Tag Archives: Surgery

The Haitian donkey brings Haitian weather back home, helping with aches and pains

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Hi All:
We finished out the week well, doing all the cases that came our way and finished off a few more on early Friday morning. As we were finishing, a lady came in, with arrested labor with her baby in distress. We gave it a try as she had delivered 2 children already normally and we figured the space was adequate for the little one to pass on out. I left the nurses and Dr. Moise to do this while I finished packing my carry ons, cleaned up the room (I try to leave all spic and span to reduce the influx of cockroaches that make the place their home in our absence) and loaded the truck. We only had the kitchen to wipe down and we would be on our way when Dr. Moise came to suggest that the baby would not be able to find it’s way out and wanted to do a C section. We did it, very thankful that we made the decision as the uterus was paper thin and the baby in major distress.  We were able to finally get the little one breathing on it’s own, repair the lady and take off for Port.

You notice that I didn’t mention the gender of the little one. Everyone is amazed that I didn’t notice but all I ever care about is keeping the mom healthy and having a healthy baby, whether it is a boy or a girl seems like the last thing on my list (and I get a lot of ribbing over this). My priorities seem a bit different than others in that department, for which I get a goodly amount of grief. However, the little one was really wedged in the pelvis and we were covered with sweat trying to get him or her out of the belly alive. I woke up the next morning with a significant strain of my neck, bouncing back home on the plane and in the airports didn’t do a lot to make it better and it still gives me some grief. I have had a couple of physical therapy treatments by my good friend, Todd Wehrmeyer, and they have helped, but am ready to have those aches and pains go, especially as I get another immunotherapy treatment tomorrow and it tends to cause aches and pains all by itself, especially as they up the dose each time I visit them.  Ibuprofen does a lot more to help me feel better, but that little remnant of stomach I have left does not tolerate it and Tylenol is like sending a child to do an adult’s job, makes me feel better but the patient, not so much.

Dr. Bartlett’s PA, Heather, called me 3 days ago and said that they were happy that the cancer progress seems to be slowed down to maybe stable and want me to continue the treatment as long as possible/tolerable. So, will submit to it tomorrow and appreciate your prayers that it will continue to kill cancer cells instead of me and, Lord Willing, prolong my life and productivity. My partner has been on vacation, so the office has been a bit of a rat race, especially as my neck is still stiffer than it should be.

I had a nice visit with Dr. William on Friday night as he came to see us on our way out. I was encouraged as he seems to be more perky, likely because he can “see the light at the end of the tunnel” and the second 2 years are less punishing than the first two years, as the lower two years do all sorts of “grunt work” to keep patients happy until the older doctors can do the surgery. A bit different, maybe more than a bit, than what we do here in the US. We talked a bit about his plans for next year, they ship them off hither and yon to round out their training, in theory, a good idea, we will just leave it at that. Dan, Duane and the wonderful team of Haiti USA members loaded a 40 foot container with stuff for the hospital as well as Rod and Debbie Wray on the 30th, so that is underway, thankfully. Since Karen and I and our family members always did this the years we were in Africa, we greatly appreciate the number of folks who help out in this area.

So, as this has been written in a couple segments as I have time between patient duties, will send this off and update you a bit later on some of the information of what we have done at CSL Haiti in the last year, etc.  As always, thank you so very much for your help and encouragement.

In His Service,

Tom and Bill

The Haitian Donkey and his friends enjoy warm and wet weather

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Hi All:

Am waiting for Dr. Moise and the med student, Dubuisson, to complete a vaginal hysterectomy (not enough room for 3 people, so I am there ready to help out if needed but Dubuisson is tougher and younger and will let him assist Dr. Moise, as the surgery is really a one doctor case with an assistant to pass tools, hold retractors, etc).  So far, the week has promised to be busy all the way, so trying to be up for it. We had two hysterectomies yesterday, 5 today, plus a bunch of other cases and, if surgical clinic numbers have any indication, it will be a crazy time. Other than the volume, things are going well with one very sad exception. Yesterday, a young lady (ok, age is quite relative now) with a huge bunch of fibroids in her uterus was complaining the last few months that the pain was unbearable and she begged me to do a hysterectomy despite her young age. I scheduled her for yesterday, we did some young kids first thing, as always, as they can’t be trusted to not eat, given the chance. She complained to me when I brought up the little ones afterwards that the pain in her abdomen was unbearable and wanted me to do the surgery sooner. We brought her to the OR about noon, but then, even before we started, she complained of shortness of breath and rapidly went downhill and passed away, despite our attempts at CPR, etc. I wonder if she had a blood clot that traveled to her lungs, likely aggravated by the huge masses in her uterus? Her pastor had a lot of kind words to say about her afterwards, so trusting that she is in heaven, but it certainly was a major shock to us all and a reminder of how fragile life is, especially here.

