Thursday, February 8, 2018

From Skip's Heart (Thanks for the Guest Authorship!)

Our day is winding down after a marathon clinic at Good Samaritan Hospital seeing prospective surgical patients. The Mayan women and their families are very patient. We started at around 8:45 and finished around 8:00 this evening. 32 women were evaluated, treated, and 9 were scheduled for surgery. We have several operations scheduled over the next few days and will be busy but our patients will be much better and back to their daily normal activities soon. We are exhausted but in a satisfying fashion. I am always reminded of mercy, God’s mercy, when I come in contact with these women and their families. Their families, by the way, are so caring, supportive and participate in their care and recovery. They do it with style and with sincere love, appreciation and support. We learned so much today from the interactions with the patients and their loved ones. We learned patience, compassion, out and out honesty with no secrets, faith-faith in our ability as well as in their belief in a mighty power, trust- in us and the blessing of God, the power of a smile or a laugh and the power of a touch, a human touch. We ask for your prayers for us as surgeons for agile, healing, skillful hands and prayers for the quick and full recovery of our patients.

Dr. Heidi has had a most eventful week thus far. I was amused by the fact that she volunteered to check her carry-on in Raleigh through to Guatemala City but failed to pick it up at baggage claim. It has been entertaining watching her make call after call to American Airlines who has now issued a statement informing Dr. Heidi that  they will make a one time exception and deliver her bag to Chichi tomorrow. Tag the bag and your finger Dr. Heidi!!! Don’t forget the bag! Secondly, she arrived in Chichi with a horrendous cough. After clinic this evening, she experienced an ill timed coughing spasm and has pulled a muscle in her lower back. Poor Heidi! We will support her and care for her and pick up the slack. To top it all off, she somehow managed to microwave her tea this morning with a set of keys still in the microwave~  Mind you, she and Tom have used the “leave the keys in the microwave as you come or go” system for the last almost ten years, so that statement is not as weird as it sounds.  Luckily, it seems the vinyl and leather wallet keychain thingy that they were in seems to have saved them from actually combusting.  So there’s that.  Feel better Doctor!  And also, please try not to burn the place down?

More to follow. For those of you reading this blog who are not a part of any missionary work, listen to me! I am very new to this concept and, in fact, I shunned the idea for years! Believe me, I had many opportunities and requests, but felt that I should care for women at home. I finally gave in and accompanied Dr. Heidi to Chichi in 2016. My life changed in 24 hours and I realized that the needs of women in third world countries far exceed the needs of women in the US. So, I ask you to involve yourself in some form of missionary work. Agape in Action is a great choice. Time or cash! Remember, Jesus tells us that what we do for the least of my children, you do for me. Think about it. Double shot. You do for Christ and your fellow man!

Let us know if you want any further information about how to get involved~  sending money, of course, is pretty easy.  Unfortunately, you will find that most missionaries have learned to kind of dread the question, “what do you need?”—because the answer is pretty much always “money” and missionaries HATE asking for money!  So if you ever want to make a missionary’s job easier, that’s how to do it.  But also, please don’t ever, ever, ever forget or underestimate the power of prayer.  Every missionary—definitely including use this week!—covets your prayers and appreciates them more than you will ever know.  Let’s go change the world together, folks!


In Christ~

Wednesday, February 7, 2018

Meet the Team

Some of the longer-time readers may remember Dr. William “Skip” Johnstone, who first joined me on a trip back in February 2016.  He was an attending physician at ECU (which is where we met) for a bit and is now in Wilmington teaching the residents there and fighting the good fight to keep the art of vaginal surgery alive.  He is an amazingly talented and experienced surgeon, and I love both learning from and working with him.  In 2016 on the trip, it was his first experience with anything outside of the United States that wasn’t a resort location.  I had the amazing and rare privilege of watching his life change before my very eyes on that trip, as they were opened to a whole, bigger world than he had simply ever known before.  Since then, he has LED two surgical mission trips to the Dominican Republic in addition to re-joining me on this trip! And all of this God has done in a man who hates to fly, folks.  Just imagine what he could do with you…

One of the third-year residents in the Wilmington, NC, program, Kimberly Hildner, is also along on this trip.  I’ve been so blessed by a constant flow of residents from this program since back in 2015 when I initially reached out for help with the trips.  All of the residents have been awesome to work with, and I’m sure Kim will be no exception (no pressure, Kim!)  She is originally from Florida and hopes to move to Denver, CO, after graduation next year to practice a full scope of obstetrics and gynecology.  I look forward to getting to know her better during the week, but am already excited about her heart for Guatemala—she has spent some time here as a fourth year medical student, where she is excited to go back and visit after we finish up our surgeries later in the week!  It’s so cool to hear other people’s experiences here in “my second home”, and it’s nice to have someone else along that can function as a tour guide of sorts.

