Sunday, 23 August 2009
Death.
Yesterday, I had another pregnant patient with a dead baby. I had seen here a couple of weeks before. Her pressure was up a that time but came down to normal before she left. Otherwise, everything was normal and the baby looked fine on ultrasound. Yesterday, she said that she hadn't felt the baby move in about a weeks. The ultrasound showed a 30 week fetus--with no heartbeat. I discussed her options with her and she decided to go home in hope that she would have a spontaneous miscarriage. To make things worse, she came alone that day and her husband was in the U.S. for four more months and she only had limited phone contact with him. She asked "Why does this happen?" I explained to her a few possibilities but I stressed that most of the time, we never know. She had had two other miscarriages but also has six other healthy children. Areli and I prayed for her and she was on her way.
At the same time that I was examining her, one of the other providers asked my opinion about another patient. The story was very limited and this was the first time we had seen him. Apparently, he had gone to Guatemala City for studies and such and was told he had prostate cancer in its "end stage." He came to the clinic because he had just gone to the local health center to have his urinary catheter changed, as instructed by his doctor in Guatemala City, but they were unable to do it. The nurse who was attending him at our clinic wasn't able to get one in either. The ultrasound showed that he had a full bladder, which means he was not able to drain urine and if it didn't come out soon, he would begin to have renal failure. He also was in a lot of pain. I explained to his daughter the situation and his options. She was very appreciative for the help and decided to take him to the closest hospital (about two hours from the clinic) to see if they could help him.
These are a couple of the sad cases--not to mention a baby with hydrocephalus (a large head due to the brain fluid not draining) and a 30 year old lady who has been in a wheelchair for the past seven years after some type of severe infection. Some of this stuff might have been treated more successfully or even been prevented in the U.S. or another country with more resources. But only God knows. If the face of disease and death, one is reminded that the most important thing in this world is eternal life, and that our time here is not long.
Life.
Our predecessor Dr. Heidi Bell was here for a week operating. I went to see her on Tuesday and scrubbed in for a case. It had been over two years since I had scrubbed in for a surgery. A lady had a good sized ovarian mass which needed to come out. And it did. I think surgery is cool sometimes because you can often solve a problem quickly and see the results in front of you--in this case a huge ovarian mass and a little bitty uterus. Sometimes that is more fun than trying to control diabetes with pills and trying to get someone to actually change their diet and health habits. Anyway, Heidi and the resident that came with her got a lot of surgeries done last week and a lot of women's lives will be a lot happier because of them.
Enough medicine. Today at our church, we had all of the people from our congregation along with the the church plants in two towns called Joyabaj and Chajbal. God has been blessing these outreaches. Since the new year, the Joyabaj group has grown from 0 to about 25 people--many of whom are teenagers. Areli and I have not yet directly been involved with these outreaches. But the pastor has mentioned the possibility of us helping out with evangelistic drama and music in the future if God gives us the time.
Well enough for now. There is more and more pictures to come. God is always good to us, but we've seen Him doing a lot of extra special stuff during the past couple of weeks.