Day three-ish

It is now Thursday morning (12am) and I'm on my third night shift so far. We've seen two more patients come and go on to the wards. Yesterday's patients were Lilian and Agnus. They, like Dorothy and Peris, were mitral valve replacements. That seems to be the trend right now. 20-30year old females with On-X valves placed...and they have all done so well! Agnus and Lilian were already to the ward when I got back to work tonight at 7pm. I went to see them, and my main girl Peris, in the HDU (high dependency unit) a couple hours ago. They were all awake and smiling. Agnus was concerned mostly with taking a shower. Today we had three cases. Chepkorir, Julia, and Diam Tolosa. Just like the other Chepkorir and Julia had MV replacements and are doing well. Everytime Julia wakes up she asks what time it is. She always thinks that it should be the next day when she wakes up from dozing off so I'm excited for her to wake up again b/c I can tell her IT'S TOMORROW! There are three things the patients say when they wake up. 1) thank you 2) wata (water) 3) how is my heart? Several of them are very curious about it and everytime something beeps, or even when sweet Chepkorir threw up, they ask "is my heart ok?" I thank God I can say "yes! it's better than ever!" Yesterday Peris could start to hear the click of her new valve. She was concerned something was wrong but I reassured her it was ok and it just meant it was working well! 

Our third patient today is Diam aka Obo Tolosa, a refugee (since 1989) from Ethiopia. He's a bit of a special case. He's a 40 yo male who was diagnosed with TB in 2000. Over the last 8 years he began developing a cough, shortness of breath, orthopnea, fatigue, abdominal and facial swelling, and he was recently admitted to a hospital with pleural effusions. They found he had Tb pericarditis with constrictive pericarditis. Dr. Galat and Dr. White did a pericardiectomy where they remove part or most of the pericardium (the sac around the heart). They said it was extremely thick, and calcified, like a rock. Since his surgery he's doing great and says he can already breathe better! I think he's the sweetest man! Every time I go to check on him I say "Huko sawa?" meaning "are you ok?" and he holds my hands, smiles, and responds "Niko sawa!" meaning "I am ok!" It seems like a simple conversation but it means a lot to me. 

Today, while I was sleeping, there was a big storm that came through. I woke up to find out the power and oxygen had gone out at the hospital. It wasn't for very long but the nurses had to manually bag the patients and the perfusionists in the OR had to hand crank the bypass machines. That's always a little scary! Fortunately, everything was okay and no patients were harmed! Just another reminder of how little control we really have.  

The storm clouds from today.

Tomorrow I'll sleep until around 1:00 then wake up to come back to the hospital and work from 3-10pm. I feel like I haven't seen Kari and Nez very much because we've been on opposite shifts so I'm looking forward to seeing them tomorrow! 

Everyday we do a small bible study between shifts and our Kenyan nurses join us. Over the last couple days they've heard us discussing Hurricane Sandy and reading about all the devastation online. Today when we asked Cynthia, one of our Kenyan nurses, if she had any prayer requests she said "the storm at your home. Do you know if everyone is ok?" I thought that was sweet and worth sharing. Know that we are all praying for you as you pray for us! MUCH LOVE!!

The OR!

Peris playing on facebook!

Tenwek Day One-ish

Jambo! It's been such a long few days I'm not sure where to begin. A group of us left the US on Friday and arrived here at Tenwek on Sunday 1600 local time. Kari and I went from Nashville to Minneapolis where we saw Luke one of the anesthesiologists we know from last year. From there we flew to Amsterdam where we reconnected with Amy and Sarah, and also met up with Mike (peds cardiologisy), John Galat (Adult CT surgeon), Malik (peds anesthetist), and Jenny Boyd (peds intensivist from UNC). We had an eight hour lay-over in Amsterdam so Sarah, Amy, Kari, and myself set out to find the Anne Frank Museum. After about 2.5 hrs of looking and asking several different people for directions, all of which consisted of "just go straight down that way." We eventually saw a huge line of people and went that direction. It's pretty fascinating. I was surprised how big the "house" actually was at first. Then I saw where Anne and the other 8 people actually stayed. There were tiny, narrow, steep staircases hidden behind a book case that led up to two tiny bed rooms and a living room/kitchen/bed room. Anyway, kind of hard to picture without going. I'd recommend a trip there for sure. After that we booked it back to the airport via train and hopped on our plane to Nairobi. Once we landed we packed 3 big rovers full of our bags and ourselves and set out for Tenwek. It was a super long drive, and it's still unclear to me why we stopped so many times, but we arrived safely!