While spending six weeks here as a fourth year medical student, she was able to travel quite a bit while she was here—but the one place on her list they never made it to?  Chichicastenango, of course!  What a great opportunity (that’s where we are now). 

Our morning got off to an early 4 am start at the RDU airport, followed by two flights with a layover in Miami.  Then the drive from Guatemala City to Chichicastenango, where we will lay our heads for the week and work.  Our little hospital, The Good Samaritan Hospital, is ready and waiting for us to start up clinic tomorrow morning, so it will be the first of several long days.

Skip has requested to write the rest of the blog tonight, so I’m nervously handing off to him now…

Heidi speaks the truth and is very passionate about her role in helping the women of the region who need surgical care. As she so eloquently stated, my life changed when I made my first medical mission trip with her in 2016. I always ASSUMED, and probably correctly, that if I took a week from my practice back in NC and operated on women in need of surgical care but who had no way to pay that I’d be extremely busy. However, my first trip with Heidi opened my eyes to the fact that NC poor and third world poor cannot compare. The profound living conditions of the indigenous population in third world countries is almost unimaginable, yet when you offer to help them, their gratitude and appreciation is all I need! The patients are cared for by their families and they go home after major surgery on Tylenol and ibuprofen and are thankful and smile a lot. Selfishly, I get more out of what we do here than the patients I think. I am looking forward to a great week with my colleagues doing what we do best for a population in dire straights. Thank you Heidi and Agape in Action for allowing me to be a part of a great mission!

Saturday, February 11, 2017

Pictures!

Okay, a quick update on last night~  Long story short, we had a lady come in to deliver her TENTH baby!  Her lay midwife called around midnight to say they wanted to come in, and they arrived about 45 minutes later... then delivered around 2:00 am.  Mom and baby were doing pretty well (especially considering the amount of meconium that was present!).  Unfortunately, this morning the baby was breathing way too hard for our comfort, and we flew him in to the national hospital in QuichĂ©~  Please pray for this little boy!!  His mom is still doing well, but we've had kind of hit-or-miss care at the national hospital so must just remain hopeful and prayerful.  We are grateful that she was brought in, though, as it would be quite unlikely that this baby would have survived without medical attention.

As promised last night, though, here are a few pics I was finally able to download...

The "obligatory" first-uterus-of-the-trip selfie... Chris, Adele, and me...


Chris and Adele operating!


A bad place to leave the clinic key... (inside the locked clinic!  Oops.)  Note the pathology specimens in background waiting to be taken up to the basket that goes in to The City each week to be read...)


Chris and Adele doing what they do best again!


Adele operating "solo" (OK, with Chris kind of hiding so it looks like she is solo in the picture...  Sometimes we cheat a little for residents and students who would otherwise never have pictures of themselves operating ;-))



Me and Chris with one of our "paychecks" for the week-- two really nice papayas from a sweet infertile couple that I've been trying to help for a while now... wish them luck!  Sweet Eva is the lady's name.


This morning's "return on investment" from yesterday's clinic... Please pray for this little boy (as yet nameless; they usually don't choose a name until sometime between 15 and 40 days of life), as he actually became quite sick after this picture.


Leslie and Katie Ann, taking care of this sweet baby in the middle of the night!  We brought Katie Ann some "honorary Doula (birth support person)" scrubs after Jess's awesome delivery and her amazing help... just didn't know she would be using them so quickly!


Sweet momma totally tuckered out after her delivery...


Mommy giving her first "liquid gold" milk to the baby!


From later this morning, when Shea was helping to support the baby's breathing with a CPAP machine... still praying this will have a sustained effect!


