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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Thursday, May 12, 2011
May 2011 - Day 4/5 - Post by Dr. Chris DeLuca - "It's Not a Tumor"
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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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"
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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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
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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Chris
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May 2011 Trip Day 1 - Posts by Dr. Chris DeLuca
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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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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