The trip down was not quite uneventful, the plane to Philadelphia was only about 20% full?, to Miami was totally packed and that to Port au Prince was probably 20% full also, mostly Americans on mission trips. We assumed the last plane was empty (as was the waiting room in Port au Prince for the return trip) due to all the unrest in country reducing desire to travel. We had a 2+ hour layover in Miami, then they announced that a bracket on the outside of the plane was broken and the Miami mechanics were getting advice from the Dallas mechanics about how to fix it. Two hours later, it was fixed, but then the pilot was running out of time, so another crew had to be found. About then, American Airlines brought a cart to the jet bridge with sandwiches and drinks and chips to calm the passengers and we were ready to go. However, by now, we had lost our push back crew, then we had lost our place in the takeoff line, so we finally took off, knowing things were going from bad to worse, seemingly. Midflight, they announced that, to encourage the passengers, they were passing out free alcoholic drinks (Tom and I figured that might have been after they noticed that the majority of us on the plane were missionaries and unlikely to take them up on the offer).

On arrival to Port, a number of our small group of passengers were unable to find our luggage, so that prompted another delay while we filed all the paperwork needed (you have to have all your boarding passes to be able to qualify for this, but I knew that from previous mishaps and always hang on to them) and we headed out without any luggage, arriving at the hospital about 1 am. Poor Jean Eddy and Dudu went back the next day as Jean Eddy has done this many times and was afraid the suitcases would be empty if we didn’t jump on it as soon as it came in, likely he is right. Only 2 made it that day and 2 the next day, but we appear to not have lost anything, a real reason to thank the Lord (and those of you who were aware and prayed for this to occur). I must admit I was wiped out, as had my Immunotherapy on Monday and the last 2 sessions have been tougher. They increase the dose each time til I can no longer tolerate it and these were #s 6 and 7. Basically, no appetite, some nausea, all over body aches, low grade fever and no energy. Other than that, tolerable. I do think that I was able to adjust my schedule for the rest of the year so that I don’t leave for Haiti on the weekend after treatment, it still is not fun if I am home, but not getting much sleep for a couple days enroute here doesn’t help fight the situation.

I have not yet heard back from Dr. Bartlett regarding my latest CT scan 10 days ago (the Spectrum reading says maybe 10% advancement in the cancer, but they also state my nonexistent spleen is normal, so one has to take that with a grain of salt). I continue to be thankful that, although I am slower than I would like to be, I am still able to work pretty much normally and Karen and my coworkers, friends and family are super supportive and I consider myself very blessed of God. When I see all the frustration and discouragement of so many of our Haitian brothers and sisters, especially those who don’t know the Lord and are trapped in the voodoo problems, I really am appreciative of His care of me through you all and your prayers. I just finished reading Job on the plane ride in and couldn’t imagine scraping myself with a broken piece of pottery all by my lonesome, seemingly abandoned by all, including God (we know better but poor Job didn’t).

Tom has repaired some things in the hospital as well as in the place we stay, again a blessing greatly appreciated. The employees thanked the Lord this morning in chapel for the downpour we had last night, I briefly woke up with the lightening bolts and thunderclaps, but the rain beating on the roof is very soothing. The dependence on God for our daily bread is so much more obvious when they have so little and one does not go to the grocery store to get rations. Not a bad reminder for us to go to Him for all our needs regularly. Continue to pray for wisdom, strength and endurance for the rest of the week.

