some absolutely awesome work over there. One of their main projects is a series of videos mostly done with finger puppets called Deditos (little fingers) portraying various Bible stories. The idea is to produce audio tracks in various Mayan languages. Most people around here can't read, so getting the word of God into their hands is a little tricky.

Lots of people are working on translating the Bible into Mayan languages, but if the target audience is illiterate, the next step is to get these translations recorded and distributed. Vina is doing that work.

Please check out John's blog at http://www.sololagracia.com/ He put a really nice write up in there about us this week.

Also check out Vina's website at http://vinyastudios.org

See pic 4 for a shot of Heidi doing some voice work for one of the videos (they're being produced in English, too, for promotional purposes in the US).

Yesterday was Heidi's last day at ASELSI. They had a really nice going away party for us and had some very kind words and generous gifts. We are really going to miss all those folks. We're looking forward to visiting as often as possible, but it's never going to be the same as living here...

In the "closure" department, one of the workers at ASELSI asked us to come to his house a year and half or so ago to check out his wife. He was pretty upset and was relatively sure she was in the process of miscarrying. So we drove out into the middle of nowhere with our ultrasound machine to check her out. The drive included about a 20 yard section where we were squeezing between a house and a fence so closely that we were touching on both sides... then there was nowhere to turn around, so we had to BACK out the same way!!!

Anyway, when we got to their house, we unfortunately confirmed his fears, that she had miscarried. We prayed with them and assured them that there was nothing that they had done to cause this - it just happens sometimes.

Well, shortly after, they conceived again and yesterday Mom came in with her new baby!!! (Their other daughter's name is Heidi, so that made an even better connection!) See pic 5 for a shot of the happy family (minus Dad, who was working...)

Today, Heidi is at the Hospital Buen Samaritano for her last clinic there. We'll clean and prepare for the arrival of the Savior's Sons team tomorrow. We won't be here - we have clinic in Canilla - but since Dr. Street is on the team and he built the house, we figure they've pretty much got it under control. Also, this team is the team that was coming in to Quiche the day that Isaac came home from the hospital. They got to meet him when he was only 3 days old.

So we're planning on driving over to Totonicapan, where they're staying, maybe on Monday afternoon to have dinner with them and share a little bit. They helped us get many of our personal possessions down here two years ago and they're helping us get some of them back home again... What would we do without those guys???

Well, we hope to have some pics from this weekend. It'll be our last time in Canilla, which should prove to be pretty difficult. We've grown so attached to the Fickers during our time here that they're pretty much family to us. Well, the less we think about it right now the better....

Also, Roy and his grandson Cameron have been here for the last two weeks and they're heading down to Guatemala City tomorrow morning to pick up the Savior's Sons team. We're doing a fair amount of turnover with Roy as far as handing over the managing of the construction of his house...

Weekend Notes

2008-07-13T20:14:00.002-06:00

Saturday morning, all of us piled into two trucks and headed to Canilla.

All of us, you ask? Yes, the three Leathermans, the three Bells, Roy, and his grandson, Cameron. The roads were, well, pretty bad. Luckily, both trucks are Toyota 4x4s with good mud tires on them. And we needed them.

Anyway, clinic was relatively routine, then we had lunch and the Leathermans flew down to Guatemala City to meet back up with John Hull and the team. Then the rest of us went down to the river to play volleyball. The river we have to cross was about the highest we've seen it in quite a while. We sure could have shot a Honda commercial - the ATVs and dirt bikes all forded about a 3 foot river without any problems. Pics 1-3 are of the game...

This morning, Roy and Cameron drove to Quiche, picked up Jacob, then went to the jobsite in Nueva Santa Catarina. Things there are not going exactly as planned, but with a little direction and a whole lot of prayer, things will turn out okay.

In San Andres, Heidi had a pretty interesting day. Remember about a year and a half ago when we tried our best to rescue a malnourished little baby but got turned around by a raging river we couldn't go through? The next day, the mom and baby got to the hospital by chicken bus and the hospital tried to save the baby but couldn't.

Anyway, the mom showed up in clinic today. She wasn't too big the last time we saw her. One of the reasons the baby was so malnourished was because Mom was half-starving herself - somewhere around 80 lbs. Today she was closer to 60 lbs. And based on her symptoms and the results of our HIV test, she's got full-blown AIDS. Her mother had come with her and explained that her husband runs around on her alot with women in Guatemala City.

Rosa (the patient) is a Christian. Her soul we are not all worried about. Her husband, on the other hand, grew up in the church but fell in with a bad crowd and got himself kicked out of the church. We prayed for him after diagnosing Rosa with AIDS and in less than an hour, he showed up outside clinic. After the unsurprising results of his own test came back, we explained his situation to him and that he is deadly contagious. We also explained that he's probably going to meet his maker sooner rather than later and that this would be an excellent time to get back into the church (around the time their baby died, he told us he was thinking about coming back).

Anyway, please pray for Rosa and her husband. For her that she stay strong in her faith and have a relatively easy go of it. For him that he find his way back home before it's too late.

Tomorrow is clinic in Chujuyub. Our last one there. Again, very mixed emotions...

Tuesday, Matt and Roy will go to Guatemala City to do some shopping. Wednesday, we probably have a quick trip to Solola to meet with a missionary there who is doing some fantastic work - we'll write more about it then.

Feliz Cumpleanos Isaacito

2008-07-11T10:26:00.002-06:00

Today is Isaac's first birthday. In some ways, it's hard to believe that it's already been a year. In other ways, it's hard to believe it's ONLY been a year.

Anyway, the same team that was here to send us to the hospital last year was here to celebrate Isaac's birthday. Gencha, our caterer, came over and decorated the tables and chairs. She also had two beautiful tres leches cakes made - one with his picture on it.

We had a pinata, too.

The team left this morning for Antigua. Russell, Bethany, and Tye are still here to spend another day with us - then they'll go to Canilla with us tomorrow and fly to Guatemala City with Duane.

Also arriving today was Roy and his grandson Cameron. So we went from a full house to a medium-full house. But it's a whole lot quieter with five guests instead of twenty. It has been a real pleasure to have the team here and we hope that maybe we'll be here next year operating the same week they're here again...

Anyway, here are some self-explanatory pics...

Woodlands Team/Surgery

2008-07-09T21:51:00.002-06:00

Today was Day 3 of the Woodlands Methodist Team. They're helping with construction work at the school in San Pedro in the mornings, then doing Vacation Bible School in the afternoons. For the second straight day, they had 188 kids - way more than they anticipated. So that's a great thing!

Also today, Heidi had two surgeries at the Hospital Buen Samaritano. Katie Ficker came in to help out with those and Russell Leatherman's dad, Gary, went down to watch. One was just a small vaginal repair and the other was the removal of a fairly good sized mass in the abdomen of a woman that the team knows. She is the mother of a couple of students they're sponsoring at the Utatlan School and she has also been taken in by Pastor Eliseo.

We were very happy to get the call from Heidi that her mass was safely out and that it did not appear cancerous - just a simple fibroid tumor in her uterus.

Tomorrow Heidi is at ASELSI. Matt will do some more work on the recording project (he was very glad to have Russell's help this week - Russ is a guitar and bass player.)

The first two pics are of Heidi with Katie and Gary. The next one is of Tye and his mom, Bethany Leatherman. And the last one is Isaac sharing his thoughts on the whole thing...

Monday with the Team

2008-07-07T21:33:00.002-06:00

It has truly been enjoyable having this team here. The teams from the Woodlands Methodist church are always so fun. They pretty much take care of themselves and we have such a great time hanging out with them.

This morning, we had our clinic in Chicabracan. We may have mentioned before that Isaac is pretty much "over" the whole clinic experience. So Matt and Bethany stayed home with Isaac and Tye while Heidi and Russell went to clinic. Matt got the builders re-started on the addition (after the weekend) and then got Isaac down for his nap. Then Bethany was nice enough to stay with both of the boys while Matt went to relieve Russell in clinic.

Bethany, Russell, Tye, and Isaac then spent the rest of the morning together while Matt and Heidi finished clinic. We saw about 40 patients and got home just before 2pm so the Leathermans could go up to the school in San Pedro and do Vacation Bible School with over 100 kids.

This evening, after dinner, we helped blow up around 300 balloons for an activity the kids will do tomorrow. Then the team reflected on the day, we shot the breeze for a while, and now, around 9:30 local time, pretty much everyone is in bed.