Saturday, February 4, 2017

Meet the Team

Ah, the ever-creative title of the week's first blog... as the long-time readers (both of them) yawn.  But let's face it~  not much has happened yet.  We just got here this evening after the several hour ride up through the mountains from Guatemala City.  After a quick run to the grocery store, we now have our beds made and rooms moved in to for the week.  Now it's time to sit back, relax, fix a cup of tea, and light the pilot light for the hot water.

Oh wait~  we also have to spend half an hour trying to get Chris's phone to recognize the Guatemalan network so she can talk to her baby!  It's funny, though-- we were pretty tempted to get irritated about that, and then I remembered that on pretty much every single trip, there is some kind of internet or phone technology that needs troubleshooting-- but every single trip, we have all the phone and internet service we need!  I have called in to plenty of conference calls or over-internet meetings from here, I've stayed up to date on email, and I've caught up on patient charts in the EMR.  All pretty amazing technology making the world smaller and smaller -- and taking away our excuses not to travel it!

Anyway, I promised to introduce you to the team so here goes:  I'm Heidi, the arguably craziest of us as this is somewhere around my 33rd trip back down here for a week after moving back to the US in 2008 (my husband Matt and I lived here in Guatemala from 2006-08).  I'm an OB/GYN, and it's kind of a long story, but this is the only place I actually practice clinical medicine anymore.  I'm starting to miss it more and more, so these trips are an amazing privilege and blessing every. single. time.

Chris (DeLuca) Schwering many of you also know~  she was a resident at ECU when I was an attending there, and this is now at least her 8th trip back since going with me as a resident!  So very cool to now be taught by my former student many surgical skills she has picked up since then... never stop learning, right?  Her husband Tony flew down with us but rode out to Canillá this morning to install some WiFi, security cameras, and other generally tech-y stuff for the new hospital there.  They left their 3 year old sweetie, Caitlyn, and an 11 month old foster baby, nicknamed "Bubbles" for privacy, in very capable hands at home~  but still, it's hard to be away from each other and the tiny ones, so please pray for comfort for them this week!  (I should also mention they have a beautiful 21 year-old daughter also-- but they're pretty used to her being away at college ;-))

Adele Moser is a third-year OB/GYN resident in the Wilmington, NC program.  She is actually the fourth resident to come down from that program in the last couple of years, but the first one that I actually knew before traveling together!  We met when she was a third year student, and I have adored her ever since.  I'm really looking forward to seeing the amazing amounts she has learned in the last four years and hopefully getting her some great operative experience.

It's only about 8:00 here, but a group picture will have to wait until tomorrow-- some of us (i.e., Adele) had been up since before 2 am local time and thus didn't make it far in to the evening!

Tomorrow we will spend just a bit of time in the market, then set up and run clinic all day.  We will have a better idea of what's in store for us once we get through usually 20 patients or so tomorrow, so clearly we will keep you posted and try to get some pictures up.

Thanks for following along with us and praying for health, wisdom, and safety this week for us all.

Wednesday, February 11, 2015

Last Day in the OR


So today was a great day to go out on in the OR!  Just two gynecology cases, and Chris and Brittany were kind enough to scrub in on Tom's cases today so I felt like I was on vacation! Plenty of time to clean up some in the clinic and get things lined up for next time.  Chris and Brittany both have been such amazing hard workers and it has been a joy to spend the week with them.  

Speaking of which, forgot to even mention the great start the day got off to!  I managed to "somehow" oversleep after getting to bed after we finished in the OR at 2 a.m., but woke up to the news that Chris was already down at the hospital and pretty much finished with our rounds for us!  What a gift.  

We did a hysterectomy that we had originally scheduled for an abdominal case vaginally, a great victory for the patient's recovery.  Then there were only a few patients in clinic today-- one was this lady, well known to me from prior issues, but sent from the local doctor who had seen her a few weeks ago and left this as the entire clinic note!  Let me translate:



Ear pain.

Pap smear today;

Dx [diagnosis]: cystocele [bladder prolapse]

Tx [treatment]: Pap smear.

Yep, that's a quality documentation there, folks!  As much as it pains me on some levels to say this, please be thankful for yes, even the electronic medical records that we use abundantly in North America.  Luckily, this patient was fine and just needed a bit of reassurance... 


Then we were locked out of the patient care areas, so this is us waiting (along with lots of family members and friends of inpatients) for them to locate the young man who had the key... How can you not love this place?!?!

