Eighteen and Dead, the Argument for Christ

100_1843She was carried in complaining of vaginal bleeding for nine months.  Her history was classic: positive pregnancy test in March, miscarriage in April, D&C (an operation to clear out the uterus) done in April, June and again in September secondary to continued vaginal bleeding.  Now it was January and she was still bleeding.  The conclusion (confirmed with ultrasound, a quantitative ß-HCG and chest x-ray) . . . she had choriocarcinoma with metastasis –this is a cancer in the uterus that if caught in the right time can be treated with chemotherapy.  The looming questions were: did we need to do a hysterectomy?  (This is a hard decision for anyone, let alone in an 18 year old, especially when out here being able to have and bear children is very important.)  Did we have enough of the medication to adequately treat her cancer without compromising other patients currently being treated for Burkitt’s lymphoma?  Would she follow-through on her treatments and labs that needed to be done?  Should we treat her?  The family’s question, “How can we afford any of this??”  Theirs was a daily struggle of food, not one of the future.

In it simplest form poverty is defined as lack of income to live.  In its broader form, poverty is defined not only by a level of income but access to a minimum level of resource –health care, education, etc..  Anyway you look at it this family was poor.  

There were many questions that we struggled with.  Why was this caught so late?  We are doctors tasked with the diagnosis and the treatment of medical/surgical conditions.  We did not receive training with respect to choosing who should have a chance at life and who should not.  We do not want that responsibility, and yet here it is.  God, if it is you will, please take this burden from us and if it is not, please give us the wisdom to know how to minister to this young girl and her family.

After talking with the hospital pastors we decided, anonymously, to use some of the money received by our supports to pay for her present and future medical bills –she would need weekly chemotherapy with additional lab tests –and also to help her family with transportation and food costs.  In starting her treatment, we decided to wait on the hysterectomy in hopes that the chemotherapy may save the uterus.

When she didn’t come back in the next week for her second chemo treatment, we were wondering what happened.  We finally got a hold of someone in her family and found out she had been bleeding heavily again and was very weak.  We told the family they had to bring her in.  This time the decision was made that she needed to have a hysterectomy, or she might not make it.  It was during this hospitalization that she made the decision to surrender her life to Christ!

The decision to accept Christ is fantastic for multiple reasons.  In this case, it was a reflection of how God had been working in her life, and the time spent with the patient, in an hour of need, to not only tell her that she mattered and was loved, but also to show her.  This is the argument for Christ –his example.   This young girl heard and was shown the message of Christ because of the pastors and staff at HBB.  They, the pastors and the staff, are here because of ABWE & Samaritans Purse.  ABWE & SP are here because of Christians who listen to God’s leading and thus give selflessly.  Christians are here because of Christ and his example.  Where is the equivalence in today’s society?  His example transcends cultures, laws, regulations and systems.

Hard decisions then needed to be made for when did we need to restart the chemo after the surgery.  The plan was made for two weeks afterwards.  She never made it for her third round of chemo.  She came back in about a week and a half later with an infection and died about three days later.  This was a hard loss for the family and for us.  Was this a life that was lost?  No.  Yes, she died but she now has life after death with God –no more sorrows, no more tears, praising God, and surrounded by his love!

Thank you for helping this girl to find love and salvation through Christ Jesus in this dark world.  Please keep praying for the family that in the midst of their hurt and grief that the love that was shown to them and their daughter while she was at HBB will also allow them to follow their daughter in her spiritual decision.

Thank you again so much for listening to God’s calling in your life to give and pray and thus helping to make an eternal difference!

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Clothes Pins and a Tour

We love our little guy and he continues to keep us entertained as he finds new ways to make us laugh!

Take a mini-tour with us through the hospital to get a feel for the  hospital, staff and patients (2 parts) -though realize I’m not a professional videographer so apologize for all the shaking!

 

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“Biannual Report”

100_1729 100_1776We are at the half way mark, month 15 of 30.  What a trip it has been so far.  So many stories and experiences.  We would like to give you an update of where we are and where we are going.

ABWE / HBB / The Hospital of Hope

ABWE, the organization that runs HBB in Tsiko Togo, and where we are currently located, is on track to open a new hospital in the Northern Part of Togo called Hospital of Hope.  Opening date is January 2015.  We are hoping to make a trip there sometime in February/March of 2015 to visit the hospital and site.