The pics are pretty self explanatory. The first two are from clinic and the last three are from the dorm tonight...

Wild Weekend

2008-07-06T20:28:00.002-06:00

We picked up our friends Sherwood and Areli at the airport on Wednesday and drove back up the mountain to get home.

Thursday we went to ASELSI. It wasn't our day to do clinic there, but it was a chance for us to visit and hang out with a team a little bit without having to see a whole room full of patients. Plus, there's always the market in Chichi.

Friday, Russell, Bethany, and Tye came in with a truckload of groceries for the team.

Friday night we drove over some pretty bad roads to get to Canilla. We hadn't been there too long when one of the Fickers' worker's wife came in pregnant, in labor, and pushing. Sherwood actually did the delivery and Areli got to watch him in action for the first time.

Then we got a call that a chicken bus was stuck on the road between Canilla and San Andres. So we took a tractor out there and spent almost four hours digging and pulling and finally got it out. After having been under a chicken bus and seeing how they're... um... maintained - my advice is to walk.

Saturday morning, Sherwood and Areli flew back to Guatemala City, the girls did clinic, the guys pulled another chicken bus out (lots of rain = lots of mud = lots of stuck people), and Duane dealt with some airplane paperwork issues in Guatemala City.

Saturday night, we had worship in Canilla (thanks, Craig) and the Woodlands Methodist Church team arrived at the dorm.

Sunday was clinic for the girls. Luckily, Craig drove them to clinic because somewhere in the slippery, muddy, rocky roads, they slid sideways into a big rock and ripped a sidewall out of a tire. Craig basically laid in a river of mud to change the tire. Fun, huh?

Tomorrow is our clinic in Chicabracan. Luckily, Russell is going to go to clinic with Heidi, so Matt and Bethany can stay home with Isaac and Tye. Isaac is getting to the age where he wants to be out and about, so being penned up in a pack-n-play for 4-6 hours during clinic isn't his idea of a good time.

Anyway, tons going on tonight (hence the terse entry) and we hope to have more time to write later...

Guatemala City

2008-07-02T08:36:00.003-06:00

Monday was our last clinic in Nueva Santa Catarina. It was a little weird to know that we're not going back. Well, Matt will probably go back to help with the construction work, but no more clinic there.

We've given all of our chronic patients enough meds to last until the end of September, at which point we hope to have someone to go out again and see them. We're working on that.

The "shortcut" road there, which runs through Totonicapan, was absolutely brutal. Yes, the Toyota is practically indestructible, but WE'RE not! After about 30 minutes on the road, we decided to take the long way around on the way back, construction delays or not. Knowing that this could add hours to an already long day did not matter. You can only get beat up for so long!

We left home at 6am, arriving in Nueva Santa Catarina just before 8am. There were about two patients there. So we spent a little time loading in and talking about the construction project. Patients began to trickle in. We don't control the numbers there, so we have no idea how many patients we saw, but we left around noon.

Usually, when we have an extraordinarily long day ahead and we know that it would be helpful to be out of clinic by a certain time, it lasts about three hours longer than that. So we had hoped to be out by noon, but knew in our hearts it would be more like 3pm. So noon was pretty exciting!

We took the long way home, driving all the way down to Los Encuentros, then up through Chichi. But miracle of miracles, there were NO construction delays and it took us just over 2 hours to make the trip - only about 20-30 minutes more than the "shortcut" and not nearly as abusive. Oh well.

At this point, Isaac had spent four hours in the car and four hours in his pack-n-play. His ideal is zero for each one. Yet, he was being pretty tolerant. Good thing, too, because we had another four hours in the car to go!

We drove two vehicles down to Guatemala City, in order to leave one for Russell, Bethany, and Tye, who fly in on Thursday. The downside of this is that with Heidi in the Toyota with Isaac, she had no help with him and had to just keep handing animal crackers, toys, and sippy cups back to him for four entire hours!

In the continuing saga of fighting mechanical problems, the Mazda has developed a seal leak where the drive shaft connects to the rear differential. We stopped in Los Encuentros to see if a mechanic there could check our rear differential and fill it, if necessary (the nut was on there too tightly to get it off with the tools we had). 20 minutes, Q20 for labor and Q20 for oil later (about $5 total), we were on our way with a full differential. Guess we'll call our go-to-guy, Martin, when we get home.

Yesterday was full of doctors' appointments and lab tests (all routine stuff, no worries) and getting copies of all of our medical records from here in Guatemala. Then we went to Dr. Hoak's house in San Cristobal for dinner. We are really going to miss them!!!

Today we'll run up to the Hospital San Juan de Dios to try to find Ramiro, our little spina bifida baby, and get his parents a little more walking around town money. They've been here three weeks now on less than $100.

Then we'll go pick up some friends from the airport and head back up the mountain.

The pic below is of the first stage of the construction at Nueva Santa Catarina. Many thanks to Roy Simmons and the Savior's Sons group for funding this project!

Almost a week already?

2008-06-29T16:58:00.002-06:00

Holy cow! It's already been nearly a week since our last post. Sorry about that. We have perfectly good excuses, though. Like we said last time, it's amazing how fast time is flying right now and how many things we still have to do before we go.

Since we last posted, Matt drove out to Nueva Santa Catarina to help the builders get started on digging the foundation for a new church there. Our regular readers know how badly they are in need of a new church. Roy Simmons and his group, Savior's Sons, are helping with money, materials, time and labor. They're paying for the foundation to be dug and poured (hopefully before they come down in a few weeks) and will start laying block when they get here at that time. We just needed a bit of a North American perspective on exactly where everything should be placed.

Later that same afternoon, Heidi went down to the hospital to do a follow-up clinic for all of the surgical patients that the Women's Team operated on a few weeks ago. All but one were doing extremely well and that one just needed a wee bit of extra attention and now she's doing extremely well. All of the surgeries seem to have been successful, there were just a few routine post-op issues. No big deal. Everyone was very thankful for their surgeries and Heidi even ended up with a couple of gifts from grateful patients.

The next day (Wednesday), Matt went down to the church he's been recording at and spent 8 1/2 solid hours behind the console. No break for lunch or anything - which is a pretty big deal if you know Matt! But at the end of it all, we thought we had everything we needed on tape to finish the project. We knew that Matt was going to have to record a few things himself (and the list has grown a bit on review), but for the most part, recording was done. On further review, though, it appears that we may need one more day of lead vocal work. Pretty routine stuff - the lead vocal is the most important track and the one we're the pickiest about - so nothing unexpected from Matt's end, but the singer may be a bit surprised! As soon as we have an open day, we'll try to arrange that.

Thursday, Heidi was in clinic at ASESLI and Matt was with the builders here at the house. Isaac was, of course, assisting Matt. Mostly waving to the workers while Matt was talking. ASELSI has a new Physician's Assistant named Cathy. She and Heidi have been working together the last few weeks with Heidi teaching some prenatal care items, especially ultrasound techniques, which Cathy is doing a great job of picking up. Also, our translator, Cecy, is still in nursing school and doing great!

Friday was Heidi's OB/GYN clinic at the Hospital Buen Samaritano. She's scheduling a few more patients for surgery, hopefully in about a week and a half.

Saturday was our clinic in Canilla with Leslie and Katie. This week's clinic was a little weird. They basically thought they were done at 11am or so. That's weird because they don't usually finish until 1 or 2pm. But they looked outside and there were no more patients. So they came in to get started making lunch. Naturally, a dozen or so more patients came straggling in later, but it's weird to think you're done so early!

Today was clinic in San Andres. Heidi's first patient was a woman she's been witnessing to for a few months now. The woman attends a Catholic church here but has not accepted Christ. She has been saying that she wants to but that her daughter doesn't want her to. On the health side, she has a heart condition that we really can't treat but she doesn't really have access to anyone who can (the closest cardiologist is in Guatemala City and she can't even afford the trip, let alone the treatment. Plus, even if we paid for everything, she almost certainly wouldn't go.) So the best thing we can do for her is get her prepared for her meeting with her creator.

Our translators' dad is a wonderful evangelist (and K'iche speaker) and he has been very diligent and patient in working with this woman - praying with her and reading her scriptures - but she is still reluctant to commit. All we can do is keep praying for her and with her and hope that God changes her heart - both literally and figuratively!

Heidi's second patient was a prenatal patient about four or five months along who said that she stopped feeling her baby move a little while back. Unfortunately, there's a good reason for that. So some counseling was in order for her.