In His Service,

Tom and Bill

The Haitian Donkey and friends are wrapping up the work in the homeland

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Hi All:

As usual, it seems like life flies by a lot faster than we would like it as we stumble along our pathway.  It is hard to believe that it is Thursday already and time to think about tying up loose ends before departure on Saturday morning. Duane and his group of 5 relatives are at the airport for their return today. Hopefully they (at least the two grandsons) will be able to smooth out their youthful pranks and regain favor with the traumatized moms and grandmother. Duane and their fathers have taken good care of these ambitious young men and done well until yesterday, when they decided to text mom that one of them had fallen off the hospital roof and broken a leg. This did not go well with nurse mom, nor grandmother. They thought it was quite funny, but meeting face to face with mom and grandma today might make them realize it was certainly not a kind joke to stress them with. Sometimes the games our minds play with ourselves and others need a bit of reflection before they are acted upon.

Dave and Kurt are seeing their share of the Haitian sun as they stopped by last night to use the phone and contact their families and looked considerably darker and redder than several days ago. They seem to be making good progress on the repairs, which I likely will see tonight as I have dinner with them at Caleb and Olga’s house, if I get done with work in time. They seem to be doing well, thankfully. Less drama than Duane has had to put up with.

The hospital work is doing well. I have had a standing rule that we don’t do more than 6 hysterectomies in a day, just to not stress the staff and myself as they can be tougher to do than in the US with less adequate anesthesia and thus less relaxation for the abdominal wall muscles, etc. Each day, when we arrive at the hospital, the patients for the day trickle in as they gather their families, funds and supplies for the surgery, we never have much of an idea who, what sort of cases or how many may come. Yesterday, 8 hysterectomies came and I told them I was too old and decrepit to do that much, but we took the cases one at a time and ended up doing all 8, plus a few extras, including a ruptured ectopic (tubal) pregnancy we saw on Monday and it wasn’t ruptured yet, so we tried to encourage her to let us do the surgery when it was still easier and less risky for her. She went home to think about it, against our advice, of course, and returned yesterday with no blood pressure, unresponsive and with a belly full of blood. Fortunately, we had talked firmly enough to her family about the risks, etc, that they came with several members willing to donate 2 units of blood and we added her to the list of surgeries to be done. I saw her on rounds today and she seemed quite open to our discussion about the fragility of life as I shared gospel tracts with her. She should do well from a medical standpoint and will encourage consideration of how close she came to eternity and to take appropriate steps to ensure her future.

By God’s grace, the infection seems to be responding well to the IV antibiotics and I feel good and sleeping like a log. I have not suffered for the availability of food and have enjoyed the variety of meals prepared for multiple sources, our usual Haitian meals made by Moise’s sister at lunch, plus those made by Mike VerKaik and his brother in law, Josh, with help from their kids for dinner with them. They made homemade crepes yesterday that I had for breakfast this morning as got home too late to bother eating last night, just wanted to head for bed and get ready for today, which promises to be more gentle? Others may not agree, but I think the weather is most wonderful here and I enjoy running around in just my scrub clothes, no long underwear, socks, etc and feeling fine. But then, a Donkey likes to keep his life simple.

 

In His Service, with Thanksgiving,

Ben, Dave, Duane, Josh, Kurt, Mike, Michael and Bill

 

The Haitian Donkey and friends rejoice in God’s marvelous mercies at Centre de Sante Lumiere

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I know I have said this before, but it never ceases to amaze me that the Lord continues to give us people with talents I cannot comprehend to help us in His service here. As many of you know from previous updates, the little Kia that could has been struggling to be able to climb the mountains in Haiti for several years and we are looking into alternatives. Jean Eddy brought it to the dealership 2 months ago and they replaced a part in the fuel system, but it didn’t run any better, so Dan and Evert worked on it last month, as it was clear the fuel was not getting to the engine and it couldn’t go. The Kia dealership said they could order and install one for $4900 but it might be a while and who knows what might happen. We found one for less than 1/5th the price in Australia but, although we had all the right numbers, even I can see that the part is considerably smaller and not the right one (and a Donkey has very limited skills in the automotive realm, as he relies on his somewhat sturdy feet to keep going). Dan told me Tuesday that he has very limited automotive skills (though I know him to be quite modest) but he would look things over. He researched it on the internet and crawled under the vehicle, looking for a tiny screen the internet told him should be inside the fuel pump. I did a hysterectomy and came up to see his progress. He crawled out, covered with diesel fuel and cleaned himself off and then returned to the job. I did yet another hysterectomy and checked on him again and he had found a tiny screen in the fuel pump that was totally plugged. It was cleaned and the truck runs like it is brand new (at least the motor) and Jean Eddy was able to bring Dr. Jo Marturano to Port to return to the US yesterday. He came back grinning from ear to ear as it works wonderfully.

