Thursday, April 24, 2014

One day

So since coming back from Cameroon I have been busy.  I was only back for a week and a half before I left to the coast for the missions annual retreat. A time of spiritual encouragement and meetings. Even though I had just been back for a short time, the time away was much needed as the hospital was very busy for that week and a half. Now retreat is done and I am back at Tenwek. Since December my life has been busy with one event after another, Trip to Lodwar, friends' visit, family visit, Cameroon and then retreat. It was a very enjoyable albeit busy few months. Now things are back to normal, and it is different not to finish one thing and immediately start preparing for the next.
I have been busy at the hospital. Here is just how one day last week went.
7am – meet in ICU to start surgical rounds, however miss rounds as asked to see patient who is hypoxic. Go see said patient and start him on biPAP.
7:30 – Join medical rounds.
8:00 – decide to check on bipap patient before heading to devotions, get distracted by very loud flow meter and go into medical ward. See that they are coding patient and help out.
8:30 – code is done, it did not go well, head up to devotions.
8:40 – get called to another code in the same ward, code said patient. Again unsuccessful.
9:30-11:00 – Check on ICU/HDU patients, enjoy some chai.
11:00 – while seeing an asthmatic in casualty a patient comes in with a swollen neck and difficulty  breathing. Observe him and help rally the troops so we can get him in the OR to put a tube in. 
1:00 – patient has tube in so I go for lunch.
2:00 – patient is out of theater and we are suspecting anthrax. Settle him in HDU and explain to the nurses how his tube needs to stay in.
3:00 – look for patient I was supposed to do spriometry on, can’t figure out what patient it is as the computer charting system is down.
3:30 sit down with nursing students who attended code this morning.
3:45 get paged out of debriefing session as a peds patient has arrived from other hospital, intubated as he has some sort of airway burns.
4:15 get called in casualty that anthrax patient woke up and pulled out his tube, yes the tube that was hard to put in and really needed to stay. Grab some staff from casualty and go to HDU – thankfully, anesthesia manages to get tube in again.
5:15 return to casualty and discover that the 2 year old managed to take out his tube, he is having trouble breathing, we struggle to re-intubate as he is awake and the drugs we are giving him to sleep are not working.
7:00 after anesthesia, with some propofol, comes and gets the tube in we get the patient settled in ICU. He is on my new vent the Servo 300 and I explain to the staff how the machine works
7:35 run home, change and grab stuff for bible study.
7:45-10:00 attend a great bible study with the interns here, we talk about our attitude and being humble.
10:00 come home, realize I forgot to turn on the hot water heater so kill time for 30 min so I can take a hot shower.
10:45 – Go to bed.
11:00 – pager goes off, the nurses are having trouble with one of the vents. Go back to the hospital get the vent working get the patient settled and happy.
12:00 – Go to bed, again. This time I was able to stay in bed until 7am when it was time to go for another day.

So that is just a taste of what life is like. Some days are crazy like the one I just shared others are a lot more calm.  Please say a prayer for us at Tenwek the next two weeks as many of the long term doctors are going to a conference and the hospital will be covered by a few of us here, some recently graduated doctors and visting doctors from the USA. I fear my next few weeks will keep  getting busier.

Saturday, April 12, 2014

God's Timing

I have been back from Cameroon for a few weeks now. A week and a half after I got back I took off to the coast with most of the other Tenwek missionaries for a retreat, a time of rest and spiritual renewal. I will write about life back at Tenwek soon but first I want to share with you some more about my time in Cameroon.

I was thankful for the three weeks I spent at Mbingo. It was good to get to know the staff there and help out where I could as they do not yet have an ICU and ventilators operating. I was able to bring them a bipap machine. A bipap machine gives pressure via a mask to help patients oxygenate better and make their breathing easier. During my time at Mbingo, there were two ladies who probably would not have survived if they had not been able to use that machine.

I heard about the first patient over supper from the OB doctor.  He talked about a lady who was about to deliver. This mom has a heart defect that is so bad she developed something called Eisenminger Syndrome. Delivering a baby with this condition has a 50% chance of mortality for the mother. When I heard about this lady my first question was – does she know The Lord? That evening before her c-section she accepted Christ as her saviour. The next day the OB team delivered the baby who was thankfully healthy. Mom did OK for the first few days but after about a week she developed massive pulmonary edema.  We were able to help her breathing with the bipap giving medications time to work. She was on the bipap for a few days and was than able to go home to her family. She still has heart and lung problems but hopefully she will be able to be a mother for her children for a few more years. I am thankful that this lady was given life both in Christ and here on earth.

The second lady went on the bipap machine two hours after the first lady came off. I had not yet packed it away as I was not sure if the first patient would still need it. However, the second patient was also in severe pulmonary edema. Her kidneys had shut down and she had not made urine for a few days. Her blood pressure was extremely high and the extra fluid was flooding her lungs. I placed her on the bipap and shewas immediately  breathing  easier. The machine kept her alive long enough so we could get some fluid off, her blood pressure improved  and her lungs stopped flooding. By morning she was smiling and feeling better. I pray her kidneys start to work on their own.

I find God’s timing amazing, had these ladies come in a few weeks earlier they would probably have not survived. I was bringing in a machine that they had not used before, I had the opportunity to show it to the nursing students I was teaching and then I had the opportunity  to show how well the machine can work. As uncomfortable as the mask and machine sound and feel to a healthy individual we all saw first hand how a sick patient welcomes the assistance that the machine gave.
Practicing putting the bipap on, I made a good patient. 

The Bipap at work