Heading home!

Wow, here we are again... another week down and on the way home!  It's amazing how quickly these weeks fly by... but usually not until after I'm really, really ready to see my family again so it all works out nicely.  We actually got here to the airport quite early for our flight (nearly four hours early, to be exact) since Duane had some errands to do before noon here in The City after flying us in.  Nick and Amanda were total rock stars on the bumpiest flight I have ever experienced in the Cessna 182 this morning, thankfully.

We are now sitting down to a nice lunch and enjoying free WiFi before heading to the gate.  We have about 4 hours in Miami and then get "home" to RDU just after midnight... Can't even begin to tell you how nice it is to live 10 minutes from the airport instead of two hours now!  Please pray for good weather for Nick and Amanda so they can get back to Wilmington safely.

Had a great couple of days in Canilla as usual-- It was so, so good to get my arms back around Katie Ficker after her horrific pregancy and surgery experience in December!  My arms could have wrapped around what's left of her (she's so tiny as she continues to recover from blood loss and bed rest) probably more than once and never let go if I had my choice.  Thanks to all of you who helped pray her back to health recently.  For those of you new to the story, feel free to check her out at https://theaaronfickers.wordpress.com/ -- but fair warning, don't start reading the most recent post if you need your mascara to still be in place for the next few minutes.  It's a heartbreaker...

It's amazing to see the new hospital under ROOF now... God has been so faithful throughout the expensive building process, and the workers-- under the leadership of Duane and his oldest son Ryan-- have done an amazing job.  It's mind-blowing to think of what will soon be happening there and the blessing that it will be to such a large and underserved area.  Until the completion of the hospital, the nearest one is about an hour away-- but the nearest one more-or-less guaranteed to be able to do a C-section is nearly two hours away!  Plus, they are both "free" government hospitals where Mayan patients especially are not treated very kindly most of the time.

As I post pictures of the new construction, I realize that I haven't really posted much of the hospital in Chichi-- the Good Samaritan Hospital-- where we worked this week!  I love the open-air design and courtyards there, which have been incorporated in to the designs for Adonai's hospital also.  So here are some shots of both...

Rooftop view from Adonai Hospital-- ready for the concrete roof/floor pour soon!

Walking around, touring the grounds-- note to the right where the roof is finished over much of the outpatient area!  We are standing in the (future) courtyard...

The view out the back of the hospital-- yep, cows and all!  It's a beautiful valley, though...

And the rooftop view over the side of the hospital, from atop the future ORs... Cloudy but beautiful day...

The clinic (prenatal area) in Canilla-- soon to move to the outpatient area of the hospital

And another one I can't get to turn the right way!  GRRRrrrrr... But this is the beautiful courtyard area inside the "Buen Samaritano" or Good Samaritan Hospital in Chichicastenango... the bottom floor is outpatient, and the upper floor is inpatient.  Love the open air feel!

The Emergency Room is also pretty open, though...

And the view from the rooftop is a little more urban in this location!

 We hope you've enjoyed following along this week, and thank you for your support and prayers-- Back the first week of May if you want to check in again!

Wrapping up at the hospital

Well, no major disasters yesterday, but we did manage to spend nearly five hours seeing about eight patients... and four of those were post-op patients from last trip who looked great!  One other was a young couple struggling with infertility who brought some lab results back for us to review and to discuss next steps.

My "favorite" patient (I know I'm not supposed to have those...) was the daughter of Anastacia, the patient who I operated on in August and who made me the personalized bag that I so cherish...

Her daughter is 23 weeks pregnant and was here for prenatal care.  The more surprising thing, though, was that Anastacia herself was carrying a 2 month old baby with her... and said it was hers and not a grandbaby as I had assumed... Being fairly certain I had removed her uterus about six months ago (and then checking my records to confirm that before asking...), I was a bit baffled!  Turns out, of course, that this baby was not hers "by blood", but she had taken the baby in because the father had died and the mother had no means of supporting her.  So this beautiful little girl gets a new chance at life through adoption... just like we do when we are adopted in to God's family as His children.

Last night we had the third of four of us sort of get the "rest of the way" sick-- Amanda went to bed around 3 or 4 o'clock and hasn't really gotten up yet!  Thankfully Nick is here and has already had the virus that he shared with her, so I'm keeping away the best I can!  Turns out he has gotten to play not only Physical Therapist and surgeon (!) this week, but nurse as well... Probably not exactly as he had planned.

