After a few minor bumps in the road over the last day and a half, we were relieved to see a clean wound during the dressing change today. With no evidence of infection, we believe it is finally on its way to healing!

Today we tried a different combination of sedating medications and Mike seems to have tolerated that better. The medication we used is sometimes called “truth serum” so of course while Mike was waking up from anesthesia we tried to get some good information from him. Turns out that his favorite disney princess is Cinderella and he truly believes that his buddy Josh  has better basketball skills then his own.

Mike has had some unexplainable hypoglycemia, even dropping down to 39 overnight. I am keeping a close eye on him and I have some dextrose IV solution ready and waiting in case we need it. Please continue to pray for the healing of the wound and for this hypoglycemia to go away. We are thankful for more good news today and believing that he is on his way to complete healing!

When all of your friends are doctors, you have a party in the waiting room before your procedure.

When all of your friends are doctors, you have a party in the waiting room before your procedure.

 

Thorn in the Flesh (not literally)

Viewer discretion advised, one photo is of the procedure.

About four weeks ago Mike started having pain in the ball of his foot. We did an X-ray and didn’t find anything. It finally got bad enough that we asked our surgeon to take a look. He advised that an I&D (incision and drainage) be done, which happened the next day. Our surgeon drained pus and cleaned the wound, then started Mike on his second round of antibiotics.
After the initial I&D the wound remained really painful. Mike was on crutches for a few days and then hobbled around after that. A week later we took a weekend trip to Lodengo where Mike had to spend almost an entire day helping to dig a new road through a river bed to help a truck full of food supplies get to the school in Lodengo. When we got home the foot got worse. Our surgeon decided that he would need to open it up and explore the wound. So about a week and a half after the initial I&D Mike was given an ankle block for anesthesia plus some local anesthesia and the wound was opened and explored. Nothing interesting was found, but the wound was washed out. It remained painful and three days after that procedure we discovered obvious infection inside when doing a dressing change.
So, yesterday Mike received conscious sedation and underwent further debridement of the wound. After excising all the dead or infected tissue the surgeon decided it was safest to open the deep wound all the way through the top of the foot. Mike now has a tunnel starting with the wound on the ball of his foot extending through the top of his foot between his second and third toes.
Watching Mike wake up after propofol was a hoot! He was just so thankful for our anesthesiologist! I have a video for future bribery!
Since the surgery yesterday Mike has been resting at home. His pain is under control and he’s receiving IV antibiotics. He has even learned to push his own IV medications! The plan is for every other day dressing changes that will require sedation.
Please pray for healing of this wound and for no more complications to arise. We are believing God will restore this active man to full health!

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Dressing Change. (Not crying, just wiping eye!)

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During latest procedure.

Girls watching Dad inject IV antibiotics

Girls watching Dad inject IV antibiotics

The month of May has been an awful one in our New Born Unit. In the past three weeks I have lost five precious premature patients. All of them born too early, all with the complications of prematurity, all needing more advanced care than we can offer, and most of them leaving behind heartbroken mamas.

I recently was having a conversation with my cousin about sometimes feeling overwhelmed; feeling like I lose more patients than I save. The truth is, I can’t save anyone. I can only treat and the rest is up to God. I have learned not to question His authority or His plan. This week as I watched a seemingly perfect little angel slip out of this world I had to remind myself that God’s plans are always greater than my own. While I may question in my mind why God didn’t heal these babies, I have to consider that maybe the truth is that He gave them complete healing and restoration in heaven.

Please pray for our NBU, for the two patients remaining. For our nurses who have seen heartbreak after heartbreak. Pray for wisdom for myself and our social workers in making decisions about a complicated case. Pray that the love of Christ will show through our words and our actions, that each of these five mothers will feel peace from above as they mourn the loss of their littles.

Born at 24 weeks gestation and only 680 grams, this little fighter survived nearly 48 hours before the struggle to breathe became too much for him to handle. He was the second twin, the bigger of the two. His sister passed away within hours of birth. Please pray for their mama.

Born at 24 weeks gestation and only 680 grams, this little fighter survived nearly 48 hours before the struggle to breathe became too much for him to handle. He was the second twin, the bigger of the two. His sister passed away within hours of birth. Please pray for their mama.

