Wednesday, October 26, 2011

I never though I would be happy about getting breast implants

...let me explain. 

Answer to first question no I have not upgraded, I am fine with the ones God gave me. 
Answer to the second question, they were donated. 

Amy Russell Lindsey, our volunteer coordinator told me that we had breast implants donated to the hospital---------------(pause)----------(silence continues)------(exclamation)---what the MESS... why, why would someone donate breast implants to a hospital in a post disaster situation. That was something I could not wrap my head around, that is until we realized that breast implants make a great gel pillow for our babies in the NICU.

Now I am proud to say we are happy about getting breast implants... well.. you know what I mean.

Thursday, October 6, 2011

The Lesson I Learned from Steve Job

Two weeks ago I thought about death; if I died what was my contribution, what issues have I not resolved, who do I need to forgive, who do I need to ask for forgiveness, have I told those that I love that I love them, am I living a life of impact or am I just living. Today I am still thinking about death… well…really I am thinking about life. Although Steve Jobs died yesterday his words, his impact continues.

Two weeks ago Karla Hernandez , Vanessa Castro, Sara Lary, Beth Kuntz and I were on our way to Cap-Haitian to hold medical clinics with Dr. Barbie. We left the hospital in Diquini Haiti at around 7:30am headed to the small airport for an 11:45am flight to Cap-Haitian. When we arrived at the airport the airline overbooked the flight and told us that we would leave on the 1:45pm flight.  After waiting for hours at the airport the ticketing agent came to me around 12pm to tell me that the plane leaving Cap-Haitian had some technical difficulties and they would not be able to fix it in time for our flight, they placed us on the 3:45 flight, this time giving us our boarding pass … so again waited. We started to joke that we should have taken the other airline Salsa Air instead of Tortuga air. Salsa air flight was on time, no delays and Tortuga air…well… let’s just say it was slow.

Around 2pm Vanessa asked if we could switch to Salsa air but we decided to wait to see what would happen with our flight. At 3:30 the sky became slightly overcast, Salsa air took off and finally we boarded the 20 passenger Tortuga air flight. The flight to Cap-Haitian usually last 15 min, but this flight took 1hour. Half way through the flight I saw the co-captain looked back to at the passengers; I smiled at him (and no I was not flirting), Heather turned to me to ask if I knew why we were circling the airport (the Citadel was in site), at the same time the co-pilot turned to look at the passengers again, it is at that time I began praying even more if possible, for wisdom for the pilot. 1hour after we took off we landed safely but not in Cap-Haitian as we planned but back in Port-au-Prince were we started. After applauding for the pilots and giving them our thanks they informed us that the weather was so bad that they could not land. The pilot circled several times but decided that he did not want to take the chance so he returned. At the same time he informed us that they have not heard from the Salsa air that took off ahead of us. 10 minutes after returning back to the terminal (amidst some angry protest from other passengers) we were informed that there were unconfirmed reports that the Salsa air flight went down. Our group thanked God that we were safe and prayed for the families of the passengers and crew of the Salsa air flight. Shaking we returned back to the hospital in Diquini and notified Barbie that we would not be going that day.

