Sunday, June 22, 2014

June greetings from Nyankunde

June 22, 2014
Pregnancy Progresses

June is coming to a close and I am one month closer to giving birth, now 32weeks gestation.  With each passing day the baby seems to be getting bigger and stronger and making its’ presence known.  It’s amazing the little things you can know about a baby before birth, like their sensitivity to noise.  I spend my mornings rounding on kids in the hospital and any time a child cries, the little one in my womb turns and kicks.  It seems more aware of its’ surroundings.  When I am quiet, the baby is the most active…but on busy days the womb is quieter. 
Do you see the hand?

I am thankful for this pregnancy period and the time to prepare for this major life change.  This past week I painted the nursery on my day off…not sure if this is nesting behavior or not.  We have the benefit of having inherited many baby items.  Decorating the nursery will take some creativity.  We were able to bring many baby items with us to Congo 2 years ago such as a stroller, crib, changing table, rocking chair, mobile, clothing/bedding, etc.  At the time it seemed like advance planning, but now I am very thankful to have these items.  We are having a mahogany cradle made by a charming gentleman in our village named Machine.  Warren and I have been thinking about how fun it would be to design and make wooden toys…so stay tuned for this possible side hobby.

I find myself wondering more and more what this little one will be like, look like, etc.  I am looking forward to the coming chapter of motherhood and less clinical duties. 

Clinical Challenges
Speaking of clinical duties/challenges, these past few weeks I have been caring for two children with
A special patient following treatment for a jaw tumor
varied degrees of right heart failure from malformed heart valves.  Patients that would normally be referred to a specialist in the US and require expensive tests (cardiac catheterization, MRIs, echos) simply walk in the door here.  They usually come with incomplete records, an obscure history, and a complete ignorance of what medications they have been on….a table rasa.  Over the past 1.5years, I find myself doing cardiac echos on a weekly basis and slowly but surely improving my skills at performing and interpreting this test. 

Two weeks ago, a young girl came in with a large heart, dizziness, and shortness of breath.  I immediately did an echocardiogram, confirmed that she was in cardiac tamponade and needed a drain to be placed immediately to drain this fluid.  Her heart anatomy was so distorted that I could barely find her left ventricle.  She had such a large fluid accumulation around her heart (a pericardial effusion) that it was causing severe cardiac dysfunction.  With Warren’s help, I placed my first pericardial drain.  Her breathing improved immediately and she felt better.  Over the last 2 weeks we have been trying to better characterize her valve problem and manage her heart failure.  Our hospital is the closest referral center from their home 150km away, so it looks like I will be her long-standing “fill-in cardiologist.”  At what point do I send her home, knowing the risks of this fluid accumulating around her heart again?    What guidance for home do I give? I can confidently say is that she cannot carry 25L jerry cans of water on her head anymore!  I can also give practical dietary advice for avoiding anemia and to come to a hospital not a health center when she is sick with fever.  This is just a sample of one of the complex patients I am faced with everyday. 

A quick story from our malnutrition program here at Nyankunde.  About 2.5months ago a mother and
The twins, their mother and grandmother
her twins were evacuated from their home by our Samaritan’s Purse team in a state of severe malnutrition.  The mother was so weak that she had to be carried to the road.  They have been recovering in the hospital for the last few months, the babies steadily gaining weight and learning how to eat solid foods.  The mother now has the strength to work again and the courage to try again.  It is difficult to understand how someone can become so severely malnourished, but we are grateful that they are recovering.  The real work begins now as they return home to farm the fields and rebuild their lives.  It is very difficult for women to make it in this culture without a male head of household.  It seems that so much of the poverty we see is related to the lack of social support in the nuclear family.  Pray for this family as they return to their home.
Nurse Bora, twins and their family, and Rachel a maternal/child health expert with Samaritan's Purse

The nutritional program continues to expand.  We have an average of 16-20 patients at any given
Our stock of F100 and F75
time.  Just keeping up with the hours of food preparation and distribution is a full-time job.  I am realizing what a unique opportunity it is to build a rapport with these mothers and minister to their spiritual needs.

Prayer Requests
1)   Strength and rest for this last trimester of pregnancy. 
2)   For renewal in the church and family, for men to rise up as leaders of their households.
3)   For Lindsey as she wants to minister to the spiritual needs of mothers and children in the malnutrition program.  The needs are endless, but God can provide for their needs and we are part of that.
4)   It is mango season here in Congo, please pray for less injuries and an awareness of the dangers of tree climbing.

A special visitor to our home, Ed Densham

From Warren

Yes, pregnancy has been hard on me too.  The mood swings, the cravings, the fatigue and general irritability!  I've experienced it all.  I've been eating plenty of cookies in order to sympathize with the weight gain.  In a short while it will all be over and life will be back to normal again!  At least this is what I tell myself.  I suspect the reality will be somewhat different.  Fortunately for me the gender roles here in Congo are strict and well-defined.  The woman is pretty much expected to do all the work.  

Things are going well.  I continue to struggle with my series of surgical nightmares, but I promised myself I wouldn't mention any gory details.  Besides that I keep myself busy gardening, riding my motorcycle, running, and playing an addictive game on the Ipad called "Threes".  Let the reader beware, do NOT under ANY circumstances download this game.  Your life productivity will take a serious hit.  

Thanks for your interest and your prayers.  We appreciate it!

My little friend helped me to write this post!

No comments:

Post a Comment