Yesterday we sent our first two surgical patients home, and we will hopefully send one more home today.  The one that we had to operate on abdominally has been predictably a little slower to bounce back (score another one for minimally invasive surgery!) and will probably be tomorrow or so and left under Tom Hoak's awesome care from here.

Today we will likely still see a few patients in clinic although we packed up all our supplies last night since we hadn't planned to, then hang out in market for a bit if Amanda's feeling up to it.  Then we will fly out to Canilla, Guatemala, to check in with our dear friends the Fickers there!  Seeing them is always a highlight of my trip.  Apparently the hospital they are building there is under ROOF now, which is just amazing.  Can't wait to see it!

Gotta share a few pics before I sign off this morning-- Dr. Johnstone with the granddaughter and namesake of our first patient, Rodas... (how many doctors does it take to figure out how to not display this sideways?!?!?  Apparently, more than one at least...)

And me trying to get the whole family to participate in a photo with Rodas... There is actually a good shot of this crowd floating around somewhere, but I'll have to find it on someone else's phone later it seems!

God bless you all and keep praying for these patients please!!

 

More people to love on and pray for!

Sorry we didn't get around to blogging last night; I got home from Tom's last case in the OR around 11, and after our two long cases for the day and a few clinic patients it just wasn't meant to be... ("it" being ANYthing other than crawling in to a nice, warm bed, that is!)

So we now have four gynecologic surgery patients in the hospital and four members of our surgical team-- and it is both a blessing and a curse to report that the patients are now officially less sick than WE are! Nick is feeling better from his cold, but he passed the cold part on to Amanda and the GI symptom part on to Skip, it seems!  No idea how I'm managing to avoid it so far, but you better believe I'm knocking on every wooden surface within reach when I say that ;-)

Both yesterday's and today's surgeries were awesome-- Despite the fact that poor Amanda was stuck operating between two dueling attendings who were literally making a sport out of disagreeing with each other!  I'm not sure I've ever laughed so hard in the OR before, and keeping it light definitely was great.  I learned a ton from Dr. Skip Johnstone with his vast experience in vaginal surgery, and he at least learned about how much he can do with WAY fewer and lower quality instruments than he is used to.

In all seriousness, though, we have done four awesome surgeries and both Amanda and I have gained valuable surgical experience.  More importantly, though, four women now have bodies that are in much better shape now gynecologically-speaking and should feel much more comfortable.  There are simply no words for the joy of realizing the privilege it is to serve these women in this way.

One of our patients, Rodas, can't speak much Spanish (only her native Mayan language), but each time I visit with her, she takes my hand and simply stares into my eyes smiling as if she will never let go.  She says more in those eyes than the largest dictionary ever could.  I deserve absolutely none of her gratitude or praise, and can only feebly attempt in Spanish words to redirect it to my God to whom it belongs... but it is still a sweet gift that He has chosen to give me just as a loving parent does with his or her children.  What a blessing.

All four are doing quite well and the first two will likely go home tomorrow.  It is amazing and humbling to know that despite the dirt floors and tired old pads-as-mattresses or cots or maybe even straw mats they are going home to sleep on, they would still rather be at home with their families instead of on a soft bed in the hospital with their pain controlled and their meals cooked for them.  Can you imagine getting on a public bus or in the back of a pick-up truck to go home from the hospital after your surgery?  And then getting out and walking anywhere from 10 to 45 minutes or so to get from the road to your house?  These ladies are tough as nails, my friends.  There is so much we could learn from them!

I do covet your prayers especially, though, as I post about once a year or so, for guidance and vision for the mission here in Chichi or in Guatemala altogether.  This week has been very slow patient-wise, and that always makes me worry-- why are the patients not coming?  Did something happen that I don't know about that tarnished the reputation of my surgeries or the hospital?  Is God just trying to tell me I'm not needed here that much anymore?  Or is He just getting ready to send something CRAZY in the door tomorrow that He knows we will need all day to deal with?!?

Patients in clinic-- though few in number-- have definitely kept us busy and on our toes!  As usual, I'm glad that many specific patients that have come in came in specifically this week when I have the specific expertise on the team that I do.  Dr. Johnstone's strong background and experience in urogynecology has been invaluable for both Amanda AND I this week in clinic~  not to even mention the patients!