I prayed long and hard if we should try for the next day, and if God did not want us to go that one more thing would happen. The next day we prayed and left the hospital at 5:30 am to head to the Airport (Tortuga air made a special flight for us to Cap-Haitian). As soon as we got off the plane we were told that patients had been waiting since 5 am for clinic to start, so we ate then headed to clinic, we saw about 300 patients in two days.
Why am I writing this? It is not to boast about clinic, it is only to give you insight to what I have been thinking about for two weeks.  That day made me think a lot about death, today Steve Jobs made me think a lot about life, and how I am living it. Read this excerpt from his Stanford commencement speech, see for yourself what he has to say about life and death, but focus on life… I know I am…
Excerpts from Steve Jobs Stanford
"If you live each day as if it was your last, someday you'll most certainly be right." ... I have looked in the mirror every morning and asked myself, "If today were the last day of my life, would I want to do what I am about to do today?" And whenever the answer has been "no" for too many days in a row, I know I need to change something. Remembering that I'll be dead soon is the most important thing I've ever encountered to help me make the big choices in life, because almost everything--all external expectations, all pride, all fear of embarrassment or failure--these things just fall away in the face of death, leaving only what is truly important. Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. You are already naked. There is no reason not to follow your heart.
About a year ago, I was diagnosed with cancer. I had a scan at 7:30 in the morning and it clearly showed a tumor on my pancreas. I didn't even know what a pancreas was. The doctors told me this was almost certainly a type of cancer that is incurable, and that I should expect to live no longer than three to six months. My doctor advised me to go home and get my affairs in order, which is doctors' code for "prepare to die." It means to try and tell your kids everything you thought you'd have the next ten years to tell them, in just a few months. It means to make sure that everything is buttoned up so that it will be as easy as possible for your family. It means to say your goodbyes.
I lived with that diagnosis all day. Later that evening I had a biopsy where they stuck an endoscope down my throat, through my stomach into my intestines, put a needle into my pancreas and got a few cells from the tumor. I was sedated but my wife, who was there, told me that when they viewed the cells under a microscope, the doctor started crying, because it turned out to be a very rare form of pancreatic cancer that is curable with surgery. I had the surgery and, thankfully, I am fine now.
This was the closest I've been to facing death, and I hope it's the closest I get for a few more decades. Having lived through it, I can now say this to you with a bit more certainty than when death was a useful but purely intellectual concept. No one wants to die, even people who want to go to Heaven don't want to die to get there, and yet, death is the destination we all share. No one has ever escaped it. And that is as it should be, because death is very likely the single best invention of life. It's life's change agent; it clears out the old to make way for the new. right now, the new is you. But someday, not too long from now, you will gradually become the old and be cleared away. Sorry to be so dramatic, but it's quite true. Your time is limited, so don't waste it living someone else's life. Don't be trapped by dogma, which is living with the results of other people's thinking. Don't let the noise of others' opinions drown out your own inner voice, heart and intuition. They somehow already know what you truly want to become. Everything else is secondary.

Patients waiting 

Sunday, June 19, 2011

30 and counting

No I am not talking about my age...

I am happy to announce that we have had 30 training sessions since January of this year.  Whoo hoo.  Most of our trainings have been centered around resuscitation.  We now have 6 nurses trained as BLS, PALS, and PEARS providers, and one nurse trained as a PEARS instructor and two volunteer staff members trained as BLS, PALS, and PEARS instructors.  I am hoping to have another PEARS, BLA, PALS training in August with another 6 staff members.

PEARS class
Sharrie Tall, helping out setting up for trainings.

And Two Were Added

Tuesday night a man came into the hospital asking for help for his newborn twins, a boy and a girl.  I had just finished recovering a patient in the PACU and though that my day was done...Oh little did I know.  Those that are in the hospital would appreciate this.  We know that there are two words that one never says, those words being equal to a curse word... yep you guessed it the Q word or the S word (quiet or slow).  Those two words can spell the end of a beautiful day or night.  Well here in Haiti since we actually live in the Hospital those two words should never ever be uttered... Apparently there is another word that should be added to the list "I'm done"  Never...Never say that word!!  Saying I am done indicates that you are asking for the craziness to start.  Ok...back to the story .

As I was leaving the PACU I began to talk to a friend of mine and decided to go to her house with her to pick up some clothes (she was the doctor on call for the night).  As we were leaving  to go with her to her house, no sooner were the words "I'm done for the night" out of my mouth when this man comes up in frantic but calm manner (hard to explain) saying that he needs help for his twin babies.  Apparently his wife went into premature labor gave birth at another hospital/clinic.  They stated that the hospital did not have an NICU to provide care or  a pediatrician available that could take care of the babies.  The hospital heard that we had an NICU ( which has been closed for over a month now until we can train our nurses), and we also don't have a pediatric physician at night nor could we call one in.  Seeing the mans face when we told him that we did not have physician there to take care of the twins broke my heart.  I began calling the other hospitals that had an NICU, either no one answered the phone, they were full or they did not have the personnel.

Dr. Spendie remembered that Dr. Regis had a maternal child clinic down the street so we went there to ask if the would accept the babies (by the way the family had no idea what heir gestational ages was, according to the dad, mom was either 6 or 7 months along).  So... off we went down the street to Dr. Regis's clinic... guys if you know Haiti crossing the street is like taking your life into own hands... anyways, when we arrived at the clinic we were able to call Dr. Regis at home as asked him if he would accept the babies.  Thank God he said yes (whoo, off the hook)... however only if we would admit them to our hospital (back on the hook :).

Dr. Spendie went to her house to change and I went back to the hospital to prepare the NICU for the babies.  I write this post in sort of a joking way but all through this I was praying and still am for the babies.  Our NICU has two incubators, neither one works.  They do not have mattresses, they do not hold any heat and the access ports do not have any coverings... essentially the incubators are empty shells.  We placed folded bed blankets to make a soft padding for their beds, a spot lamp that functions as a heat lamp when brought really close, and for coverings we tore a plastic bag and taped it over the ports.