My family came to see me off! Just missing Graham (Already got to facetime her tho :)

Jenny, Nez and I found some time to go for a little walk!

Our first mission was to set up and organize the ICU. Nez and Tom had set up a lot beforehand b/c they came earlier so we didn't have a ton to do; I was thankful for that! After that we showered, ate dinner, and had a meeting to discuss the week. Sarah, Amy, Kari and I were pretty pooped from the lack of sleep so we all (Nez included) went back to our living area. We spent some time together in the living room and talked. Amy and I started on a 1,000 piece puzzle. We are determined to finish it.

 Taking a second to chit chat while setting up!

 Our first patient, Dorothy, getting back from the ICU.

As I was walking to lunch I heard a little voice singing....I found him!

Today we had two surgeries. Dorothy is a 24 year old mother from Kapsowar who needed a mitral valve replacement. She is already awake and talking and doing awesome! Our second patient is Peris, she's 24 years old. Peris is my new bestie and I already know her life story...which is certainly touching. She got a mitral valve replacement today. She told me she has been feeling sick for several years and had been to several doctors. They did many X-rays and would not tell her anything; they'd send her home with different medicines. Finally, after worsening symptoms like coughing, edema, chest pain, shortness of breath, and the inability to work she went back to the doctor. The Xray showed and enlarged heart and a "spot" on her lungs so for 6 months she was treated for TB. It also showed something wrong with the electral acitivty in her heart (which I'm thinking was a-fib). She did not get better and used all her money on medicine. Her husband began drinking alcohol and became "violent" with her. After 6months she took her son and left and found a family willing to house them. She began prostituting herself to have the money for her medicine but eventually ran out. It was then that she met a man who was in charge of an organization that helped children pay for their medicine and medical bills so he began paying for hers. It's unclear to me when but after that she got another Xray and this doctor said it was her heart and she needed an echo done. The man who had been supporting her knew about our mission at Tenwek so he brought her, as well as some others, here. We have seen several patients in clinic but Peris was one of the ones sick enough to require surgery now. She said she had the surgery for her son so that she can save money from buying all the medicines to buy him a bicycle! How badly I wanted to say "We brought one!!" but I couldn't, so I'll send her with a soccer ball(way more fun in my opinion). Five hours after surgery Peris wanted to sit up in a chair so she's currently sitting up asleep in her chair but I don't have the heart to wake her up. She's a sweet girl with a sweet smile.

Tomorrow will bring two, possibly three, more cases. We are focusing on valves this week; mostly just Mitral and Aortic valves. We have a few patients this week that are very very sick. One we will do on Wed morning and another one on Thursday. I'll keep you posted on them but I know the team is anticipating some more difficult cases coming up. The goal is to do more complex repairs now so that when we are away the Tenwek team can do the simple repairs.

Anyway, that's alot! But it's been a long few days. Between our shifts we have started doing short devotionals and including the Tenwek nurses. We have some specific prayer requests that I'd love to pass along! Our ventilators, though we now have many, still are not working. With much sicker patients coming up in the week we NEED working ventilators. As always, pray for oxygen and a lot of it! So far, no shortage of oxygen alarms have sounded tonight. Pray for Amy as she is having an RA flair up, especially in her hips. I can't imagine doing all this while in pain. Pray for our patients obviously; as Russ says, don't just pay for their heart, but their soul. Also, pray for our Tenwek nurses as they learn something totally new! Tonight we have Aaron and Cynthia. They're AWESOME!

Thanks for the love and prayers, I hope you're not having a bad case of the mondays. good news for you is...monday night football!! Hoping Andre Roberts has a big game so I can defeat Emelyn(don't think for a minute I'm not following my team). Love yall!!