Tomorrow we only have clinic patients and Tom's surgical patients scheduled so it "should" be a little more low-key of a day.  We will try to let you know tomorrow night, but I somehow kind of doubt it... Let's just say I've spent enough time here to know better! ;-)

My very favorite picture from today is this one-- Not many people in the world have a picture of themselves with their spouse in the OR, scrubbed in for a case and praying over the patient before starting.  Photo cred to Skip, who I encouraged to "play heathen" during the prayer in order to snap the shot.

Also, the "obligatory", traditional "uterus selfie" from yesterday-- thanks to Erin for taking a break from PT student duties for a bit down at ASELSI to join in our OR phone also!

Also, our last patient from today, who we will most likely do a hysterectomy for in May (long story, but she is just not ready yet for this trip...).  SHE asked at the end of the consult if she could get a picture with US on her phone-- so of course we said only if we could take one with ours, too!  Another Guatemalan "first" for me this week.  She and her husband are adorable and were so much fun, even after waiting over eight hours to be seen by us today!  Again, puts things in to perspective some and very humbling.

God bless you all tonight or whenever you are reading this, and remember, "IT'S ALL GOOD"-- according to both God in The Bible (Genesis) and my favorite catch-phrase and Spare Change song!!

Clinic Rocks.

After a pretty good night's sleep, it was off to the races in clinic today!  At first I was a little concerned when we "only" had 12 patients, but by the end of the day we were thankful and could see that once again, God sent us just as much as we could handle...


Out of those twelve, we scheduled four surgeries, have four coming back later in the week to review various labs or other studies, admitted one for overnight management of her diabetes (yes, it was THAT bad...), and have at least one that Skip is going to "have" to come back to further care for!!  Although ideally we would see only surgical patients for scheduling this early in the week, it was really a nice mix today--


Please pray for two young couples who have both been married for 10 years with no children~  They are both, of course, heartbroken over it.  One couple will come back with some labs to review later this week and can hopefully be helped with some hormonal treatments.  The other lady, though, will actually be having surgery on Tuesday which may take away any chance of fertility (for you medicalese-speakers, she has at least one large hydrosalpinx and we're hoping it's not bilateral...)


Also pray for our four surgeries that are scheduled:  three "vag-a-thons", which is the affectionate term we use for vaginal surgery that will take several hours for prolapse, plus the young lady with the tube problem and infertility.  Also pray that some more patients will find us if they need help during the week!


Of course, the lady we admitted for diabetes control could use some prayer help as well!  Her name is Manuela, and she really needs some good help with her diabetes... We are very hopeful, since Paul and Lindsey with Agape in Action have a clinic in their town this Tuesday and every month!  So we will get her started on insulin and then send her to them for continued care afterwards. 


Last but not least, pray for health for our team-- Nick has a pretty bad cold coming on that we hope to not all catch.  Everyone today was a bit dehydrated with various symptoms but we're working on it and improving.  No one passed out, so that's good, right?  Great attitudes and patience and clinical skill, though, were abundant and I really don't see that changing with this team.  We were able to catch a couple of pictures today, which I will try to post when we get back to the apartment.  (We're at a restaurant for dinner now... It's only 9 pm after all...)


More to follow...

Meet the Team!

One of these times I’ll come up with an original title for the first blog of the week, but obviously today is not that time… For those of you new to the blog, WELCOME to one of the favorite parts of my world~  and—most likely—THANK YOU for letting me “borrow” your loved ones for the week to help here in Guatemala… To those who follow our little adventures regularly, welcome back and thank you!  Your time and prayers really are appreciated.

Today I have the privilege of traveling with a team of four, which is pretty close to a perfect size I think!  There is another attending or senior physician, an OB/GYN resident (From the Wilmington, NC program), and her husband who is a Physical Therapist!  So far I’m the only one who will admit to speaking much Spanish, though, so we will see how that part goes…

Dr. Skip Johnstone has told me for years that he wanted to come down with me to Guatemala, and I’m so thrilled he is finally making the trip!  He trained at ECU a few years back and worked there on faculty with me for a while as well.  He is a very accomplished vaginal surgeon, so this week I get to take on one of my “other” all-time favorite roles—that of a student again!  It’s amazing how God continues to provide these great opportunities for both me and the women we will be serving.

Please pray extra hard for Dr. Johnstone this week, as he had to really struggle with the decision to miss a dear friend and mentor’s funeral today in order to fly down.  Also pray for peace and comfort over Sam Atkinson’s family~  May we truly be honoring to him in our teaching and operating efforts this week, as he was very well-known for both of those things.  Rest in peace after a life well-lived, Dr. A… You will be so missed!