It can make for a very long day when you have nearly 100 patients to see and the first two are very time consuming, but that's the biz, as they say.

Also, today, a woman brought her baby in with a very severe case of spina bifida. Given the extremely poor level of care here in Guatemala for babies with spina bifida, there is quite a bit of internal debate about what to even do for her. Leslie has had experiences with spina bifida babies here who have been operated on, just to fight and eventually succumb to infection (the baby's behind is pretty close to a wide open spinal column - get it?)

Meanwhile, Isaac found out what it's like to be an 11-month-old missionary. Sometimes the job of serving others is less than glamorous. We had to make a run from Canilla to Chichicastenango (about two hours, about half of it off road - always fun during the rainy season), then another 30 minutes to Quiche, grab a quick bite to eat, then an hour and half, also off road, out to San Andres to get Mommy from clinic, then an hour and a half home. So Isaac spent 5 1/2 hours in his carseat today. He fussed for about 10 minutes, total, during that whole time. What a little trooper!!!

Anyway, in one town we came into, we were intending to make a shortcut that would trip about 30 minutes off our trip. We bumped into Geronimo, one of Martin's helpers, who moonlights as a Tuk-tuk driver (three-wheeled taxi). Geronimo asked where we were headed. We told him and he got this concerned look on his face. He said that the road ahead was pretty bad. We've driven on worse, and we've got this awesome Toyota that's one of the best off-road vehicles in the country. He said, yeah, the road's bad that way, too, but what he was more concerned about were the number of people he'd talked to so far in the day who had been robbed on that road. It was market day in Chiche and there was a band of robbers just hanging out on that road (which is pretty narrow with cliffs on either side - nowhere to run) waiting for people with money to come through.

So we skipped the shortcut on Geronimo's advice, probably missing out on an opportunity for a cool story and a great blog entry. But sometimes the point of life is to miss out on good stories. So instead of an exciting testimony of how we fended off a band of machete wielding robbers using only a Pooh-bear and a can of Diet Pepsi, you're stuck with what you just read. Sorry.

Tomorrow we drive two hours off-road back out to Nueva Santa Catarina, hold what's sure to be a VERY long clinic (the last time we were there the weather was so bad we only had a handful of patients), then drive two hours home, unpack, repack, then drive two trucks to Guatemala City. We have a few doctors' appointments on Tuesday, we need to visit Dr. Hoak, we need to visit a patient in the hospital in Guatemala City, we have some shopping to do, and then we'll pick up a friend from the airport on Wednesday. We'll leave the Mazda in airport parking for Russell, Bethany, and Tye, who are coming in on Thursday to prepare for the team from The Woodlands United Methodist Church, which arrives on Saturday.

Two pics. One of the road we drove on today. Another of Isaac being cute.

Tick-Tock

2008-06-23T20:23:00.002-06:00

Our time here is really winding down and we're starting to feel that. Today was our bi-weekly clinic in Chicabracan. We will only be at this clinic two more times before we leave. Because we have not identified our replacements yet, we are going to be referring our chronic patients to a nearby village where our friends at Health Talents have a clinic. You can read more about their adventures at their blog, which is linked on the right hand side of this page under "The Dunhams".

Replacements not identified, you ask? Yes, we thought we had worked all that out, but a last minute change of plans left us looking again. We are in the process of working with some folks to make that happen and we ask for lots of prayers for guidance, wisdom, and clarity - not just for us but for everyone involved.

So clinic this morning was a combination gynecology, obstetrics, pediatrics, and dermatology test. Luckily, Heidi's pretty well trained for the first two. The other two we've learned a lot about since we've been here, but we still ask for help every now and then.

We have an American dermatologist we consult with by email and will be sending some pics that way very shortly. See the first two here for a preview of that.

Also, it seems like Isaac wasn't the only kid in this area to have had diarrhea in the last week. So we treated a bunch of that. Isaac's seems to have passed (no pun intended) so he's in a little better mood now. We can only hope that all the other kids have similar luck.

And there were the standard pre-natal patients and several with some questions about their periods. Women here tend not to know terribly much about periods for a couple of reasons. One is that there are a lot of cultural misconceptions about periods that are pretty persistent. There is the belief that if you do not have your period for a few months and you're not pregnant, it'll start coming out of your nose.

Another reason women don't know too much about periods is that they don't have many in their lives compared to American women. It's usually not too long after a girls starts getting her period that she gets married and pregnant. Then, after giving birth, women usually breastfeed for two years, thus suppressing more periods. Shortly after they start up again, there's another baby on the way. This more or less continues through their reproductive lives until a fairly early menopause - again, at least by American standards.

So we get a lot of questions. Again, Heidi's pretty well qualified to answer these and Matt's becoming a lot more knowledgeable about this stuff than he ever wanted to be - at least in Spanish. Who knows what he knows about this stuff in English?!

The third pic is of a really cute kid we just happened to take a picture of. Hard to resist, huh?

This afternoon we played with Isaac a lot (since he was more or less ignored during clinic this morning - thank God for Baby Einstein DVDs and laptop computers) and answered a bunch of emails. Oh, and Matt spent some more time with the builders on the expansion project.

Matt is already planning a short return trip to Guatemala in September to help another missionary family get set-up here. Read about THEIR adventures here:
http://www.allisonfamilyinguat.blogspot.com

Tomorrow, Matt will make an early morning run to Nueva Santa Catarina to supervise the initial digging on the foundation for the new church there. Roy's group, Savior's Sons, is planning to start laying block for the walls when they come down in less than a month. So we've got a lot of work to do before then! Matt will try to make sure we're at least digging in the right spot.

Tomorrow afternoon, Heidi has a clinic in the hospital here next door. This is pretty unusual, since we don't work there, but it's a follow-up clinic for the patients the Women's Team operated on a few weeks ago. Most of the patients went home with catheters, so we hope that those are all cleared up now.

Wednesday morning, Matt will be recording with the church group near Los Encuentros. Thursday is ASELSI and Friday is Heidi's OB/GYN clinic in Chichi. Then it's back out to Canilla again.

Saturday Clinic

2008-06-21T13:32:00.002-06:00

Friday was relatively routine (in the jungle). Today was a little less so.

Remember the friend who was robbed at gunpoint in her house a few weeks ago? Well, her male help needed to leave for a week or so and she is going to be there "alone" with another girl and 11 kids.

So David and Craig hopped on their motorcycles and rode down there this morning to help out for a few days.

Also, the plane is out of commission for a week or so now. It's time for the annual inspection and Aaron is tearing it apart for that. It's weird - we don't have any flights scheduled - but it feels a little unusual to know in the back of your mind that that option is not available.

In clinic today, we had a pretty sick and dehydrated woman come in who needed an IV. Katie's the best stick we have and even she took two tries to find a vein she could use. After a liter or so of fluids, the patient hopped up and headed home. The stuff works, apparently.

Shortly after that, a woman came in in labor. A little while later, Heidi, Katie, Felicia, and Leslie delivered a healthy baby boy. 5lbs 15oz. (Picture 1 is Mom and Baby).

Isaac is not only getting a new top tooth, but he's also suffering from a bout with diarrhea and his poor little butt is paying the price. Diaper changes are accompanied by lots of crying now. It LOOKS like it hurts! He's being a good little trooper, though. He's a lot cuddlier than usual but is more or less in decent spirits. He even felt good enough to pose for Daddy on the hood of the Mack dump truck. (Picture 2)

Zona Reyna Clinic

2008-06-20T19:15:00.002-06:00

Last night we drove out to Canilla to spend the night and be ready for a possible early flight to Zona Reyna. This is the same village we've been to a few times before - there is no road that goes there, so it's a Cessna flight into a runway only about 8 feet wider than the airplane.

There is only one little spot in the village where anyone can get phone reception and since it's in a completely different climate (though it's only about 20 miles away by air) we have no idea what the weather is doing there until someone walks to the top of a hill and calls us.

Well, at 6am the phone rang and they said the sky was open. So two flights later, clinic was in full swing. Leslie, Katie, Heidi, Craig, Felicia, and, of course, Duane (the pilot) spent the day there seeing a few hundred patients.

We're still struggling to evangelize there - there basically are no Christians in this village - and since we don't speak K'ekchi, we depend on translators who aren't Christians, either. We keep praying for a breakthrough - which hasn't happened yet - but God hasn't given up on us so we won't give up on these people.