Then a bit later was probably the most entertaining laparoscopic surgery I have ever done~  just a sterilization ["tying tubes" to not have more pregnancies], but add in the fact that part of our troubleshooting involved a (sterile) rubber band as pictured here and literally holding the light cord up against the scope the whole time with one hand while operating on a screen that was over the patient's right shoulder instead of at her foot where it makes sense for gynecologists was... let's just say "challenging"... We found success, though, and have great surgical war stories to tell now so all was worth it!



The post-op patients are all looking quite great and very sweet-- especially little Micaela, who we had to take back to the operating room yesterday as you might recall.  The young man with the amputation looked much better today than we were expecting, and we expect that all but maybe one of the patients will go home tomorrow.  Please continue to pray for their recovery over the coming weeks and months. 

Tomorrow it's market time, helping Tom with some cases, then headed out to my second favorite place on earth (it becomes my favorite when my family comes with me!), the Fickers' home in Canilla, Guatemala.  Also fairly commonly known as towards the middle of nowhere, but a place where God has chosen to do great things through some amazing people of His.  Can't wait to see firsthand the work that has been going on!!  Check them out at the links on this blog to Adonai International Ministries and Rachel and Katie Ficker.   All who meet them are blessed, as we hope you are this evening...

Good night.



Saturday, August 16, 2014

Arrival Day

Well, the first blog post of the week is usually a “Meet the Team” post where I let everyone know who I am travelling with… but this week is a little different.  I flew down by myself this week and my team is essentially joining me down here from in-country!  I was certainly a little bummed when I had no one stepping up and able to come down this time, but as usual, God has provided.  Now I’m as excited about the team as any recently… “God is good, and God is sovereign” will be somewhat of a theme here in case you are a new reader to this blog!

Anyway, I’m headed up to Chichi in a nice bus now that God also provided, this time through reaching out on facebook to some of the other local missionaries and hitching a ride with a team coming up (from Michigan and North Carolina, no less!) to work with Manos de Jesus and Pray America.  They’ve been great travel buddies and it was really nice to get to meet some of their long-term missionaries that I had not come in to contact with yet.

Tonight I will get to meet Drs. Jared and Melissa Cardwell, another one of the couples who are down here with Docs for Hope.  Some of you remember they are the amazing physicians that have agreed to staff the hospital now BEING BUILT out in Canillá (because God is good, and God is sovereign!) full-time for the foreseeable future.  All of the docs in their group are Family Practice-trained but very surgically minded and trained also.  They have an 18-month old son, David, who I can’t wait to meet either.  I love how kids are becoming a more regular part of these trips lately!

Please pray for their family as they are just recovering from a recent and seemingly quite nasty stomach flu, and pray that this week would go smoothly as far as their travels and our medical care.   I’m not sure where they are with Spanish, either, so some supernatural language lessons wouldn’t be a bad request.

We are also hoping to be joined by Dra. Lindsey, a Guatemalan-trained physician that has been working with Agape in Action for the last several years since her graduation from Medical School.  She and her husband Paul are such bright lights in this country and the ministry!  She started working with Jim and Kathleen Street now many years ago as a bilingual secretary, and became interested in the medical side of the practice.  She put herself through Pharmacy training without even mentioning it to Jim and Kathleen, and then Nursing  school as well!  When she and Paul then decided they wanted to go on to Medical School, Agape and Jim and Kathleen personally helped them with some scholarship money in hopes that they would serve in the capacity they are in now with Agape. 

God is good, God is sovereign—and God provides.

Lindsey’s infectious smile and love of learning all things in women’s health care and medicine will be such a joy this week, and her English skills are amazing (although she would never admit it).  I’m hoping I’ll get to see that fun look on her face again this week that Sarah Gore and I caused several years ago when we handed her a scalpel and guided her through a surgery for the first time!  Oh, how I WILL miss formally teaching medicine…


But God is good, and will provide.  Please pray that we never forget to give thanks for His grace and His goodness as we work a likely quite tough week.  We will try to post some pictures of faces to put with names tomorrow, but for now there’s just me crashed out on the bus here since I left the house shortly after 1 am local time to start travelling.  Tonight’s sleep will be sweet, friends…