Prayer Support

We are not sure of the exact numbers of people who are praying for us, but we know there are a number of you who do and we are very thankful for your prayers.  We do feel “watched over and cared for” – especially on those really busy nights when things feel “out of control” and one can lean on the arms of our Heavenly Father and know that there are people who are at that moment lifting you and your family up to Him.  We could not be here without your prayers.  We also very much appreciate your words and thoughts of encouragement that you share with us through responses to our blogs and emails.

The Blog

The blog continues to be a joy/therapeutic to write.  We have 132 subscribers to our site and an average daily viewership of 25.  Our blogs are a reflection of our experiences/feeling as they happen.  Our goal is to relate our experiences as best as we can to you, so that you may share in the ups and downs of missionary life and know how to pray for both the Togolese and us.

If you have any questions, suggestions about a blog or would like to know about something specific please, feel free to write us.

Financial Supporters

We presently have two sources of income, Samaritans Purse and you, and with our current monthly commitments we are at 100 plus percent of support to the end of our term.

Outside of that we have roughly 70 financial supporters, 18 monthly donors and 52 one time and or intermittent donors, who have given anywhere from 25 dollars to 6,000 dollars.  Our goal, which we have met, was to raise 1,200 US dollars a month.

Looking over our expense records, we spent about 6,000 US dollars a month while in Switzerland for the seven months and are presently spending about 3,200 US dollars a month while in Togo.  Our major expenses in Togo, not including rent are as such:

  • Student loan: 866/month
  • Groceries: 650/month
  • US taxes: 306/month
  • US medical License/organization fees: 250/month
  • Health Insurance: 240/month
  • Electricity: 200/month
  • House Help: 162/month
  • Internet: 70/month
  • Other (gifts, household consumables, printer paper/cartridges, transportation, etc): 456/month

Noah

Noah continues to grow and explore in all sorts of ways.  Most recently he was branded as the “escape artist.” This was because one day as we were working in the hospital, we heard a “Mama, Dada, Mama, Dada,” and turned around to find our son walking in the hospital door with Fred’s shirt and no one accompanying him!  He’d managed to get out of a locked door at our house without our househelp knowing and walk all the way into the hospital, about 400meters, all by himself!  He’d had a good number of people out looking for him that day!  The next day thankfully one of the missionary wives saw him headed toward the hospital again and was able to stop him and get him back home.  Since then we’ve had a lock put on the door high up and out-of-reach of young fingers!

Future

As we look to the future and where God would have us to be, we are uncertain.

In staying in the field long term, there are many challenges including Noah’s education, establishing a monthly salary, planning for retirement, and establishing a home as well as ministry.   We would go from part time missionaries financially supported by Samaritans Purse and you to full time missionaries supported only by you.  Our monthly expenses would likely double including new costs such as rent, hospital fees, retirement and ministry funds (supporting the hospital and local churches).

These have not been easy months for us –as many of you may know from reading our blogs, but God has been our continual support and He is working in our lives and the lives of our patients –though not always as fast and direct as we would wish for. But we are whole heartedly asking God for clarity on whether He would have us to stay on the mission field long term.

As we pray for God’s direction in our lives we would ask you to pray as well.  Pray with us that God would give us clear direction on where He would have us to be and then the faith to follow that wherever it may be.  And pray also for what role you, our supporter, would play going beyond June 2015 –as a continued and/or new prayer/financial supporter.

God Bless

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Feb 27, 2014

IMG_2208I am down.  I am struggling.  I called a friend, a teacher, a doctor who participated in my training.  We talked.

In the middle of January, I told my wife, we have been blessed / lucky so far, no major OB cases were we wonder “what if”.  Yes there have been a lot of difficult OB cases and yes, there have been a number of medical cases were we have wondered “what if” . . . a 28 year old mother of five admitted for sepsis secondary to provoked abortion dead 16 hours later.  I was with her for the last 5 and wondered out-loud what if.

It is surprising what a month will do.  I have now two cases related to OB and post-partum where I wonder “what if”.

Oh Lord, you know our situation, you know what I will face today, give me strength, give me wisdom to prevail.”