The skies here in Canilla were starting to look pretty dark and we have no way to contact the group in Zona Reyna to tell them this, so we were a little nervous that they were going to have to spend the night out there. Then, almost out of nowhere, the plane appeared with the first load. Duane went back for Craig and Leslie and the skies here in Canilla started closing fast. They made it back in with minutes to spare. God is good!

Anyway, we're all safe back on the ground here in Canilla. Don't worry, though, if anything had gone wrong, we'd have sent Isaac out to take care of things. He's been working out...

No News is Good News...

2008-06-19T15:53:00.002-06:00

There's not much new to report today except on the construction front, but we wanted to touch base since we will gone for the weekend. David Ficker, Craig, and Juan came in yesterday from Canilla and have been working hard with Matt on the construction project. They had some electrical wiring to finish up and are now working on getting the gate installed.

Otherwise, the last two days have been spent planning and working on some administrative things. Heidi and Isaac have a one-way ticket back to the U.S. now booked, which is very bittersweet. It made us realize in a more tangible way that we really are "short-timers" down here now. There's a lot of loose ends to tie up for patients before we leave, so we've been working hard on that. Please continue to pray for our replacement to be found soon!

Today Heidi had clinic at ASELSI, which went very smoothly. It was the first time in a long time that we've gotten in and out of ASELSI without seeing at least one patient who required a lot of time and follow-up (Think new cleft palates, new hydrocephalus, six-year olds who aren't talking yet, etc...) We did have one lady who we referred to the hospital today with classic symptoms of appendicitis, though. Please pray that she does well and is taken good care of.

Sorry no pictures from clinic today-- saw lots of very cute kids, but unfortunately we forgot the camera! So the first one is of the boys working on putting the gate up. You can see that things are getting greener here with the start of the rainy season. The next one is of Isaac supervising the work... It's a tough job, but somebody's got to do it, right? The last one Craig and Juan have yet to come up with a plausible explanation for...

Monday Clinic in Chujuyub

2008-06-18T07:41:00.002-06:00

Yes, today is Wednesday and we're just getting around to blogging about Monday. Maybe we've been in Central America too long...

Anyway, Monday was our monthly clinic in our friend Regina's village of Chujuyub. We told them to give out 30 numbers, so we ended up seeing between 35 and 40 patients.

As usual, many were non-specific pain complaints, headaches, gastritis, etc. In the US, these people wouldn't go to a doctor, they'd go to a Walgreens. Those aren't too plentiful here, though, so they come to us.

We did see a man who broke his leg a year ago and is still walking around with about six pins and a rod sticking out of it. He seems to be doing all the right things as far as getting to his doctor's appointments. We gave him some medicine for pain and some confirmation that he's doing everything he can do. It's just that people who aren't as nourished as they should be don't heal that fast.

We saw a young man who told us that he works at a computer all day and by the end of the day his eyes get dry and itchy. He says it happens when he watches TV a lot, too. (Not your typical Indian patient, huh?) We gave him some eye wetting drops and the advice to take some eye breaks every now and then to make sure he's blinking. (Matt informed him that back when he used to play a lot of video games, sometimes his eyes would dry out because he was focusing so hard he wouldn't blink!)

We also saw two cleft lip patients. Both of these are patients Regina brought to us. One we've been following for some time now. His name is Tomas. He's the one who we give milk to, but also gave Mom a breast pump. She says she's breast feeding the baby as best as she can, plus pumping about 4 ounces each time and giving that in a bottle. Plus, they're using the formula we give them to supplement. We're willing to bet that they aren't purchasing any and the baby is still growing. He should be plenty big enough for his surgery in January. (Picture 1).

The other one is named Angelica. We actually saw her at our house a while back but they haven't been back to see us since. It looks like they should have. She is a year and a half old and only weighs 14 lbs. For comparison, Isaac is 11 months and weighs 23 lbs. They don't live too far from San Andres, so we're referring them into Leslie's nutrition program in San Andres. It's a lot easier for them to make that trip than into Chichi. Regina offered to come with them so she could know where the clinic is in San Andres, too. (Picture 2).

Just in case you were feeling good about yourself today, here's a little more of Regina's story. Many of you know that she is a widowed mother of seven. She was pregnant with her seventh child when her husband was killed in an accident. (There's no insurance or social security here, so she's basically on her own.) Her baby was born with a pretty severe cleft lip - as were three of her previous six kids.

Regina didn't really speak Spanish at the time, doesn't have a job or a skill to make money, and basically has very little to fall back on. She knocked on our door one Friday afternoon and said that she heard there was a team here who could fix her little girl's face. Unfortunately, there wasn't, but we promised to help her. That's when we started finding out about cleft palate kids and what resources there are here to help them.

In partnership with ASELSI, we got Carolina her surgery, along with her brother Otto. Regina has learned how to speak Spanish and navigate the transportation system here - from Chicken Buses to hitchhiking in the back of pick-up trucks passing by, she can get anywhere.

Since she learned about us and what we can do to help people, she has brought us nearly a dozen cleft kids, maybe two spina bifida babies, a baby who was becoming malnourished because her mother had the worst case of mastitis we've ever seen, and a couple other pretty hard luck stories. All of this is done of her own initiative and willingness to help families in her village. Often, the travel is done on her own dime. (We almost always give her some money to help with her "pasaje", but she had to come up with it on her own to begin with.)

Nearly a year after we met, we found out that her oldest son also had a cleft lip and palate. His lip was repaired but his palate wasn't. He speaks with a severe impediment. We've been working to try to find some help for him, too. The speech therapy place here in Quiche basically said that he needs a plastic insert for his palate before therapy will do him any good.

Anyway, with nearly NOTHING to work with, this woman has become a lifeline for so many people in her area. And with us leaving at the end of next month, we're working to get her tied in to the other missions that we partner with so that she can continue to help people. She also has the number of our funding group in Houston so she can call them if she needs more assistance than what she's getting here.

Okay, the other pictures. The third pic is of Heidi handing some medicine to a patient in clinic. You can see her bins sitting next to her on the floor. When we do clinic, we put four of those trunks in the 4Runner, along with our ultrasound and Isaac's playpen.

And the last pic is of Isaac in the back of the 4Runner, shouting at a stray dog that's walking by. He loves animals! Just behind the truck is the local school. During recess, all the girls come out, press their faces against the fence, and ooh and aah at the little gringito. Isaac just hates all that attention, you know...

Today, David, Craig, and Juanito are coming over to do some more work on the addition. They'll probably spend the night and work tomorrow, too. Then Thursday night, we all head to Canilla for a Friday morning flight into Zona Reina for another day of clinic there. Saturday and Sunday will be business as usual in Canilla and San Andres. Monday we'll be back in Chicabracan where we'll probably be flooded because we only saw patients with chronic care cards last time (the team was here and Heidi wanted to be around to help them).

Weekend Stuff

2008-06-15T18:24:00.002-06:00

The Women's Team finished up their last two surgeries on Thursday morning while Heidi was at ASELSI and they left mid-afternoon on Thursday.

It's always a dramatic contrast from a house full of 20 people to just the three of us. Luckily, John and the team did a great job of cleaning before they left, so we just had a few little things to do to finish up.

Also, since the boys' workday got cut short on Wednesday due to a wicked hail storm, Matt had a few things to finish up on the electrical system in the addition so the workers could continue raising walls.

Friday was Heidi's OB/GYN clinic at the Hospital Buen Samaritano, plus a visit to the National Hospital here to check on the team's patients. Then our friend Virginia (from ASELSI) came up to spend the night so we could head to Canilla in the morning.

Saturday and Sunday were our clinics in Canilla and San Andres. They were more or less routine.

Thursday, before the team left, our friend Regina brought two-year-old by the house. This is a boy we've seen before. He's a pre-op spina bifida patient from her village. We told the parents to really watch the bag on his back that contains the tail end of his spinal cord. We told them that if it starts to leak or anything, they are to put down whatever they're doing and RUSH to the emergency room.

They called us last week to tell us that the baby's bag had started to leak a few days before and they wanted to know what to do. We begged them to come to the hospital that very minute. Two days later, they came. The docs at the hospital here saw him and referred him to Guatemala City. We gave them some money and some advice on how to get to the hospital there.

We did hear from them (indirectly - through Regina) and heard that they are in Guatemala City, the baby has been admitted to the hospital, and that Dad is trying to figure out how to navigate the system (to get permission to visit his son - hospitals here are very different from hospitals in the US) but the important thing is that the baby is in a hospital.

In other news, Isaac's Great-grandma Arquette turns 90 this coming week. So he painted her a picture we'll scan and email north. Here are some pics of that... uh... adventure.