Speaking of Dr. Jo, she is a psychiatrist who comes twice yearly for 2 weeks and has a growing population of patients. Sadly, they have considerable struggles with understanding that they need to take the meds on any sort of regular basis and sometimes get a bit upset about things. One was wailing for hours yesterday morning in the wee hours, we first thought someone had passed away at the hospital, though I didn’t know of any candidates, but, after we were fully awake and could navigate ourselves to investigate, she was walking all over the grounds sharing her sadness with everyone, whether they wanted to listen or not. We also did an albino patient in his 40s with a huge cancer growing on his face. We managed to get all the visible cancer off and close the incision under considerable tension, but I fear that it has invaded into the bone as we scraped it off his cheek bone. To balance the sadness that abounds here, we did a difficult hysterectomy today, tons of adhesions in a 43 year old lady who had a bunch of painful pelvic masses. Since she had no children, I was reluctant to do it, explaining to her that I would put a definite end to her even remote possibility of having children. There was a younger man with her, I asked him what relation he was, as all decisions are a family matter, rarely does one make a decision alone. He said he was her son, but adopted. I told her that I was proud that she had raised an orphan, as that is not so common here in Haiti. He enthusiastically told me she was the greatest mother that ever could be and with that assurance, I could safely proceed with the surgery.

Another talented person we are greatly blessed to have help us regularly is Johannes Schuerer (and his wonderful wife, Luise). They have been invaluable in helping us navigate several administrative issues in a way that is acceptable to the Haitian culture as well as in a Biblical fashion. After over 40 years of service in the Bible Institute, they are able to guide us and the Executive Committee of MEBSH through some of the quagmires that we find in our work here. Once again, with their help, we feel that a major difficulty has been resolved (hopefully the last one for quite a while, Lord willing).

As usual, Dan and Tom have done a number of repairs and improvements to the facility, including repairing the toilet in my bedroom so that it does a better job of removing semisolid waste and the offending odors that accompany it. Overall, surgery has gone well, though I ended up having to transfer a perforated typhoid patient that was 5 days down the road at government hospital and I fear struggling for his life. If he had come earlier in the week, I would have done it, but it is not a wise surgical practice to do a huge surgery with a good chance of complications and then leave Dr. Moise alone when he is not yet considered a full fledged surgeon by Haitian standards. He likely would get a lot of unfair criticism and I need to be cautious with doing things that most likely will have negative results in our small facility.

Although it is rainy season, we have not had a lot of rain in the daytime and we have been able to pour several slabs of cement, one around the community health department to keep things clean and Duane hopefully will put a roof on the waiting area for the patients to be protected from the beating sun and pounding rain. We also have some Haitian style toilets that have been installed there, fairly interesting. I have loved the weather, especially the gentle warmth that abounds, though do resort to having my sweatshirt available from time to time. We are not hurting for food and are doing an admirable job of keeping our youthful figures in order.

Once again, many thanks for your prayers and support for the ministry we are able to do here for God’s glory.