Drs. Amanda and Nick DiSarro were contacts from Julia, who came down on the last trip.  She is a third year resident in Wilmington (same program), and apparently Julia made her experience sound good enough for others to start signing up!  This is a huge blessing to me and the women who need help there in Guatemala~  Once again, God provides.  I’m really excited to have Nick as a PT along, too, as it will hopefully allow an opportunity to re-connect a bit with the PT and Special Needs programs down at ASELSI (another great mission just outside of the town we are working in)—I haven’t made it down there in quite a few years, so I’m excited to go back and reconnect!

Today we have been traveling since around 3 am so far and still have “miles to go before we sleep”.  We should land in Guatemala around 1pm local time (2pm EST), then drive up to Chichicastenango where we will work the first part of the week—about a 2.5 hour drive without traffic, but it usually takes an hour or so to get out of Guatemala City Saturday traffic unfortunately!  Hopefully we will all sleep well tonight and be ready to hit the ground running tomorrow! 

Wrapping Up Here in Chichi...

Our week has certainly continued to be awesome here.  The first two surgical patients went home this morning, and the three from yesterday (Maria, Sebastiana, and another Maria!) looked great today and should go home in the morning.  Today was absolutely gorgeous weather-wise, and we finally got a chance to walk around some after seeing patients in to the early afternoon.

Oh wait-- forgot that we didn't blog yesterday.  That might be because we didn't get out of the OR until nearly 10 pm!  Might have been worth mentioning that is why we appreciated today's restfulness so much!  As usual, though, our anesthesiologist arrived about 2.5 hours after she said she would, so we didn't start until nearly noon.  With our two "vag-a-thons" (both of which really, really apparently wanted Julia to have the fullest learning experience possible-- they helped quite a bit by bleeding from everything we touched to really test and hone her troubleshooting skills!) and one just plain old vaginal hysterectomy, plus Tom's leg amputation closure (don't ask), it was a more than full day.

We called a few patients back to see if they were at all interested in going ahead and getting their surgeries done this week since we had today open, but no takers.  So I guess today's rest was just a much-needed gift from God.

Here is my new favorite picture from the hospital-- Julia with two of our post-op patients (both of the Marias) who were making their "laps" around the courtyard balcony.  Many of you have heard me say that I will never be able to prove it scientifically, but I swear that the sun and fresh air help these patients to heal better than our dark and cooped up hospital rooms at home!

This evening we were able to walk around Chichi and enjoy two of my favorite restaurants (the first one isn't going to start offering the desserts that are on their menus until tomorrow-- one of the many stories that helped coin the often-used phrase "Guat-EVER!") and some shopping.  Just being able to sit and visit Latin America-style-- unhurried, unscripted, and destressed-- was really nice.  

Now clinic is all packed back up in the "bodega" (storage room) for the next few months, and after rounds tomorrow we will head up the road a half hour or so to meet Duane at the closest airstrip.  He will fly us out to my second favorite place on the planet-- the Ficker "compound" in Canilla'.  (When my family is there with me it's probably my #1 favorite place!)  I can't wait to introduce Julia to one of my "other families" there.  

Friday we will see whatever gynecology-type patients they have found in their clinics over the past few months, and get to see the progress on the new hospital firsthand!  God is doing some amazing things there, and it is a privilege to even know the folks whose hearts and hands He is using in His work.  

I'll leave you with another fun picture of Julia and I outside the hospital-- note the prominent display of my "Dra (=doctora) Heydi Bell" bag that a surgical patient from August presented me with this week. Yep, I totally cried!  What an amazing gift.  It has her name on the back, too, to remember her by.  The patients themselves here are such gifts and such a privilege to work with that when they give you a gift on top of that, it is deeply touching.

Clinic and OR Adventures!

Wow.  I'm not sure we could ask for a better two first working days!  Clinic yesterday (Sunday) looked like a pretty packed house in the waiting room, but there were only 15 patients so it wasn't too bad.  We scheduled four for surgery, had two that we sent for other exams to come back later in the week with results, and have at least two that want surgery on a later trip.  Today we scheduled one more surgery for tomorrow for a "grand" total of five.  But it's never about the quantity...

We are blessed to have had fantastic results on both of the "vag-a-thons" we did today (that is our "term of endearment" for a long-- like, marathon-long-- vaginal surgery.  Also known as a TVH with repairs and high uterosacral suspension for you gynecology geeks out there ;-))  As long as recovery goes as expected, these women will feel SO much better!  I'll spare you the goriest details of why, but trust me... life will be more pleasant!