In my conversation with this friend I was reminded that I was a good doctor, a good person, here in Togo doing a service.  She told me to remember the success and the saves.  Interesting advice.

I do not remember the good times, the saves, or the success.  I, instead, remember the failures, the struggles, the defeats.  These struggles mark me with strong emotions, and it is these emotions that I remember.  It is these emotions that rule the day when I am down that make me question what I am doing.

Oh Lord, help me to glorify you.  Have mercy on those I see in your name.  Do not punish them for my compliancy, pride, sin”

It is tough.  In a full day at OB clinic I will see many patients.  Of the 25 plus patients I see, I only remember the two difficulty “what if” ones.  That fact that they continue to come to our clinic for follow up is a testimony to them, their strength of character.  I am not sure I would.  I would run.  Yes, I am the doctor and I am here.  But on days like this I am only there because the airport is 3 hours away, and outside of purchasing a ticket home, I am not sure what I would do.  Beside, my wife is post call, at home with Noah . . . I have no other options.

Thank you Lord for the Togolese people, there heart, their desire to know you and their example.  I am not worthy.”

After the first case, the surgeons, medical chief and I visited the patient.  Our object was simple, to give no excuse, simply to explain what happened.  During this process, the patient explained that she was a seamstress who makes clothes and understands from time to time things happen.  And when they happen, you correct them and move on.  She then went one to say she hoped that what had happened would not affect her relationship with us the doctors and the hospital staff!  She continues to come to our hospital, to our OB clinic, I have seen her two times.  Her husband has invited us to their baby dedication.

Thank you Lord for her, for her faith, for her example.  I pray that you will bless her life and that of her family.  What successes you have promised me, I pray you give to her.”

The second case is tougher.  I have no description, no details.  All I can say is she comes to our clinic for follow up.  We pray.

I am at your mercy Lord”.

Today, my wife is on OB call, she started in the morning and has yet to come home.  I start my OB call tomorrow.  Our OB deck is different than most.  We manage not only the mothers but the babies, with their complications, that are born either at our hospital or at an outside clinic.  We are blessed to have a post resident pediatrician guiding us in our decision making and handling some of the more difficult cases.  Presently we have quadruplets, weight between 1.29 kilos and 1.6 kilos, born at an outside clinic; we have one baby on day number fourteen of IV antibiotics for 2 positive blood cultures, we are waiting the third; we have a baby who is seizing regularly with fever and on scheduled phenobarb, we are not sure of the source of the fever.  Outside of that we are in the process of inducing a pregnant lady who is at 42 weeks gestation and the baby is no longer living –four days ago the baby was fine.  And we are watching a mom, 20 weeks gestational age with a 2 cm dilated cervix, in whom we have placed our first cerclage (a stich to try and keep the cervix closed) –we hope to stop an earlier delivery.

“Lord God, thank you very much for Dr. K and her patience and care for not only the patients but us (me and my wife) for taking the time to train us and to give us a new set of skills.  We pray for her and thank her for her time here at HBB and for her safe travels as she heads back to the states for a few months prior to heading to the Northern part of Togo to help start and run the Hospital of Hope.”

God Bless

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I am emotional (A rant)

Staying dry while it rains!

Staying dry while it rains!

I am emotional.  I cry a lot more in silence these days.  I have been here before.  It comes when re-reading a blog, reflecting on a comment and or seeing a sick patient.  It comes out of the blue, a 180 degree turn of emotions.  I fight it, swear, ask for strength and it is gone, as quick as it comes.

But it comes.  And when it comes I wish I was home in a different setting, a different hospital, a different life.  When it comes, I am mad at the place, the patient, God and the world.  I cannot believe we have not learned from our past.  A 100 years ago, maternal mortality/morbidity in US was six persons per 1000.  Then we learned how to wash our hands and the mortality/morbidity fell.  Then we discovered antibiotics and it fell even more.  Then we developed ventilators and then it fell again.  Today it is 0.1 person per 1000.  This place seems like a different world.  It has not benefited from the advances of mankind.

And then the emotion goes and I realize the opportunity I am in.  My training in the US was composed of diagnosis and treating disease processes in infancy.  Many times during my training, I wondered about the futility of what we are doing and or the medications we are prescribing.  Treatment was a memory process.  In Africa it is not.  Here you see the end result of untreated/unvaccinated hepatitis and tetanus, malaria, hypertension, congestive heart failure, rheumatic heart disease, pancreatitis, etc.  Here you learn to appreciate the well patient checks, vaccinations, and abnormal lab values.  You learn to appreciate the diseases you treat because you not only see the end results, and many times too late; but you get to see the medication and treatment process work.