About an hour later the babies arrived, the first one a boy, weigh 1.36 kg the second baby, a girl, weight .65 kg. Both babies arrived on oxygen at 2 liters via nasal cannula wrapped  like little mummies in cotton.  Both had increased work of breathing, the baby girl's temp was 35.6 C and she was pursing her lips blowing puffs of air out.

Dr. Regis was able to place an umbilical catheter in the baby girl so she could receive fluids while we were able to get a peripheral line in the little boy.  Since mom was still at the other hospital and dad was not around I decided to kangaroo the baby girl  (well a modified kangaroo) I had a T-shirt on. Her temp finally came up and her breathing began to stabilize .

On Thursday night  in the middle of bible study one of the nurse called me to the NICU the little boy began to have some problems breathing. His sats were in the low 50's I was able to use a bulb suction to do somewhat of a deep suction and remove some really thick secretions (Thank you Sinai/Rainbow team for thinking to bring them) .  After about an hour his breathing began stabilizing.  I had asked the nurse to call Dr. Regis to come in as soon as I came into the room when I noticed the baby's breathing... I have to officially say that he is now one of my favorite docs.... He came in less than 15 mins to assess the babies ( which in Haiti traffic is amazing).

It is now Sunday night and the babies are still holding on.  Please keep praying for them.

Monday, May 16, 2011

It Was The Best Of Times, It Was The Worst Of Times

Late post started 5/16/11 

It is 4am and we are still up.  That beginning alone should alert you as to the type of night that we are having.

The Best of Times: 

This past week has been a week full of celebrations. PULSE (Pediatric Universal Life Saving Effort) was here to provide a four day training course for the nurses and physicians at the Adventist hospital and the General hospital here in Haiti.  By the end of the training several of us were certified as BLS (Basic Life Support) instructors, PALS (Pediatric Advanced Life Support) instructors and PEARS (Pediatric Emergency Assessment Recognition and Stabilization) instructors, the others were certified as providers.  PULSE also donated several manikins to our training department so that we would be able to hold courses here at the Adventist hospital in Haiti, in addition they donated supplies for our NICU and Peds unit.  Needless to say I was speechless with joy (speechless is not something I do very well, ha ha).

This week we also celebrated the birthday of one of our local awesome docs, Spendie.  On Thursday we celebrated the birthday of Lynn our orthopedic coordinator, on Friday we celebrated Brian's birthday (a few day's earlier but hey), and today we finished the week at the beach for nurses appreciation week and the actual celebration of Brian's B-day... I told you there were a lot of celebrations.  Ok, back to the story.  It was an awesome fun relaxing day at the beach... then the fun ended.

The WORST of times: 

On our way back from the beach we came upon an accident.  We stopped to see if we could help but not much could be done.  Three people were dead on the road, another was in the ambulance with a head wound and several more were transported to a nearby hospital. I have seen death before, but I was not prepared for what we saw.  For some of the others in the car it was the first time that they saw death ( I pray that the image does not stay in their head).

Later that evening an orthopedic surgery a patient threw a pulmonary embolism, fortunate it was a small one.  He was started on anti-coagulation therapy and is doing well.

A few hours later a three day old infant in our NICU began having respiratory difficulty.  She is stable now...

Sorry for the brevity of the post, but as I started it at 4 am and we are still up... I am going to bed... ops.. I meant I was going to bed, just got a call off to NICU


Sunday, May 8, 2011

Another Example Of How A Soft Answer Turns Away Wrath

Judges 8:1-3

After the battle with the Midianites led by Gideon the men Ephraim became angry with Gideon for not including them when the battle started with the Midianites. NET) Judges 8:1 The Ephraimites said to him, "Why have you done such a thing to us? You did not summon us when you went to fight the Midianites!" They argued vehemently with him.

Gideon answered softly

Judges 8:2 He said to them, "Now what have I accomplished compared to you? Even Ephraim's leftover grapes are better quality than Abiezer's harvest! It was to you that God handed over the Midianite generals, Oreb and Zeeb! What did I accomplish to rival that?" When he said this, they calmed down.


Proverbs 15:1 A soft answer turns way wrath.
It overcomes anger
It overcomes pride
It overcomes fears

Sometimes it overcomes those things in us.
In our next situation, how will we answer?