I miss the rains down in Africa

The “city” water system in Kapsowar is a 4 inch diameter metal pipe that runs 13 kilometers from the hospital to a mud hole in the forest. In the last 2 kilometers before reaching the hospital the line is tapped 42 times by various people living in the community who also need water. To say the system is flawed is an understatement. In fact, the system is even flawed by Kenyan standards. During our last drought the hospital was forced to drive an ambulance to the river to fill buckets of water to use for cleaning and cooking. A newspaper caught wind of this and printed an article trying to motivate politicians to do something about the water situation at the hospital. Unfortunately we have yet to see any improvements.
So now we find ourselves in the middle of rainy season, with no water. Last year Mike installed a rain water harvesting unit, and life has been easier since. Unfortunately this week our tank was mismanaged and completely drained overnight. We woke up the next morning with no water in our house, no water in the city line, and no water in our rain tank. Bummer! We taught Layla and Evelyn a simple rain dance (just kidding) and prayed for rain to fill our tank again. That night it rained (this is rainy season) and we literally stopped to thank God.
That night I was reminded of my selfishness. My prayers for water surround my personal needs to wash my hands, flush my toilet, and cook for my family. Think about the people, especially children, who die each day because of their lack of access to clean water. I remember to pray when I am directly affected but so often I forget my neighbors when my own needs are met. It’s like my eyes are shielded to the hurting world that is literally right outside my door. As my heart was convicted of this truth, I was reminded to pray for all of those suffering, even tonight, because of a lack of water. For my neighbors in the valley who give their babies dirty water to drink because that’s all they have, knowing it will make their little ones sick. For the mamas right now who are holding dehydrated babies with diarrhea, debating if they should spend precious resources on medical care or wait it out another day. For all of them, I am reminded to pray. Lord help them.

My husband is a genius; here's the rain water gutters and tank.

My husband is a genius; here’s the rain water gutters and tank.

The Blink of an Eye

This morning I was reminded that at any point in time, even in a matter of seconds, my day could change, my week could change or even my life could change. As I write this in the comfort of my own home knowing that my four littles are sleeping soundly I am truly in awe of God and his provision. 

Shortly after I left for work this morning, while Mike was home with the kids, Oscar had a seizure. He has never had a seizure before, and this one came completely out of the blue. Not knowing what else to do Mike scooped him up and ran him to the hospital. The seizure lasted about two minutes, until about the exact time he reached me. When I saw Mike running towards me I knew something was wrong. As he passed Oscar’s limp body to me my doctor brain took over. Within a few short minutes Oscar’s breathing rate became normal and he started to fight off the crowd of people prodding and poking him from every angle. Other than being sleepy and confused, his exam was normal. He was clearly post-ictal with confusion, drooling, shivering, and drowsiness. When we quit poking him he fell asleep. 

His lab work up was normal. Other than being sleepy his exam was normal. However, because of the way that Mike described the seizure and because he had fallen and hit his head this morning we decided to drive to the city two hours away to get a CT of his head. The fall happened about an hour before the seizure. He was sitting on the floor with Evelyn and the two of them started fighting over a toy. Oscar got angry and threw his head back, hitting it on the floor. He cried right away and was easily consolable. Honestly the fall wasn’t any worse than other falls that he has taken; he’s a two year old boy! 

To complicate matters the medication most commonly used to stop seizures, diazepam, is out of stock in nearly all of Kenya! A drive to the city would also get us a chance to look for diazepam to have on hand in case we would need it. All these factors combined, we packed up Oscar and made the trip. The CT was surprisingly quick and painless, and only cost us $45 I might add. By the time the CT was done Oscar was running around like his normal self. The radiologist read the CT as normal, and by my limited radiological skills I would agree with that. However, just to confuse us all the radiologist wrote “Normal head CT. Advise MRI”. With a quick consult with the rest of the docs in Kapsowar, we decided to stop at the CT and monitor for any further seizures.

On our way out of the hospital I stopped by the pharmacy and asked about the diazepam situation. The pharmacist informed me that they had it in stock but that I would need to see one of their doctors to get a script. I explained that I have a Kenyan medical license and I could write the script myself. She disappeared and came back with the boss. He looked at me and reluctantly said I could have one vial. So after paying a whopping 80 cents for a vial of diazepam, we were on our way back to Kapsowar.
Tonight Oscar is pretty much his normal self. We will be keeping a very close eye on him and praying that the seizure does not return! Should he have another seizure we will return to the city for an MRI and EEG. But I am praying and believing that won’t be necessary! Days like this make me even more thankful for the blessings that I receive in abundance from the giver of all good and perfect gifts! 

Good News

We received word this morning that our application for work permits has been reviewed and we have been approved for two years! We all let out a sigh of relief. This is such great news and is definitely an answer to prayer!

We want to thank you all for praying for us and supporting us through this fiasco. It’s been a long week and I am thankful we can rest easy this weekend! 

Another 30 Days

Just as planned we spent our morning at the department of immigration. Unfortunately we were not given work permits. Our passports were stamped, giving us 30 days to complete the process of getting work permits. We were told that the permit applications are reviewed on Thursdays. Ours will be reviewed this Thursday and hopefully we will have work permits on Friday. 

This isn’t what we were hoping for, but it’s better than our Plan B! We are thankful for the gracious extension, and thankful that our kids endured the long day so well! Now for some American pizza to celebrate….to Dominos we go!