You all know that I love to teach, and it's been awesome to have Julia here to make me feel useful!  (She's probably just humoring me-- she truly needs very little direction, but is definitely gaining valuable experience.)  It really kind of makes it a "win-win" situation.  I love the way God works that.
I have a few pictures to share-- and maybe a story or two... we'll see how it goes.

Here's some of Julia's pictures of our clinic set-up, both sides of the room.  She especially made sure to include the "bucket system" for speculum storage-- the red bucket is for the dirty ones to make it easier to remember ;-)

OK, most interesting patient stories:  We did get to explain to a patient and her husband today that the "urban legend" that is popular here-- that if you don't have your menstrual period for a while because of using birth control, it will eventually come out of your ears, eyes, and nose!-- is decidedly NOT true.  This episode of "myth-busters" brought to you by a couple of OB/GYN residencies ;-)  The man and his wife actually took time to specifically thank us for explaining to them why that cannot be true.  Honestly, that felt great.  THAT, my friends, is the essence of truly practicing the "art" of medicine-- working together with patients to find a solution that works for them is such a privilege.

Please pray for Tomasa.  She is a 45 year old mother of TEN who I'm pretty worried might have cervical cancer.  Her biopsies have been sent and follow-up arranged, but prayer is definitely the most powerful treatment that she has good access to, friends!  She continues to weigh heavily on my mind tonight and is etched deeply in my memory... (It probably doesn't hurt that she has an adorable 4 year old granddaughter who happens to be named "Heidi", either...)

Also pray for Paulina and Santa, our surgical patients from today-- and the three ladies we will operate on tomorrow.  Oh-- and you might also want to send some prayers of thanks that our sweet anesthesiologist, Dra. Iris, was able to catch the OR door before it feel straight on to Julia's head at the end of the first case!  Seriously.  It fell off of it's top hinges-- Yep, we broke the OR.  It will be interesting to see when it gets fixed.  In the meantime, I'll just enjoy the slightly better air flow from the missing door ;-)

One last photo-- this is sweet Santa, who we operated on today, and her adorable husband-- He must be quite proud of those dentures, because you never see him without a smile!  I met them in August and commented on how lovely her "traje" or traditional dress was.  He was in western clothes that day, but said that he often wears his traditional dress also.  I asked him to wear it when he brought her back, and he did!  I am totally smitten by this sweet couple, so here's a quick reminder of what it is all about in this photo:

Actually, I lied-- THIS photo here is REALLY what it's all about!  I know it was probably inappropriate to snap the photo, but I was so. very. touched. by this man!  He is the husband of Paulina, our first patient in the OR today and first patient in clinic yesterday.  As soon as we put her up on the exam table to do her exam, he hit his knees.  Right there in the middle of clinic on the hard tile floor, he prayed for her until after we were done.  What an example of what a husband is called to be!  May we all learn from this man-- most likely illiterate, but he knows what is important.  Sometimes, that's all you need to know...  God bless him and all who are reading this tonight!

Day One ~ Just travels!

Thank God for a smooth travel day so far!  Our 4:00 am scheduled taxi showed up about 8 minutes early and patiently waited, loaded our 200+ pounds of luggage in the car and cheerfully drove us up to RDU airport.  Then the most stressful part of the morning:  weighing in the bags!  One *might* have tipped the scale at 51 pounds, but the very nice lady who had been called in to help as the computers were having issues cheerfully let it slide.  As a bonus, she was scheduled to work our flight and knew it would be overbooked—so she went ahead and checked our carry-ons through to our final destination for free and we were all kinds of LIGHT weight going through security!

Both flights have been smooth, and we are excited to get our shoes on Guatemalan ground in the next hour or so at time of writing!  I’m also super-extra-excited that Dr. Tom Hoak will be there to pick us up—I haven’t seen him since February and it always feels weird being there when he is not like we were in August…

Guess I should tell you who “we” are.  For the new readers, I am Heidi Bell—I had the privilege of living in Guatemala with my brand-new husband Matt from 2006 – 2008, and delivering our firstborn son there in 2007!  Talk about a place that gets in to your heart and never lets go!  Since moving back to the U.S., I have had the unbelievable privilege of being able to continue women’s health surgeries about once a quarter for a week each time—now going on well over twenty trips since 2008 and counting!  I love the continuity of care of having patients I have been seeing for years and years, as well as the ability to really follow-up on patients and how they did after surgery—a privilege often not afforded other short-term missions teams.  I do OB and Gynecology care, and mostly surgeries for pelvic prolapse most weeks.  I love The Lord, my husband Matt, kids Isaac (8) and Micah (4), and especially my in-laws who come down from Michigan to help take care of them during these trips for continuing to make them happen!

