Wednesday, February 23, 2011

Time

This is only my second post for February. Where has the time gone? I have been thinking more about time recently. How much more time do I have with my new friends before they return to the States? How much time do I have until I go to Kijabe (actually as I am revising this it is Sunday and I am already at Kijabe)? How much time until my friend comes to visit? And the worst question how much time do I have left before I have to say good bye to Tenwek and return to Canada? Time flies. I am looking forward to some of these things, hoping they come soon and others I wish I could put off for a few months. It reminds me of when I was younger and Oma (grandma) would come and visit in September – my brother and I could not wait for her to come and time would not go fast enough but on the other hand the same time Oma came was when school started and we wished summer would go on forever. Time – it is a good thing it is out of our control – and in God’s hands.

I am not looking forward to these goodbyes and am looking at the busyness that I will have in the next month (I return to Canada March 31). There are many projects that I have procrastinated that I need to complete. I need to leave more knowledge with the staff so they are able to get by without me. I have been trying to do my job in a way that is more educational than me just doing things – I think I may be in trouble in a few months when I actually have to do the work rather than just explain how to do it .

I also wonder if there will be a time when I come back. I often find myself saying if/when I come back I will do ____. I am sure I will know all in God’s time but please pray that his plan for my future – wherever that may be will be revealed to me, and that I will have peace with it.
Those of you who are on Facebook may have seen that I have been spending my time in various ways – some friends and I took off for a weekend and did something I never thought I would do - we rafted the Nile – wow what an experience if you are ever in Uganda I suggest you do it – it is amazing.

I have also been busy at the hospital – figuring out how the ventilator works – after 4½ months I have finally figured out that one of our ventilators is backwards SIMV means AC and AC means SIMV – I think (I miss the Evita). I have also, finally, started to work on basic instruction manuals for the vents, something I should have done long ago but procrastinated. We have had a real ICU this past week with 6 very sick patients please pray for them for me, we currently have a young man in the unit who is 30 years old, he has severe heart failure and has been on Dopamine for over a week. This morning he was sitting up brushing his teeth, while on 15mcg/kg/min of Dopamnine – his blood pressure 60/35, we don’t know what to do with him, if he were in Canada we send him to a Cardiac surgery unit and he would be in line for a crazy surgery or transplant or something. Here we will have to eventually turn the Dopamine off and then he will die – how do you do this to a completely conscious young man. We did manage to turn the dopamine off, his BP is still very low but his kidneys are functioning and he says he is fine. Last week we also lost another young man to Guillain-Barre, I found this difficult as back home we would trach him and ventilate him for a few months and then get him into rehab and his chance of survival would be reasonable. Here the decision was made not to intubate as the likely hood of him surviving our ICU care for a prolonged period of time (high likelihood of VAP, bed sores, other nosocomial infections etc) the fact that he also was immune-suppressed made this highly likely. We were also wary of giving him a ventilator for months – we only have 3 and if one patient ties one up for such a length of time then we are in trouble.

I have also been asked to update on the quadruplets born after Christmas – I am sorry to say they are now the quad-triplets, we lost one of the girls a few weeks ago, the other 2 girls were also battling some infections but appear to be getting stronger. The little boy is doing fine (strange, as girl neonates tend to do better than boys). Please continue to pray for these babies as well as all the other patients in the hospital.

I was hoping to add some pictures to this post but I am having some difficulties with internet so next time.

2 comments:

  1. Habari Annette,
    you are having a very interesting blog and you are surely doing a wonderful work at Tenwek! From your last post I saw that you seem to currently be in Kijabe. I have been to Kijabe in the past as well and I have delt with teaching about ventilators there. I am a Paediatrician, working for the last 3 years in a PICU/NICU. What are the 3 ventilators you have at Tenwek? Which of them do you prefer to use for neonates? Do you monitor CO2 at Tenwek or do you even have a blood gas machine there?If you had a Servo 900 C, I could send you an English manual for it. At some of the Servo 900 in Kijabe, attached is a fast track guide for the different modes (a laminated 2 page paper). Together with Steve L. I have also written a short introduction for the Servo 900 which I also could send you if you were interested. Another good person to ask at Kijabe is Burton L, an adult Intensivist and Pulmonologist. Should you be interested in me sending you he material, just send me your email or ask the above 2 people in Kijabe, they also have my email adress and they could give it to you. May the Lord bless you and the work you are doing at Tenwek and also guide your way when you prepare for going back to Canada!
    Blessings, Holger

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  2. So much to process in such a short time. I am sure this experience will remain with you for the rest of your life. I hope that you can be at peace with leaving, knowing that God holds your future in His hands.

    Such difficult choices to make in the hospital in Tenwek; this will also cause some reflection and possibly frustration when you return - we (in this culture) are more apt to waste because we are not in want.

    Thanks for sharing your journey. Peace to you as you savour and suck the marrow out of these last few weeks.

    spot

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