But this is not the first time I have been emotional.  As a young engineer I worked for a small company for 6 years and I was emotional.  During my time there the company went through it all –downsizing, bankruptcy, start up, environmental issues, health and safety issues, etc.  Shortly after I was hired I realized the trouble the company was in and I made a choice to stay, to learn, to make the best of it.  It was an interesting 6 years.  I learned a lot.  I often said my 6 years of experience there was like 12 years in a normal company.

But there is a price when you become emotional.  Something has to give.  When I left that company, I quit.  I walked away.  I wanted no more.  I took time off, went to France and Switzerland, lived with my brother and finished my MBA.  And when I thought I was ready for work again, I looked for a job and went through some interviews.  Everything looked different.  Prior to taking my first engineering job, I saw work as an opportunity to prove yourself, to gain wealth, to become famous within a circle.  Now all I heard was a sales pitch, a presentation without substance, passion, or ideals.  It was then I thought, maybe I should change careers.  And now I am here, 9 years later, the same position, the same struggles.  Ironic.  Who would have guessed?

It gets to me that we struggle with the basics, that we cannot create a solid society, a sustainable society.  Why are there hungry people?  Why are there people dying of curable diseases?  Why are we complacent?  Why do we treat people different based on relationships, position, status, color?  It gets to me when I know we could be that much better and yet, it seems, we choose not to.  The problem is not me.  The problem is not you.  The problem is us.  The problem is sin!  We choose this.   We promote this.  A case in point.

A 28 year old mother of three, 17 weeks pregnant is in decompensated liver failure secondary to Hepatitis B.  She has a small liver and lots of fluid in her belly.  Her problem started mid-November.  She has been tapped four times, by an outside clinic, for ascites over a two weeks period.  We saw her for the first time a few days ago.  On Monday we hope to run a few more test to see the degree of liver failure.  If her 6 month survival is low, we cannot do anything for her.  However, if she is still alive in 10 weeks-time we will do all we can for her unborn child who will most likely grow up without knowing mom.  If her 6 to 12 months survival is good we will be challenged with our next obstacle, to find 12 plus months of medication and hope she responds.

But this is not the point.  The point is hepatitis B is a treatable disease.  Yes not everyone responds to the treatment, but it is a treatable disease.  What one needs is access to medical care and to medicine.  We choose not to provide that access.  Not only that, an immunization exists for Hepatitis B.  In the states it is a standard part of newborn care since 1991, here it became the standard in 2007.  Some would argue well we have it now.  Not good enough.  Not good enough for her kids and her unborn child.  We have failed her.  We have failed her children.  How can you not become emotional?!  How can you not take a moment to pray, to ask for a miracle, to ask for a better place?!

The greater my wisdom, the greater my grief. To increase knowledge only increases sorrow.”  Ecclesiastes 1:18.

God Bless

UPDATE (a bit technical for the doctors that may be reading this blog)

We have run additional test on the lady in question and have calculated a MELD score of 13, which in her case is good news.  Having stated all this, her only abnormal findings are an INR of 1.5, T.Bili of 1.5, Hep B positive, ascites and platelets of 115.  With these findings we are questioning if hepatitis B is the actual cause of her liver failure and or are we missing something.  We have presumptuously treated her for schistosomiasis.  We have redone her echo to verify a small liver with irregular boarders and a heart that is contracting well, and we have tapped her and are presently in the process of ruling out TB.  We are now in search of a Lab in Lome that can verify additional hepatitis B markers that would include viral load.  This could confirm our diagnosis and give us a basis to verify if and when we treat her, if the treatment is working.  From there, our challenge with her will be treatment, which at this time we are estimating will cost about 1500.00 US dollars (wage range for an unskilled worker to a doctor is 70 to 450 US dollars a month).  A quick thank you to the doctor at Tri State for the curb side consult.

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“Doctor!”