I was given an unexpected gift from God a few months ago when I put out some feelers with local NC OB/GYN residency programs for interested travel partners.  I couldn’t believe it when the Wilmington/New Hanover (SEAHEC) program said they had a fourth year resident that they could send!  Julia Posey showed up at the house last night cheerful and calm after a long night shift and day, and her very sweet and easy-going spirit is sure to be a blessing to many this week.  I’ll pray that she has a GREAT surgical as well as personal/spiritual experience this week and hopefully can encourage others from her program to come in the future!  I’m sure she will be missing her husband Darrell and four-year-old son Landon this week, so prayers for her and her young family please!  Also, she is in the process of interviewing for jobs all over North Carolina right now so I’m sure she’d love some guidance…

Now the plan is land in Guatemala, hope to get all our luggage through customs unimpeded (there’s a new political party in power now after recent elections, so hopefully they won’t throw us any curveballs!), and drive on up three hours or so to home, sweet home for the week in Chichicastenango.  We’ll then probably grab some groceries and pay-as-you-go cellphone and internet time and then likely crash. Hard.  Both of us are running on fumes sleep-wise, so hopefully tonight will be very restorative before a long day in clinic tomorrow!

God makes me laugh!

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

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

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

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

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

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

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

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

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

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

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

Thanks and good night,

heidi.

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

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

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

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

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

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

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

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

Team "YO"

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

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

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

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

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

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

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

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

Wrapping up and continuing prayers needed

Wow.  What a trip this has been!   I think I last wrote on Tuesday or Wednesday, so a quick update is in order of course.  We finished up the surgical week with the vaginal hysterectomy and laparoscopic tubal removal for sterilization on Wednesday, then stuck around to help Tom with several more cases (hernias, gallbladders, and a thyroid) Wednesday afternoon and Thursday morning.  ALL of our patients looked fantastic Thursday morning and were discharged—even Aura, who had a major surgery on Wednesday morning, was asking to go home!  We felt comfortable sending her knowing that she lived near where we would be doing clinic this morning (Saturday), so off she went.

Sweet Micaela, the lady we operated on twice, may have looked the best of the bunch.  God’s grace and provision, clearly, since it could in no way be accounted for by the “perfection” of surgical performance.  It is so humbling to see families of patients bring us gifts on top of the financial offerings they are making to the hospital—from apples (ironically, imported from the USA!) and avocadoes to hand-embroidered hand towels since they know we “have to wash our hands a lot”, they are such sweet and generous thoughts. 

Truly, though, what really makes it worth it is the smiles we can occasionally even catch on camera like this one from Marta—she stayed one day longer than “usual” after her Monday surgery, likely due more to the fact that on Tuesday, she got the news that her brother had passed away.  He had been sick for a few years, but the news was still quite hampering to her recovery.  Wednesday was the funeral, and then a large group of family and friends descended upon her in the hospital that evening!  What a gift it was to be able to get this sweet smile after all that from her when I asked her to pose with “Flat Stanley” from my second grader’s class ;-)

Thursday afternoon we flew out to see firsthand ALL of the change and excitement that God is bringing about to His people in Canilla’ where our dear friend the Fickers live.  There are no words for how amazing everything is that He is doing there!  From a full-fledged university-affiliated nursing school (with 37 students enrolled!) to footings and walls being poured for a full-fledged HOSPITAL, to doctors and other health care providers coming out of the woodwork to volunteer faster than housing can be found for them all, to EIGHTEEN kids currently under age 10 running around the compound, to another airplane that has been donated and may be able to be flown down soon, and all around in everything in between, nothing is short of miraculous.  And yet all of it is just a tiny reflection of His Glory and Grace.

I’ll share a few more pictures to leave you with for the week—mostly just for fun. 