Women's Team Day 3

2008-06-11T17:15:00.003-06:00

Today was the third day for the Women's Team from Houston. They had three more cases today. There were four scheduled, but due to a freak hail storm and the resulting power outage(s), the last one got scratched.

Tomorrow morning, they'll try to pick up the last case or two and get ready to leave.

Also, today, the Fickers flew in to do rough electrical work on the addition. Duane dropped the boys off and then had several more errands to run with the plane. Thanks to Martin, the Ford is now functional again and the plan was to drive it back to Canilla tonight with the trailer behind it (with the rest of the stuff that just came down from the US). As the boys were leaving, though, they blew a trailer tire and didn't have a spare. So, hopefully, a local tire guy will be able to help out.

Below are some pics - one of John in the kitchen, looking quite chipper for 6am. Another is of Dr. Chavez and Dr. Mata. Then there is a shot of the air hockey tournament. And, for fun, a shot of what our courtyard looked like after the hail storm. See, we weren't kidding!

Women's Team Pics - Day 1

2008-06-09T22:00:00.002-06:00

Clinic this morning, then two pretty difficult cases this afternoon and evening. Several more scheduled for tomorrow...

Women's Team!

2008-06-09T13:03:00.003-06:00

The team from Women's Hospital in Houston came in last night. All of their stuff made it okay, which is nice. We had some time when they first got here to get organized for the week, have a nice dinner (thank you, Gencha), and get some sleep.

This morning, Heidi and Malachi went to clinic, Matt and Isaac worked with Martin to fix the broken torsion bar on the 4Runner ($25 and about 30 minutes - not a tough repair), and the team started on clinic in the hospital.

Thanks to the advertising the hospital did and the contacts we made through Ceritas, they had plenty of patients. In fact, we're already scheduled into Wednesday. With any luck, we'll fill up the rest of the week's surgical schedule tomorrow morning with some late comers.

We hadn't forgotten how fun this team was from last year and had really been looking forward to this week. And even with some new faces, they are just as fun and easy-going as they were last year. And Isaac LOVES all of the attention he gets! He'll probably be a royal pain when he has to entertain himself for five minutes at a time next week, but this week is a blast!

John is meeting with Eliseo (the pastor whose school our funding group is helping to build in San Pedro), then he'll meet with the director of the hospital here. The main thrust of that meeting is to assure them that we are here to help them in any way we can, and to assess their changing needs and how we can help fill those.

When Jim and Kathleen first came here, the hospital needed EVERYTHING! After several years of support from them, the hospital is pretty much on its own two feet from a day-to-day operation standpoint. Now we need to figure out how to address more specific and more focused needs. Hopefully, someday, when we ask what we can do to help, they'll say, "you've already done it - we're fine". Then we can help somewhere else!

Anyway, we'll try to post some pictures tonight.

Weekend in Canilla

2008-06-08T15:19:00.002-06:00

Here are some pics from the weekend. The team just showed up so we'll explain most of this later...

You can see clinic, the Fickers' new truck, us towing another truck up the mountain because he didn't have enough power or traction to make it alone, and the torsion bar we broke on the way home.

Clinic in the morning, a trip to Martin's to fix the Toyota, and surgeries...

Cleaning Day

2008-06-06T19:52:00.002-06:00

Heidi went to the Hospital Buen Samaritano for her OB/GYN clinic today. Matt, Isaac, and John were here at the house cleaning and preparing for the arrival of the Women's Team on Sunday.

One of the dorm rooms had basically been turned into a full storage room because of the building project. So we moved the four extra beds out and took them to the Utatlan School to join Roy's stuff.

Also on the to-do list today was an attempted repair on the washing machine. It died a few days ago. Matt and John got the thing mostly apart but couldn't find the problem. Working on putting it back together was a little entertaining, at least for Heidi. Check out the first picture for "you might be a redneck if..."

The second pic is our 365 picture of Isaac today. Don't forget to look up our little project. The link is in yesterday's post.

Tomorrow we head to Canilla for clinic. On Sunday, the team comes so we'll head home from San Andres a little early to meet them.

400th Post!

2008-06-04T21:37:00.003-06:00

So we've been busy here around the house the last two days, preparing for the Women's Team to come in this weekend.

Yesterday, while Matt was recording some vocals (some went better than others - there's a bit of touchup to do - sure wish I had pitch correction!), Heidi was deep-cleaning the kitchen. Fun, fun, fun.

Today, we were both busy working and cleaning. It started last night when one of the washing machines died. It's nearly ten years old and has washed countless scrubs, sheets, towels, and assorted other team stuff - not to mention the Street's and Bell's clothes. Naturally, it died when it was full of water.

So Matt siphoned all the water out and took it partially apart in place - enough to see that he's going to have to get it out of the laundry room to try to fix it for real - so we'll just wait until we have a little more beef here (John, we're waiting!).

Also, since the rainy season has started, the weeds in the garden have gone crazy. Some weedwhacking was in order. Naturally, the weedwhacker wouldn't start. You know, after living here for nearly two years, we still had no idea where to buy a sparkplug for a small engine. Forget buying one at the places where they sell weedwhackers and lawnmowers - we got sent to the auto parts store where they had one that was... well... apparently close enough. Weeds whacked.

With the building project going on, we have tons of construction materials laying around. When we're here by ourselves, we use some of the dorm rooms for storage. So the bodega had to be re-organized to make room for all of that.

With a fun day of deep cleaning the kitchen behind her, Heidi continued her efforts in the living room. She also watched Isaac for most of the day, since we figured that washer disassembly, engine repair, and weedwhacking were not really suitable activities for him. Isaac has been SOOOO good the last few days. Not that we're trying to jinx ourselves or anything, but what a fun little boy he's become. A pleasant and welcome (and stark) contrast to his first six months.

Anyway, here are a couple of pics - one from the recording session and one of Isaac clowning around on the couch.

And here's a link to a little project Matt started three months ago. It's called Project 365. The idea is to take a picture every day for a year. The idea is to make you a better photographer, and in our case, to document a year in the life of Isaac. We'll try to update every single day (we've only missed one so far), so swing by every now and then. (We didn't mention this before for fear we'd lose interest in the project, but now that we're about 25% through, it looks like we have a decent chance of making it!)

http://www.flickr.com/photos/24446863@N07/sets/72157604059212810/

Stormy Monday

2008-06-02T14:51:00.002-06:00

We haven't really talked much about the tropical storm (Alma) that came through, but we're still getting some effects from that. We didn't get any wind, but it's raining a little more than usual and that's probably from the storm.

We drove to Nueva Santa Catarina this morning. In the past, we had usually gone through Chichi and Los Encuentros, providing a rare opportunity to enjoy some pavement, but with the construction on CA-1, it could take up to three hours to get to clinic. So we took the "shortcut" through Totonicapan today. It's off-road and pretty difficult driving, but Matt and the Toyota were up to the challenge.

As an extra added bonus, we had Malachi with us. He has been a tremendous help. For clinic today, were expecting about half the countryside to be there. We weren't there last month, so a full house was scheduled - somewhere in the neighborhood of 50 people. On our arrival, there was exactly one patient. Maybe the 40 degree temperatures and the steady downpour were a factor. In all, we saw around 8 people - 3 pregnancies, one newborn, and a few random other patients.

The original plan had been for Malachi to stay as long as possible, then we would drive him about a mile to where the chicken buses come by and he could get back to Xela like that. Since we got out early, we just drove him into Xela.

Duane and the boys had planned on coming to the house today to do the wiring for the addition. As on the previous three attempts, there was another emergency. One of our missionary family friends who lives near Lake Atitlan was robbed by four gunmen last night. Duane was going to try to fly down to help with the aftermath and was waiting hopefully for the weather to clear. At press time we have no idea whether he made it out or not. We called from Xela and offered to pick up anything they might need at Hiper Paiz (think: Walmart) and drive it to them, possibly spending a few nights to help with security. (The parents are actually in the US trying to raise support money and their 21-year-old daughter is running the orphanage essentially alone.)

We suggested that perhaps we could pick up some groceries and a microwave as a minimum and bring it over. After all, people still need to eat. Maybe some money, too. Deb said that the robbers had disconnected the microwave and had it set out to take but that they forgot it so they were good on that count. Also, she had asked them not to take her purse, since it didn't have any money in it. They rifled through it and decided there was nothing of value to them there so they left it. So at least she still has her passport and her bank card. She's afraid the house is being watched, so she won't go get any money, but she can if she needs to.