100_1445It had been a relatively challenging night.  I hadn’t gotten home till about 11pm and one of the patients I’d been managing overnight was laying heavy on my mind.  I wanted to go over early to see her and check on how things were doing.  As I was getting close to the hospital I noticed a man and woman supporting between them a younger looking woman who looked like she was struggling to walk.  I wondered who she was and what her story was as she looked vaguely familiar.  As I walked into the hospital they came in a different door and she collapsed on the floor, I quickly realized she was pregnant –we moved her to a bed and rolled her to maternity.  She was confused and groaning.  She looked full term.  Suddenly I realized why she looked familiar –she was one of our patients that we have been following in the Obstetrics clinic.  When we got her back to maternity we were unable to find fetal heart tones.  I was in the process of ultrasound machine out when I heard the nurse call, “Doctor!” I looked over and the patient had quit breathing.  I went over and assessed for pulse and was unable to find any, so we started CPR and in the meantime I am calling out for different things that we need.  My husband comes and as we get a pattern going, I try to find out any history from the mother of the patient of what has happened.  What I find out in total later is that the night before she had complained of some back pain that sharply ran down both of her legs that had continued till this morning when they had been able to bring her in.  The last time she had felt the baby move was from the night before when the pain had started.  “We need to save her!” is the thought running through my head, “God please help!”   After 45 minutes of coding her, we make some “last-ditch” efforts and then we finally call it.  My heart is breaking . . . she was 14 years old and we lost both her and the baby.  I went into the bathroom and cried.  I could only pray that somehow through our monthly/weekly interactions with this young mother-to-be that she had somehow come to know our Lord and Savior.  The sun was shining, but it felt very overcast to me that day.  Are we really making a difference?

“People are like grass; their beauty is like a flower in the field.  The grass withers and the flower fades.
But the word of the Lord remains forever.” 1Peter1:24

It was a different day –New Year’s Eve and I was on call.  The day had been steady, nothing too heavy, just continuous.   We had a full OB floor and two in labor.  One had been in earlier that morning –this was her 5th pregnancy and her second set of twins –all still living!  We’d actually sent her “home” that morning as she had showed no cervical change over 12 hours and her contractions seemed to be lightening up.  We told her to stay close by the hospital, though.  I had been able to go home around midnight and had been asleep for about three hours when I got a phone call, “Doctor, the twins are back and ready to deliver!” She’d walked in just 5 minutes prior and was complete!  I quickly rushed over to the hospital to watch as the first baby delivered –the baby is crying and doing very well.  I stepped in and worked to find the fetal heart tones of the second.  I reapply gel to the probe, move, wait, listen and am unable to find heart tones. I quickly move to get the ultrasound to find heart tones and position of the second baby.  This has been the most trepidatious part for me in the past watching and waiting and knowing when to intervene.  I turn on ultrasound machine but it’s not working!  I quickly unplug and move the cord to another outlet.  I plug it in again and flip the switch . . . ok, it’s still not working!  “Doctor!” –the head was crowning!  “Thank you, Lord!”  The second baby came out just as handsome as the first –two beautiful baby boys!  I cried.  It was a wonderful way to start a new year!  I hope and pray that we make a difference and not just in prolonging lives or helping to bring in new life.

“For everything there is a season, and a time for every matter under heaven:  a time to be born, and a time to die; a time to plant, and a time to pluck up what is planted; a time to kill, and a time to heal; a time to break down, and a time to build up; a time to weep, and a time to laugh; a time to mourn, and a time to dance; a time to cast away stones, and a time to gather stones together; a time to embrace, and a time to refrain from embracing; a time to seek, and a time to lose; a time to keep, and a time to cast away; a time to tear, and a time to sew; a time to keep silence, and a time to speak;  a time to love, and a time to hate; a time for war, and a time for peace.”  Ecclesiastes 3:1-8

Whatever your season of life, we pray that God would bless you and be with you and draw you close to Him in this new year.

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“Blah, Blah, Blah” . . . we think that means “I can swim”

Wow!  It has been so much fun to watch him go from barely moving to crawling to walking and now to swimming!

Noah continues to be an ever-present blessing in our lives!  God knew what He was doing!!

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Nine patients, two points of view and a question

Baby Fred and Big Fred (In appreciation of my work, this new mom named her son after me!)

Baby Fred and Big Fred (In appreciation of my work, this new mom named her son after me!)

