Louis's surgery March 22

Little Louis, whom I mentioned in my last blog, was operated on yesterday for his long-standing intestinal pain, even tho the anesthetist, Sandy, was delayed 24 hours in arrival. The visiting anesthesiologist with the ENT brigade was able to do the anesthesia with Dr. McKenney. Pray for rapid healing and return to little rowdy boy activity! We look forward to the day soon when Louis is out playing soccer with the other boys from the center. The saying "Lord willing and the creek don't rise!" has real significance here, and we saw it yesterday with torrential downpours that kept many of the first day ENT patients home. Here is little Louis before surgery during a pain-free spell.

Patients, New Believers, Heroines

March 21, 2010

Tempestuous start to the hot season here, interrupted by welcome respites of cool rain. Hear our friends in Tulsa, OK are under snow right now, preventing our anesthetist friend, Sandy, from taking off this AM. Awaiting her arrival for 2 much needed surgeries for patients from the Children’s Center!

Following up on last blog: Dubis’s, the 52 yr. old woman with the suspected uterine cancer whose surgery was made possible by donations from our Tulsa Sunday school class, had a hyatidiform molar pregnancy. There will be followup hormone studies for awhile to be sure she remains cancer free. She returned last weekend, having opened up the incision and needing admission with us for IV antibiotics, but is recovering now at home. Thanks for making her diagnosis and surgery possible! We are SO thankful for the relationship John has with the private city hospital and the generosity of the OB-GYN surgeon there. This is not the first time he’s donated his skills and time!

Andrea, the 11 year old whose mom died this past year, has made a decision to follow Jesus in her young life, and with several others having made the same decision in our Sunday School class, we are following her closely to be sure she gets the discipling she needs to be fruitful. Christine, the lab director who is teaching our wee one’s Sunday school class, has bonded to Andrea and is studying regularly with her. Christine is a very timely addition to our church, with the departure of our Guatemalan pastor and family. We are beginning to see some fruit from our 5 years of teaching here….perhaps the 12 strong men I’ve been praying for to form the base of our church group will be mostly youth! Jorge, a 13 year old from a very troubled family, has chosen recently to follow the Lord and arrives sparkling and eager to study. All are entering the time of most temptation in their lives here, their teens. Few make it through unscathed. Pray for the 6 youth that are beginning their walk with the Lord.

This month, I have graduated 6 new students from the nurse’s aide class, so we again have a “pool” from which to select new employees. One has been hired at the children’s center, and another comes on board tomorrow in the hospital. Because of a 3 week planned trip to the US beginning this week, I am sad to not be able to orient her as I’d desired! I have also begun the yearly CPR training, difficult as we can’t afford to pay them to come in on time off and our low staffing doesn’t allow them the leisure of escaping during work time to take the course. But slowly, 3-5 at a time, I am plowing thru the list of nursing staff and doing a 6 hr DVD course with all. Learning from the example of our neighbor, Dr. Don, I put the basics of CPR to a song they all know to hopefully improve retention. I will complete the last group of staff when I return in 3 weeks.

The most inspirational person in my last month has been Liz, who directs the Children’s Center with Iain. They are increasingly getting very difficult kids and babies, as the equivalent of our DHS system has discovered them and are sending them hard cases. Among the recent arrivals was Louis, an 8 yr. old that began coming to our Sunday School. He has now been a patient for over 2 weeks in the hospital, so becoming well-known to all of us. He had an abdominal surgery right before coming here that has left him with some complications, so is awaiting surgery, in much pain at times. Also a patient for several weeks now is little 8 month old Orlin, with head injuries from abuse. He needs a feeding tube to prevent or control the constant aspiration from bottle feeding, so he too is awaiting a surgery. Both were admitted right as iain left for a planned return to his homeland, Scotland. While we “feel” for Liz as she has been a constant fixture in the pediatrics ward, rarely leaving the 2 untended , the blessing has been the chance to see the character and resilience of Liz, making it work with her own son at home and she at the hospital. Her ever-cheerful presence in a full ward, listening to and encouraging the other young women, has not only been inspirational but VERY helpful in being able to address the needs she sees close up there. Thankful for the chance to know the “real” Liz, and be able to rub shoulders with another giant in the faith.