Also, her brother-in-law lives in Guatemala City and is coming up to spend some time so our presence, while welcome, isn't necessarily needed. So we came home and we'll just stay on high-standby for them.

Anyway, that was the day. After leaving Xela, we had another bumpy, muddy ride home, but we're here now and will be until Thursday. Matt has some recording scheduled for tomorrow (please pray for that - in the nearly two years we've been here, we've heard a VERY limited number of decent singers, and we're recording vocals tomorrow!)

In pics, the first is of Malachi doing a prenatal ultrasound. You can see our translator/pastor Matilde next to him. He is actually dressed pretty appropriately for the weather.

The second is what happens when you say, "Hey Malachi", then take a picture. Hee hee!

Third is the newborn baby we saw along with his mother. She is the one we told you about earlier who we had diagnosed with severe pre-eclampsia and sent to the hospital. She didn't go but delivered at home. Within a day, she seized. They took her to the hospital and we were not too hopeful about her chances, but she pulled through - probably due in large part to the huge number of people praying for her.

Fourth is a shot of the clinic room with Isaac trying to see what's happening on the exam table.

And last is what your shiny, clean truck looks like after four hours driving through greasy muddy roads. As the rainy season just started, there isn't too much deep mud yet, but all of the dust that had been on the roads just got turned into this 1/2" thick layer of slickness and slime. Fun.

Every Day an Adventure

2008-06-01T17:34:00.002-06:00

Friday was Heidi's birthday. Matt had cooked for her and had a surprise present. Isaac had a surprise, too. His was a screaming wake-up every two hours starting at 10pm. Every time, it took an hour or more to get him back to sleep. So we "woke up" on Saturday morning pretty stunned and really sleepy.

When Matt stumbled into the kitchen to get some caffeine for us, there was another surprise. The Fickers' F-350 was parked in our driveway. We checked to see if anyone was in it, perhaps having slept there instead of waking us up, and needed a ride to Canilla. Nope. Empty.

So we arrived in Canilla to find that the Scaggs family had arrived as expected, but they were a little more tired than we had anticipated. That's because they had had a 10 hour trip from Guatemala City. BOTH vehicles they were in had broken down!

So what do you do when you're broken down on the side of the road in the middle of nowhere and it's about to get dark? You call Martin. He came out and towed the Ford back to our house since it had a bunch of construction material in it. Aaron and Joe drove out to get the crew in two other vehicles and everyone eventually got home.

Anyway, clinic was good on Saturday. Mostly routine - and we had lots of help. Malachi has learned some Spanish in his last two weeks of class and was an even bigger help than last time. Plus, Felicia Scaggs is about to start medical school and was helping out, too.

Saturday afternoon we continued our tradition of playing beach volleyball. Except that since the rainy season has now started, it's a little soggier than before. Oh well, it's still fun!

It turns out that Malachi is also a worship leader, so we had a chance to do some worship on Saturday night, too. It's nice to be able to do that since we're always working during church and never get to go.

David Ficker is in the US right now with Craig, getting ready to drive a truck down through Mexico with a load of goodies. With any luck, we'll see them this coming weekend. Please keep them in your prayers. The trip through Mexico can be pretty stressful and this is David's first time "flying solo".

Today was clinic in San Andres. We had a false start when the keys in Leslie's 4Runner turned out to be the keys for her clinic in Chiminicijuan instead of San Andres, but Aaron made a high-speed run on a dirt bike and got them going.

Heidi got a chance to continue to evangelize to two families she's been working on (with the help of her translator and her translator's father) for a few months now. She also got to take a possible bullet fragment out of a guy's chest. She had to carve into the "H" in the patient's "Hollywood Gangster" tattoo - also a first. The piece was small enough and shallow enough that it really could have been anything, but the bullet fragment story seemed believable enough...

She also got to work on a big swollen bruise about the size of a baseball on a woman's stomach. It seems she was on the receiving end of her husband's bad temper a week or so ago.

Leslie and Malachi got to work on a woman who fancies herself a "natural medicine" specialist. Apparently, natural medicines don't work too well on diabetes because her blood sugar maxed out the machine we have. She was feeling pretty bad and they started her on an IV. A few minutes later, when Leslie stepped into Heidi's room, Heidi asked how the patient was doing. Leslie indicated that she was feeling well enough to be giving her own (unsolicited) consults... Yeesh.

Anyway, the first picture is a little deceiving. It looks like the mouse we found in the pharmacy is about to have a pretty bad day. Yes, but not what you think. Leslie asked Matt to "handle" the little visitor she found. Matt grabbed one of the kittens and tried to put it to work. Turns out the kitten is afraid of mice - at least living ones. Once we had addressed the mouse in an alternate fashion, the kitten was pretty intrigued with the remains. Go figure.

Next is a shot of Aaron and Joe trying to catch some of the Tilapia in their backyard pond to transplant them to the pond at the airport. Now that the rainy season is here, the airport pond will keep water in it a little better and the backyard pond is getting a little overcrowded.

The next two pics are why we insisted on a Toyota. The roads are now pretty muddy and it's SO nice to have lots of power, a good four wheel drive system, and relatively new tires. Some of the other vehicles on the road struggled a little more than we did.

Tomorrow is our monthly clinic in Nueva Santa Catarina. Malachi will go with us and help as long as he can before he has to head back to Xela. Matt will also get a chance to take a look at what work has been done since we were out there last to kick off the construction on the new church. Roy's group, Savior's Sons, will be down in July and we're hoping to have the foundation wall complete so they can start laying block at that time.

Back in the Saddle

2008-05-30T12:42:00.003-06:00

First things first. Happy Birthday to Heidi! Much like me, she quit counting years ago, so she's twenty something-teen years old. If you didn't follow that, then you're too young to worry about how old people are anyway.

Yesterday, Heidi was at ASELSI. Poor Isaac had been traveling for about a week and was as schedule-confused as he could be. So he and Daddy stayed home to try to get a schedule re-established. It also gave Matt some time to work on a preliminary mixdown of the stuff he recorded at the church in Los Encuentros before we left.

Heidi had a busy day in clinic. She saw some pretty interesting patients, including a newborn baby with a golf-ball-sized mass on his arm. Also an 8-year-old with some type of mental problem. He has been kicked out of school for being disruptive. It's possible that he's autistic or something like that.

Fredy, our little imperforate anus patient, showed up with a prolapse of his colostomy. If you don't know what any of that is, just keep reading and don't worry about it. It's pretty gross.

She had a 4-year-old who doesn't talk. He seems to be more or less normal, physically, but his verbal and comprehension skills just are not where they should be.

Anyway, that's just a sample. She didn't get home until nearly 3pm. That's pretty late for ASELSI. Most of their workers are Mayan women whose husbands allow them to work with the understanding that it's a half day and that they'll be home in time to fix lunch (the main meal of the day for Guatemalans).

Today, she was in her clinic at the Hospital Buen Samaritano seeing a post-op patient, a couple of pre-op patients for the team that's coming in about 10 days, and a boy. (Yes, it's her gynecology clinic - don't ask.)

Some pics... First is of our translator, Cecy, with the stethoscope Heidi gave her for her nursing school. Second is the pancake breakfast Matt made for Heidi for her birthday this morning. Plum pancakes - yummy!

Next is a picture of Isaac's hands after attacking Jake yesterday. Apparently, Jake is shedding. He also seems to have missed us when we were gone. He let Isaac tug on his mercilessly for a total of about an hour yesterday. With all the hair Isaac pulled out, it's a wonder Jake's not bald.

The last pic is Isaac's first time on a school bus. Our mechanic friend Martin recently made a trip to the US to get a semi, a pickup, and a bus. Part of the way he makes his living is by buying discount vehicles in the US, bringing them here, fixing them up, and selling them. Well, the semi and the pickup deals both fell through and he only ended up with the bus. But Roy managed to fill it nearly full with furniture and construction equipment for the addition to the dorm.

Martin showed up at the house this morning with the whole load of stuff. Then we took it down to the Utatlan School to put it all in storage until the addition is done. Roy, it all made it here unbroken and undamaged. That mattress already had tons of stuffing coming out of it when it left the US, right? Just kidding.

Anyway, Isaac got to ride in the bus with Daddy and he loved it. Maybe that's a good sign for a few years down the road????

This afternoon, Malachi (Katie's friend) comes back to the house from Xela where he's in language school, and rides out to Canilla with us in the morning.