What a day! Or is this a week now or a month?  I am not sure.  The days are fuzzy.  It seems like one long day.  Time is for me a point of reference, a tool, used to measure things, not a constraint.  It does not dictate when I can eat, sleep, etc.  I eat when I am hungry and there are no patients to see.  I sleep when I am tired and there are no patients to see.  I take care of Noah when he is awake and my wife is working.  I work when my name is written down on the schedule and or I am called over.  It is my life.

#1.  The call was straight forward, a transfer from an outside clinic.  The story, 38 weeks pregnant, in labor and stuck at 5 cm (need 10 cm to deliver).  Fetal heart tones are present and strong.  A “no brainer” I thought.  The history is blurry and not clear.  She has been seen twice at a government clinic during her pregnancy, which in itself is not unusual.  The patient is fine but saying she is only 7 or 8 months pregnant.  To the ultrasound machine we go.  Can you say twins at 31 weeks and 4 days?!!  This is not straight forward anymore . . .  steroids, magnesium and antibiotics.  Delivery occurred 2 days later.  Babies are still with us, and doing fine.

#2.  7 year old boy admitted for persistent fever X 10 days.  Work up is negative for malaria.  However liver enzymes are 5000 (normal is less than 50).  Hepatitis B and C are negative.  Liver ultrasound is normal.   In the U.S. the next steps would include further blood tests and a possible liver biopsy.  Treatment would depend on the diagnosis and would be tough under ideal situations.  Here there is nothing to do.  The boy dies 2 days later during the night shift.

#3.  A young women who is pregnant at 35 weeks, started seizing this morning.  She is transferred to us.  On admit she has a short seizure.  Recovery is slow for her but the baby, by doppler, is doing well.  Her mother and mother-in-law are by her bed side.  The history is, like most histories, blurry and unclear.  We start her on magnesium, steroids and antibiotics and pull out the ultrasound machine.  Can you say twins at 30 weeks?!  Mom seizes again during the ultrasound, fetal heart tones drop, to c-section we go.  Delivery occurs immediately.  Babies are still with us and doing fine.

#4.  35 year old man with known Hepatitis B and bad ascites (fluid in the abdomen).  He is struggling to breathe.  However with a little bit of oxygen he is doing better.  After taking a history, I am frank with him.  I tell him there is nothing we can do for him, and that he will die.  He asks when.  I tell him I do not know.  I ask him if he knows God.  He says he does.  We pray.  He dies 12 hours later.

#5.  Another OB transfer, known twin gestation at 29 weeks.  Reason for the transfer, mom has high blood pressure.  Work up gives mom the diagnosis of severe pre-eclampsia with severe thrombocytopenia.  Babies are both breech (butt first).  To a c-section we go.  Babies are still with us and doing fine.

#6.  13 year old boy admitted for seizures.  History is unclear, seizures are atypical.  Patient has tetanus.  Treatment protocol in the states would probably include sedation, paralysis and ventilation to stop the seizures.  We cannot do that here.  We treat the best we can.  The boy dies 6 days later.  This is the 2nd person we have lost in the last couple of months due to tetanus.  The other one was 8 days old.

#7.  A patient known to us.  We had seen her in OB clinic at 22 weeks.  She had ruptured her membrane.  We told her, at that time, that she most likely will lose her pregnancy and that there is nothing we can do.  However, if by God’s grace she was still pregnant in 4 weeks, she should come back to us, and we would do all we can.  Today she is 33 plus weeks and has been sleeping on the OB floor for the last 7 weeks with daily monitoring.  The baby appears to be doing fine and growing appropriately.  We plan to deliver her by c-section at 34 weeks.  We are praying for a healthy baby.

#8.  She is a beautiful young lady who is once again pregnant.  She is here, in OB clinic for her second visit.  She is HIV positive, newly diagnosed.  It is my job to tell her.  I have done this before.  I hate it.  The news sucks the life out of people.  It ages them.  This is no exception.  I am close to tears.

#9.  She came to the OB deck at 25 to 26 weeks complaining of contractions.  She was 4 cm dilated.  We treated her with magnesium, antibiotics and steroids.  She slept on the floor of the OB ward for 10 days prior to delivering at 26 to 27 weeks (normal is 37 plus weeks).  The baby is still with us and struggling.  We have resuscitated him once.