Women's Health Newsletter-update by John, March 3, 2010

A couple of weeks ago, Joel T, one of the FP Docs, referred a lady to the city for an ultrasound exam. Seeing Loma de Luz on the referral, the radiologist, a friend, assumed that I had sent the patient , so sent her back to me with URGENT on the results. He saw evidence of uterine cancer. He also called a mutual friend, the GYN surgeon that I work with in La Ceiba, who took a quick look and confirmed the radiologist's finding. Dubis and her husband, Domingo, showed me the ultrasound exam. She reported that Doctor Sae told them that it could not wait and that I was the one who could make it work. Now and then her husband sobbed and interjected "There is NO Way, we have no money". With the exception of feeling that a CAT scan was appropriate to have a better idea if we were dealing with metastasis, it was easy to agree with the other opinions from a quick look at the ultrasound. The following day, Friday, I met with another radiologist who has the capacity for a CT scan and with the surgeon. We agreed on Tuesday as the surgery date, depending on the results of the CT.

On Saturday, Penny and I crossed 2 rivers and several creeks to visit with Dubis and Domingo. They agreed with the plan, but needed continual assurance that we would not let money stand in the way of her receiving the care she needed. "Dios puede hacerlo". (God can do it!) I wrote them the referral for the CT and called Dr Sae to confirm the plans.

As well, Penny sent a note to her "Foul Weather Friend" (FWF), Nancy, who responded that she would "pass the hat" in Sunday School class the next day. Indeed, "Dios Puede": the hat yielded enough to cover the deeply discounted prices of the CT and pathology exams and a good start on the anesthesia bill. Neither Dr Sae nor I will charge the patient and he (the owner of the hospital) will overlook the hospital costs.

Monday evening, with a CT result of "no evidence of metastasis", Dubis was admitted and at 7 am on Tuesday, we were in the OR. As we got to the point where we could open and examine contents of the uterus, we found what appeared to be a very different kind of probably benign tumor, and one that would be unheard of in a post-menopausal patient. On Friday, nine days after her first exam, and amidst Domingo's interjections that "we have no money" and that "Dios puede", Dubis was discharged. I am awaiting the pathology results.

On Friday while I was discharging Dubis, Penny was walking one of our young pregnant patients through the HIV clinic at the public hospital. On a VERY happy note, the clinic lab negated our positive, preliminary "screening" test.

But if you would, please pray for another of our young pregnant patients, whose screening test affirmed her HIV. Pray that she will both continue with her prenatal care and with the HIV clinic; that her baby is not infected and for her healing.

Zippety Doodah, Zippedy Aye, My o My what a wonderful day

Friday, I (Penny) had planned to use my day in the city to walk a pregnant young lady thru the HIV system in the public hospital while John did the other errands. Was struck by the dirt and disorder, garbage, broken equipment outside the buildings in the hospital compound. The nurse that we finally got routed to was efficient, very kind, neat and informative- a wonderful contrast. When I asked her how often this confirmatory blood test turned out negative when we had a positive from our hospital, and she tersely replied "Never", and I watched S's eyes well up with tears. This is pregnancy #4 for her, and we had already gotten a negative on her husband. The Nurse poked S's finger after cleaning it with water, as she was out of alcohol. She did not have gloves to use. While we waited for the 15 minutes for her to read the results of the blood test, she began to outline the protocol that S would immediately begin, due to the pregnancy. When I again said, "Now, that’s IF its positive". She brushed away my statement and continued her efficient teaching. At the 15 minute mark, she turned to read the test- and said quietly, "It's negative!" She quickly asked S if she could still get blood out of the previous stick (so as not to waste another lancet!) and she could, so she did a second confirmatory of a different type- also negative. YEAH!
We went to a dirty Dunkin' Donuts to celebrate, and S talked about how she felt, like she had a new life. She had walked with this hanging over her head for a week, wondering how she'd contracted the disease, as she was clear that she'd been a "senorita" when she married and that her husband was faithful. She stayed with us all day as we did our errands about town, commenting frequently how free she felt. Made me think of how I felt at 18 after I’d ended a year’s search for the Truth and encountered Grace!
Resolved: visit the HIV clinic to bring alcohol and gloves! Pray for our friends who weekly visit patients dying there of AIDS, and help them with their needs.

Yesterday we had Andrea up for the afternoon, to make cookies for our Sunday School class, just have some 1:1 time with this 11 yr old orphan from the Children’s Center. Her mom died in October, so Andrea will be raised in the Center she’s done with school , one of her mom’s last requests. She has seen and felt too much in her 11 years, so is a joy to see her eyes sparkle. Christine, 26 yrs old, full time lab director here that has bonded quickly to the Honduran kids and employees, came up midafternoon and took Andrea for a ride on her moto, and a hike up to the water tower. We made lasagna for Andrea to test out and bring to Liz and Iain, the Children’s Center parents. Think it was time well spent!