There’s the one of “Flat Stanley” taking a rest on some lovely coasters or doilies that one patient’s family gave to us, then him getting ready to go in to the OR with me…

Then Brittany enjoying the view of Guatemala from Duane’s Piper Aztec, en route to Canilla’ from Chichicatenango.  She was so carefree and easy-going this whole week!  What a great travel partner…

Then several of the hospital grounds, including one of me playing (and losing) “king of the mountain” with Jacob and Joshua Ficker (Ryan and Katie Ann’s boys), and one of the well drilling rig that is due to start drilling any day now (it was promised in January…), and the final hospital plans for any who are interested.

We then move along to the nursing school to see Katie’s first day of TEACHING CLASS in the newly-built “wing” of the school dedicated to the nursing program…

And the last are just for fun:  Chris, Tony, and Caitlyn playing on the swingset, Abi and Grace posing for us with “Flat Stanley”, “Flat Stanley” getting ready to take off in the Cessna, and the hospital grounds from the air…

We will leave you finally with a few shots of the volcanoes seen from above the clouds on our way back down to The City this morning—I will never tire of that view!

Please continue to pray with us for healing for our patients, and spiritual growth and renewal for Chichicastenango, Canilla’, Guatemala, the US, and the World.  God bless you all.

Long Day Today

So it's 10:15 and Tom just started his second-to-the-last case of the night!  Suffice it to say it has been a long day... We had two add-on surgeries in addition to the four major cases we had scheduled, so it really has been one of those days.  God is good, though, and it is a still a privilege to serve here with people who tirelessly continue on anyway!

The first bit of good news is that our patients from yesterday looked great this morning... Here they all are, hanging out in the sun and getting some fresh air on the hospital balcony.  I can't prove it scientifically, but I swear that it must be healthy for healing!  We'll hope so in their cases anyway...

Aaaaaannnd Chris got to visit a bit with Caithlyn also... even for lunch and a consult or two!  I love the "more the merrier" attitude towards everything-- even a medical consult and ultrasound-- here in Guatemala.  They really are a close and loving people, and couldn't be more pleased especially to welcome a cute baby girl in on the action!

The good news in this picture here is that we are doing a successful laparoscopy here in Guatemala!!  The bad news, though, is that the bluish hue you see in the upper right of the TV screen is the radiopaque string of a laparotomy sponge... You medical types will know a bit more about what that means, but suffice it to say we had to go back and fix a boo-boo.  Praise God-- as always!-- for sending such a clear word through the Holy Spirit that we had left the sponge in the first patient as we were operating on the second... and God bless sweet Anastacia's family for being probably less upset about it than we were... Yes, complications happen.  Even mistakes.  Doctors are human-- and I think that goes double for me sometimes.  But thank God-- again-- for the resources to deal with them safely and for recognizing them early.  Didn't help the surgical schedule any, though...

Going to check again on the patients now as Tom finishes up a laparoscopic (!!!) gallbladder, then will see if he needs help with an emergent amputation that came in today.  A young man had some type of unexplained injury while drinking on December 22nd.  His foot was badly injured and there were some fractures in the leg bones.  He spent two weeks at the National Hospital here in Quiche, but then left AMA (against medical advice) when they recommended amputating some of his toes.  He has since tried to go back for treatment, but the clinic has not been open since the doctors have been on strike.  (I'll refrain from offering commentaries on free government healthcare at this point... ;-))  Anyway, he now unfortunately has a completely more-or-less mummified foot that will need to be removed in order to clean the injury to a point that it can be managed and heal!  28 years old.  

We also saw six or seven patients in clinic today, and a little drunk man that approached me in the pharmacy across the street asking for help with some prescriptions.  His wife had a C-section Friday and was discharged with prescriptions from the hospital.  He was "responsible" for getting them, but had apparently drank the money for them at the local watering hole before bothering to pick them up.  What a mess he was!  He is in a Baptist Church here (or was at one point...) and knows The Lord.  He knows he is in sin and needing a change.  We pray that he will bring his wife to see us tomorrow since we gave him a free appointment for her, and that there will be reconciliation in his life and in their marriage.  

Again tonight, we are thankful for so many, many things.  We hope you are, too!

Eclectic Mix Today!

So today was a busy but productive clinic day!  And I even had another new "first" even in Guatemala-- a rarity these days really...  Started the day off with a phone call from Dr. Chris, letting me know that their flight had been cancelled because the Guatemalan airport was apparently CLOSED because of volcanic ash from "Fuego" in Atitlan... So they are rescheduled for tomorrow and it looks as if they will be clear then!  Never had a trip delay for a volcano before...