Two points of View

When will this end?  How long can I keep this up?  How did the old missionaries of the past do this alone with less resources?  On the other hand, what a wonderful job!  What great experience!  I cannot wait until tomorrow comes!

A question

Am I nuts?

God Bless

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The Gift

“They’re coming tomorrow, do you want me to call you when they’re here?”

“Who’s coming?”

“You know, my friend whose baby had the arm problem . . . . “

The “arm problem,” how could I forget?!  In the first few weeks that we were working out here they had wanted us to get comfortable with the OR, the OR techs and just the “way we do it here in Africa.”  So our first few c-sections, we worked with one of the general surgeons here.  But after that, we were on our own.  This patient had been one of the first few that I had initially done on my own.  My husband had asked me that morning if I wanted him in there with me and I had told him, no, that I could handle it alone.  It was supposed to be a “simple” repeat c-section that was planned, no surprises, right?!

So I had gowned up, the patient had her spinal and was all prepped and draped.  I cut and everything seemed to be going to plan.  It was a little more challenging as I had always been used to having a second physician in the OR with me –even in the US there had always been a second physician/resident in there to assist.  “Uterus,” I called as I was getting ready to cut into the uterus and pull the baby out.  Incision made.  Baby’s head . . . ok, got it . . . now for the shoulders and arms, but this is where I “hit my snag.”  I got one shoulder out but couldn’t seem to get the other.   I got my fingers under the one shoulder and was pulling in an attempt to move the arm across the chest and up and out, but in the process of the pulling I suddenly felt a pop at the level of the elbow, the baby then quickly emerged.  As I was handing him off to the pediatrician, I noticed how limp and motionless that arm suddenly seemed.   A lot of thoughts went through my head at the time, wondering if this kiddo was going to be permanently injured for life and praying that he wasn’t, wondering what the Togolese would think of this “new” Yovo doctor –would they trust me with other c-sections? Talk about needing to swallow some humble pie!

I did a lot of praying over the next week, as he ended up requiring and extended stay with an x-ray and phototherapy.   We were very upfront with mom and the family from the beginning and instead of getting upset with us they thanked us and continued to be very gracious to us over the next few days.   Before she left, I told the mother, I would really like to know how things progressed for this baby and explained it could be six months to a year before we would know what recovery, if any, this baby would get in that arm.  And then the family had left and I hadn’t heard anything from them since.  I kept asking the pediatrician if she’d seen them in follow-up at the clinic and she’d said “No.”  I asked the nurse who knew her if she’d heard anything from the family and she’d told me “No,” as well.  I’d kind of given up seeing them again and thought they’d been “lost to follow-up” and I would never know.

And then the question had come, “So do you want me to call you when they’re here?”

“Yes, yes, please call,” I said.  Unsure of what to expect when they were to come.  Hoping and praying that the baby was moving the arm again –at least a little better than previously!

It came on a day I was very tired from being post-call, “They’re here, doctor.”  So I headed over, unsure of what to expect . . . smiles, angry faces, a forever handicapped child? As I 100_1511walked in I was greeted by smiles and one of the best gifts I could ever see, a beautiful baby boy moving BOTH of his arms and holding them up to me!  Thank you Lord!!  After a very nice conversation with the family, I was getting ready to head out the door when they asked me to wait, they had a present for me!  A present? For me?!  I was brought to the point of tears.  I had already received a gift wonderful enough in seeing this baby move both of his arms, but the family had lovingly and undeservedly brought me a “Togolese” gift and had even wrapped it!  I felt very humbled again but this time with a sense of joy, love and peace and extreme thankfulness to God for blessing this family and me in such an undeserved way!

Sound at all familiar? . . . As we go into this new year may we truly appreciate the gift of his Son!

”The Son of man came not to be ministered unto, but to minister, and to give His life as a ransom for many.” Matthew 20:28

God bless,

See our updated prayer page and new pictures!

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Merry Christmas from Togo! (2013 Christmas Newsletter)

100_1620Our Christmas letter is now posted!  Go to our website under the “newsletter” tab or click here.

Hope and pray that you have a blessed Christmas and happy New Year!

Please also see our updated prayer requests as we head into this new year and be looking for new pictures to be coming soon!

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