Back Home

2008-05-28T14:23:00.002-06:00

We are back home here in Quiche. We flew back in from Detroit yesterday and then crashed in a hotel in Guatemala City. We probably could have driven back, as we landed in Guate around noon but we had gotten up at about 1am Guatemala Time to drive to the Detroit airport, took two flights, and waited about an hour for our luggage to arrive. We were tired!

Isaac fell asleep at around 3pm in the hotel room and slept for four hours. Then came the dilemma of whether to wake him or not. His nighttime sleep is usually around 12 hours. We didn't really want to wake up at 3am with him.

We woke him up, he was completely useless, then we put him back to sleep. He woke up at about 4am and thought he was up for the day. Luckily, we got him back down until around 6am. His body is completely confused with the 2 hour time change. Matt will probably stay home from ASELSI with him tomorrow to try to get him back on Guatemala Time and to get some music work done.

US of A

2008-05-23T18:03:00.002-06:00

We're back in the United States for just a few short days, resetting our 90 day visas and spending Memorial Day weekend with Matt's family in Michigan.

It's amazing what things you really forget about here - like that the people are so big (tall and... well... big). And how few dogs there are. And how few bombs. And how clean it is. And how many lights there are at night.

Anyway, probably some more later. Nothing really too exciting to report.

Quiet Days - Part II

2008-05-21T17:50:00.002-06:00

This is part II of our blog for the day. The title of the first part doesn't really fit this part, but we'll go with it.

This afternoon, Matt took his recording equipment down to a little church outside Los Encuentros. They had asked him to record them about a year ago. He went down to listen to them and they were NOWHERE NEAR ready to record. He spent some time discussing basic musical concepts with them and they agreed to practice.

Also, in the meantime, one of the guys' brothers got involved in drugs and owed someone somewhere in the neighborhood of $25,000. That is an amazingly high amount of money here. Well, the guys in the band decided to all pitch in and help him pay it in return for his promise to get out of that line of work and get back in the church. Brotherhood is pretty amazing. However, instead of having time to practice, for about a year, they were all working extra jobs.

In all that, though, they apparently found time to practice some, because when Matt showed up today (with pretty low expectations), they were a completely different band. We recorded nine songs in about three hours, which is almost unheard of. Now the vocals will all have to be redone (long story but it involves insufficient monitors and rain on a tin roof) but most of the instrumental work is done.

Matt will mix down what he has so far and get back with them in two weeks to re-do the vocals. He'll also try to add some things that need to be added and maybe do a few edits himself. It's just easier, quicker, and better. But for the most part, these guys were ready.

Anyway, here are some pics of the session.

Quiet Days

2008-05-21T14:49:00.003-06:00

Clinic on Monday was our last one for a little while, since tomorrow we fly to Detroit for 4 days. Our visas need to be renewed one last time, so we are taking a chance on a cheap Spirit Air flight that we found.

The last two days have been just running errands, catching up on paperwork, squaring some things away for the team that is coming to operate in June, and packing. It's always nice for Isaac to have a few days at home to get back on schedule a little.

We've been interrupted only by a few drop-ins and phone calls for help-- the most notable being a little baby who we diagnosed with hydrocephalus at ASELSI last week. We sent her to the hospital here to begin the process of getting her surgery and promised to help cover expenses. They came by to get reimbursed for the CT scan that had been done, which confirmed our clinical impression. Less than 500 quetzales (about 80 bucks)!

Please pray for this little baby and her mother, who does not have a husband in the picture. (He used to beat her, so she moved out, which is quite rare and gutsy here for a woman... Now she's got a disabled kid all on her own, though, which is more difficult than we can even imagine)

Other than that, we will simply be praying for safe travels and for all of the other missionaries that we are deserting over the weekend to not have anything too crazy come in to clinic! We will be back next Tuesday.

Slow days pretty much bring on the posting of more gratuitous pictures of our son, so here's the latest installment-- Those of you who knew Matt in his marching band days might appreciate these...

Monday in Chujuyub

2008-05-19T13:27:00.002-06:00

Today started rather early. Katie's friend Malachi spent the night here last night after doing clinic with us on Friday, Saturday, and Sunday. His plan was to catch the 3am chicken bus to Xela to be there in time for his morning class. So Matt got up and took him to get his bus. Waking up at 2:30am is never fun, but a lot easier when you consider how early we go to bed here (we don't have TV).

Today was our third time in Chujuyub, the small village where our friend Regina lives. Since Isaac has started crawling, he's less interested in being penned up in his pack-and-play, so it's awfully nice to have help in clinic. Katie and Hannah drove over from Canilla to give us that help. Three clinicians can move about twice as fast as one (because we actually like each other and spend a wee bit of time chatting amongst ourselves) and it allowed us to not have to turn away patients. We had around 50 today. There's no way Heidi could have seen that many by herself with Isaac in the room.

This afternoon, we're working on some last minute details for the Women's Team who is coming in in June. Proving that there's no possible way to make a system... well... Guatemala proof, Heidi went down to the hospital to talk to them just a few minutes ago and the hospital director had no idea the team was coming (in three weeks). We have a letter that we've distributed to all of the key hospital personnel that we made them sign to prove that they've seen it (typically, when a team comes in, at least one key person will swear up and down that they didn't know the team was coming, even when we KNOW we gave that person the letter two months before).

This time, though, we had given the letter to Dr. Patty's secretary, who is usually one of the most dependable people around. She didn't give it to Dr. Patty, which was surprising to everyone, including Dr. Patty.

Anyway, we'll spend most of tomorrow filing paperwork with the government to obtain permission for the team to operate here. And we think that Duane, David, Ryan, and Joe may be flying in to do the rough electrical work on the addition to the dorm. (We say "we think" because we found out that they had to make an emergency medical flight this morning which pretty much messed up their plans for today and may push a few of those plans into tomorrow, which may push the electrical work out a day, too.) Those medical patients sure are inconvenient, aren't they?

Wednesday will be a bit more paperwork, a recording session in the evening at a local church (please pray a whole lot for this, it has all the makings of a sonic disaster), and then we get up early Thursday morning for a flight to the US to reset our visas. Our 90 days will be up early next week and Guatemala doesn't take as kindly to illegal aliens as the US does.

In pictures, the first is a pic of the three girls all seeing patients. The second is of Heidi teaching Katie how to drain a cyst. The third is of a few of the patients in the waiting area - sitting in front of the two 4Runners. The fourth is one of two twins who came in today. Mom and Dad were hoping we would give them some free milk. The good news is that the babies are growing great. Yes, it's a bit of work for Mom to breastfeed twins, but it's so much better (and safer in a country that doesn't have access to clean water to wash bottles) for her to breastfeed. We weighed them and told them to come back next month and we'll look at them again. If they're still growing well, it's more breastmilk. If things start turning south, we'll see what we can do to help them out.

And the last pic is of Heidi, Katie, Hannah, and Isaac.

Long Weekend

2008-05-18T18:50:00.002-06:00

We are just getting back tonight from a series of long (but fun!) clinic days with the Fickers. We drove out there Thursday night to get an early start on Friday, flying up in to the jungle. Some of you will recall a small village we went to a few months ago called San Pedro-- A place where there are no roads in or out, no electricity, and only one protestant church, with just a few families.

Leslie, Katie, Hannah Ficker, our evangelist friend Armando, Katie's medical student friend Malachi, and Heidi were all flown up by Duane on Friday morning. The village people were faithfully waiting for us, and had several hundred patients lined up! Our best guess is that we saw around 250 patients in about 6 hours, since we had to fly out before dark.

Luckily, most of the patients had pretty basic problems that were easily helped or treated. That meant that we had time to let Armando preach for a while, and the people truly seemed interested in his message. Time will tell, but we feel like hearts are beginning to soften there in that area and that God will continue to open doors.

We all got back to the house safely, but tired and sweaty and smelly! Everyone tried to get a good night's sleep before clinic in Canilla on Saturday. That clinic was not terribly bad with all of the help that we had. It was great to have some time in the afternoon for another beach volleyball match at the river. What great fun to have the entire Ficker clan in town at the same time!

Today's clinic was a little more challenging... We started out early with a one-year-old baby with pneumonia, for whom we recommended a trip to the hospital. The family refused to take her there, and essentially asked what was behind door number two-- So we gave her some IV fluids and some oral antibiotics, and hope that you will continue to pray with us for her recovery.