Anyway, we got up and even got a few minutes in the market before getting started, saw 18 patients (3 more had signed up but left before we called them even though we were done by 4:30 which is pretty early by my usual Sunday standards!)  So we even got to get in some hot chocolate with guacamole and a side of great people-watching as they packed up the market for the day, and a gorgeous dinner with Tom and Jana. 

Today’s patients, as usual, were quite an eclectic mix… maybe even more than usual today even.  We happily scheduled six surgeries though.  (For those interested, four “vag-a-thons” and two simple vaginal hysterectomies—definitely a theme!)  We also saw a couple of young ladies for cysts and what-not, a middle-aged lady with a mass in her butt cheek (not a gynecological problem, but who’s keeping track?!), and a sweet little 75 year old whose family is convinced that all of her problems started when her uterus “fell out and hit the floor” with the birth of her second son about 50 years ago… as you can imagine, I had to do a little translating for Brittany on that story!  Other than that she kept up nicely ;-)

Please pray for our surgical patients for the week:  Tomorrow we have Anastacia for a vag-a-thon (unfortunately caught her with her eyes closed!)  Her sweet daughter-in-law was tearful after our prayer with her and very anxious for her safety!  She has 9 children, but they are apparently all daughters!  So yes, definitely pray for Anastacia… ;-)

Second up will be Micaela, a sweet patient that Leslie sent that is a “frequent flyer” at their clinic asking for help with her heavy bleeding.  Apparently a few weeks ago she felt weak from bleeding and called the ambulance.  Four hours later when they showed up, they took her to the health center and gave her a shot of vitamin K which supposedly helped some.  Probably time to go ahead and get that uterus off her hands, don’t ya think?  Please especially pray for her husband, who is NOT in the Church or willing to go/hear about Christ although she is.  As a matter of fact, it was the ladies in the Church who apparently told her that she definitely needs her uterus out.  Occasionally those Church ladies get it right ;-)

We will round out the day with Marina, who Tom has been seeing for similar problems and who is ready for surgery!  Her husband was actually quite sweet trying to talk her back in to it when she considered backing out, reminding her how long she’s been miserable with this!

Also remember to pray prayers of Thanksgiving for the lives that we all have been blessed with—not like Manuela, who only has 3 of her 10 children still living and needs surgery which we will hopefully be able to do for her in April (her tissues need some preparation and her diabetes needs some better control first!)  Or like the men and women we watched carrying ridiculously heavy loads after market today—only to do it again on Thursday and next Sunday to try to make a buck or two.  Also pray that Manuela and another patient with a very similar story will find their way back in April so that we CAN help them surgically.

The last picture is of our future rising ER doc posing in the doorway of the “Emergency Room” here at the hospital—it’s actually a single room equipped mostly with some stretchers and a couple rolls of gauze!  Not exactly your level 4 trauma center, but we do what we can…

Thanks for your prayers.  God is good.

Safe arrival and meet the team

Always, always thankful for safe and uneventful travels, but this trip was even BETTER than usual because now I live 10 minutes from the airport!!  Beats the dirt out of getting up to drive at least an hour and a half to the airport.  I didn't even have to leave the house until 4 am, so I got to see Matt when he came home! Bonus.

So tonight there are just two of us here in Chichi, but it's SOOOOooooooooOOOoo nice to have Tom and Jana in the country and upstairs again!  They are doing a back-and-forth from Guate to the US schedule these days and my dates haven't lined up with theirs in a while.  Praise God for that joyous reunion!  (And double-praise him for their cooking skills; they are amazing!)

I'm travelling this week with Brittany Walsh, a fourth year medical student from ECU-- She is actually going in to Emergency Medicine instead of OB/GYN now, but we kind of bonded and planned this trip back during third year when she thought she would go in to OB.  Her continued strong interest in women's health, though, as well as great attitude and easy-going personality, will hopefully lend itself to a great week all around!  Here's a selfie we tried to take, but I really stink at taking selfies and we're also pretty much in our PJs for the night already, so we hope you'll excuse our travel-weary look...

Tomorrow afternoon or evening we will be joined by Chris, Tony, and Kaitlyn Schwering from South Carolina, who our regular readers will remember as the OB/GYN, her husband and baby girl that have been coming down with me and/or on their own since Chris was a resident at ECU!  I'll have to get her to tell you how many trips; I've lost track even of my own but I'm pretty sure it's in the 20s since moving back to the US in 2008.  Wow.  God is good.