Another tiny baby came in, seven days old and unable to eat because of such bad fungal infection in her mouth. She was also bleeding quite a bit in her mouth, and Leslie gave her a shot of Vitamin K which we hope will help. (This is pretty standard procedure for most babies in the U.S., but few receive it here) We will also continue to pray for this baby's recovery and growth-- she only weighed 5 pounds 3 ounces today.

There was a prenatal patient who came in today for the first time in several months. Unfortunately, we found her baby to be dead on ultrasound, at about 5 months of pregnancy. She was there with her husband, who was very interested in doing what is best for his wife and will hopefully bring her in to the hospital sometime this week. He was also interested in hearing more about Christ, who he did not know much about before today. Katie, Heidi, and a local evangelist were glad to share with both of them what they could, and we will pray that He continues to seek the Lord and finds a good Church in his community.

Tomorrow is clinic in Chujuyub, the third time we will be visiting that village. This will be the last in a long string of long clinic days. We will spend Tuesday and Wednesday packing and catching up on other things, and Thursday we leave for Detroit for a few days. We'll get some R and R, grandparent time for Isaac, and visa renewal all in one!

Day at Home

2008-05-14T20:35:00.002-06:00

This morning started out with a nice gift from Heidi to Matt. Isaac woke up around 6:30 but Heidi took him out to the living room and gave Matt another hour and a half to sleep. NICE!

Even nicer was the fact that Heidi and Isaac went to market while Matt was still out. A surprise find was Reese's Pieces, which Matt made into some pancakes when he woke up. Try it, you'll love it!

The only real business item today was a meeting with the builder.

Oh, and Isaac's ten month birthday was on Sunday, so we took his 10 month pics today. He hasn't been much of a ham for the camera in the last week or so, so below are two that we got.

Tomorrow is clinic at ASELSI, Matt has a meeting with a church group that wants him to record them, and we're meeting a friend of Katie's who is coming in from language school in Xela. We'll leave as soon as he gets here to head to Canilla. Duane will make two flights up to Zona Reyna for clinic on Friday (weather permitting).

It looks like the clinicians will be Leslie, Heidi, Katie, Hannah, and Katie's friend (a third year med student).

Wheelchair Jornada

2008-05-13T15:02:00.002-06:00

Jornada is the word we use here for a team. So a wheelchair jornada is a wheelchair team. There is a group based out of Chimaltenango, Guatemala that imports broken and damaged wheelchairs, rehabilitates them, and then distributes them to those in need. They came to Chichicastenango today (at ASELSI).

Duane flew in this morning with Martina, the little girl they're taking care of, and a girl named Clara and her mom. Both girls are profoundly retarded and wheelchair bound. Neither of them had a wheelchair until very recently when the Fickers turned up an adult sized wheelchair for Martina. Martina is 9 (more or less) so while the adult wheelchair was better than nothing, it still wasn't exactly optimum.

Neither girl could have tolerated the three hour drive from Canilla, so a 12 minute flight was infinitely better. Add this to the list of times that the airplane has been such an amazing blessing to us and the people of this area.

Matt picked up the group at the Quiche airstrip and drove them to Chichi (there is no airstrip in Chichi).

A team from the United States had come in to help out and it included a couple of physical therapists who were very helpful with Martina. They said that it really looked like she had gotten some very loving treatment, as evidenced by the soft condition of her burn scars. Without countless hours of massage and therapy, her type of scars usually contract so badly that movement is nearly impossible.

They said that it's really important that we get Martina on her feet, though, as the lack of weight bearing can cause a weakening of her bones and will eventually make them very brittle. They have a standing machine at their shop in Chimaltenango that they hope they'll be able to fit to Martina. Since she doesn't really travel very well, we're hoping that a few phone calls and some measurements will get her a machine that'll help.

In addition to a wheelchair for Martina and another for Clara, they presented Duane with another wheelchair, two walkers, some crutches, and a cane to be given out to those in need. It shouldn't take us long to unload those! There is a huge demand here for those things that we often take for granted in the U.S.

Below are some pics from the day.

The first is the group gathering to pray before the day started. The second show some people waiting patiently for their turn to be fitted. The desks are where people sign for their wheelchairs, get their pictures taken, and receive their free hygiene kits (many families here don't have washclothes, bath soap, or toothpaste).

The third and fourth pics are of Martina with the team of people who worked to get her fitted into her wheelchair. Some of you might recognize our translator at ASELSI, Cecy, who was with Martina all day, too.

The last picture is of Duane loading Clara into the airplane.

Tomorrow is another day off. Matt will meet with the builder to do some planning for the next steps in construction and Heidi will get ready for ASELSI on Thursday, Zona Reyna on Friday, and our normal weekend clinics.

Monday/Friday

2008-05-12T19:38:00.002-06:00

Mondays are never fun. Unless they're also Fridays. In which case they're still often not fun. See, because of our weird week, Monday is really Friday. When it says "Monday" on your calendar, that's the last day of our work week, which makes it like a Friday. But Fate seems to not want to let us off that easy.

This morning, Isaac woke up between 5:00 and 5:30. And he had no interest in going back to sleep. It was Matt's turn to get up with him, so he did. Shortly after, though, Heidi's cell phone rang. Keep in mind that it is still WELL before 6:00am. It was our friend Regina. Matt asked her if there was a clock where she was - kind of a stupid question since she can't tell time - and told her that, no, she could not speak to Dr. Heidi because she was still sleeping. Well, the phone had woken Heidi up anyway, so we eventually put her on. We will admit that this is the first time that Regina has called us with something ridiculous.

Her call was for a friend who was "bien malo" (really bad). He had a cold. We told her that if he was truly "bien malo", they needed to go to the emergency room. She said that they could do that, but would just be given a "mountain of prescriptions", which is completely true. We told them that we would be home in the afternoon after clinic and would help fill those prescriptions if that's what they needed.

Clinic today was in Chicabracan. This was our last time to go with our evangelist, Juan Diego. He will be moving to Honduras next month to continue his studies in theology. He promised to recommend a friend to us and since we've been so impressed with him, we have no doubts that his friend will be great, too.

We normally see around 30-35 patients in Chicabracan. Today was around 50. Several were prenatals and all of them are doing pretty well, except one. She says she's 39, which would make Heidi and Matt about 13. She came in about 8 months ago with some early symptoms of menopause. Today, she and her husband came in with some rather suspicious complaints. We asked if she was pregnant. They said that the midwife had told them after the last baby that that one was their last one, so they couldn't really be pregnant. Not only is she pregnant (for the 12th time), it's with twins. Not exactly the news they were looking for. So, yes, it's still possible to get pregnant when you're starting menopause.

Through all of this, Isaac, who has recently learned to crawl and pull up, was not too excited about being penned up in his pack-n-play. Suzy will gripe at us for this (our pediatrician friend who just visited last week), but you'll be glad to know that a piece of black licorice can keep a 10 month old happy and quiet for nearly an hour. Messy, but quiet and happy. We were also smart (or crazy) enough to bring our laptop, which has a DVD player. We put it behind some boxes where our patients couldn't see it, but Isaac could. Baby Einstein videos are like magic, too. All things considered, he did great with the whole 6 hour incarceration thing. Luckily, there aren't too many of these left.

When we got home from clinic, exhausted, there were two more patients waiting for us at our front door. Matilde, the pastor from Nueva Santa Catarina, was here with the sister of a patient we've told you about before. The patient was one of our prenatals there who we diagnosed with pre-eclampsia and recommended a trip to the hospital. She ignored us and delivered in her house. Two weeks later, she quit talking and couldn't walk (we're thinking maybe a stroke???). They called us and asked us what they should do. We sent them to the hospital where they prescribed some blood pressure meds, which her husband went out and bought. Matilde and the patient's sister came all the way here today (two hours each way) for some ibuprofen and vitamins. We'll hopefully see her in our clinic out there in a few weeks and help with some more meds.

Also waiting were Regina and her sick friend. He may not be too terribly sick, but he's not too terribly young, either. He apparently had an infection of some type, because he had prescriptions for some antibiotics and some cough meds, which we gave him.

Tomorrow, Duane flies in in the morning with some patients who need wheelchairs. There is a team coming up to ASELSI who will be giving out wheelchairs and we have a couple reserved for these patients. Either Heidi or Matt (whoever wins the coin toss) will ride down with them and help out while the loser of the coin toss stays home with Isaac and chases him all around the house. (Just kidding about the loser of the coin toss - as far as you know!)