In His Service,

Dan, Tom and Bill

A thoroughly chilled Haitian Donkey straggles back home to ice and snow

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Hi All:
Once again, the Donkey loved the heat and humidity in Haiti, although I must admit I did wear my MSU sweater coat at times when not out in the sun. Thus, kept warm and had a good time getting things done with his friends and family. The surgical cases went well, we aspirated a lady with a huge thyroid cyst of 110 ml of fluid, bloody, so suppose she hemorrhaged into the cyst recently. She had had surgery at our sister hospital 10 plus years ago, something she never told us (Haitian medical histories are a bit colorful, the patient tends to try to tell you what they think you need to hear to do what they feel you need to do to fix them, if that strung on statement makes any sense). Plus, communication can be a struggle even for them. Many times, I have asked a patient how long he had had the mass and was told a long time (this is through my Haitian nurse interpreting, so it is not my lousy French or very limited Creole), how long is long, 2 months, 2 years, 20 years? If they can tie it to a major life event, such as the earthquake, a hurricane, etc, this helps a lot, but even events like a child’s birth is somewhat limited as they don’t always know how old the child is, etc. They had left a thin scar, not visible til we had her lying down with the good lights of the OR and asked her what the scar was from. Always a challenge to sort things out.

We continued to do a number of hysterectomies, as several organizations have been doing pap smears when a team of medical personnel comes for  a week or so to do screenings, a blessing as there is so much cervical cancer and we end up removing the risk if they are old enough to not have any more children, etc. Regular testing is not a viable option as the chances of the patient returning or seeking further care is very limited, so we try to reduce the odds if the patient is interested. This included one of our nurses who is doing well and went home happily on Friday. Bonne Fin, our sister hospital up in the hills, continues to have demonstrations blocking patients from seeking help there as they want more of the electricity produced by the hydroelectric plant they have. It seems that many people have somewhat unrealistic expectations of what someone else should do for them? The amputation went well and she seems happy to have that off, as it took weeks to convince her that this was the only option. Unfortunately, the poor lady who had her head bashed in by “a robber,” passed away Friday afternoon after struggling for life all week. When I asked on Monday where her husband was, as I wanted to talk to him and make sure he knew her prognosis was not very great, I only got a lot of muttering about things from several family members amounting to “they weren’t sure.” My other team members asked if we were required to report possible assaults to the police, it seems they have little interest in investigating domestic violence, etc, a bit discouraging.

Dan and Evert did a number of projects and made good progress on their assigned “work list.” Unfortunately, of course, we could not get the Kia back on the road, hopefully it will be repaired in the next couple weeks and functional for the next trip. Road conditions and dirty diesel fuel takes it toll on vehicles, despite careful usage. So, we ended up renting a van, something I didn’t even know was an option and had a nice trip back to Port early Saturday. We landed in Miami and I turned on my cell phone to find that they had cancelled the rest of our flights due to the ice storms predicted. They intended to have us go this morning, Sunday, on to Charlotte to connect on to Grand Rapids. With me needing to get my IV food and fluids hooked up, that was not a charming alternative, so managed to catch a flight to Chicago with Tabitha (and get in the same row as her without us asking, but that was an extra blessing). Nothing on to GR, but I had been feeling poorly in the afternoon yesterday, partly due to having to unhook my IVs to get home, as I usually do, but a struggle to get enough fluids down as I cannot drink much (and eat less) at a time with my short pipes and was quite chilled and nauseated. So, was very happy that we could go on rather than spin our wheels in Miami. Plus, given the weather back home in Michigan, I doubt that the early trip today to Charlotte would have gotten us much closer to home today. We were very blessed to have my brother, Brian, and sister, Margie and husband, Gord, drive to Chicago and take us home in a Suburban complete with heated seats, lots of pillows, blankets, hot tea and great company and got home at 11:00 pm with only the last hour or so on slick and slippery roads. I still am puzzled that we got the 3 seats so quickly as while we waited to board the plane, they stated they were weight restricted and had to get rid of 12 passengers before they could get off? We just thank the Lord for getting us on the flight.

I have tried to see if the “guaranteed 24 hr arrival” luggage promised last night at 7 pm (our time) on our arrival without luggage in Chicago could be found, but all the numbers and internet access sites they gave us to use if things didn’t go as planned just gives a standard computer reply, “we are looking into it and will call you when we have more information.” We are sure the 6 bags will come in due time, but it does make one puzzle as 4 allegedly went to Charlotte on another flight (ours was cancelled) and 2 went on to Chicago. The site they gave us to track them doesn’t allow me to put the entire number into the computer and then tells me I have the wrong number. All combinations tried end up with the same result. The bags are mainly products of the Women’s Center that I normally carry home in my suitcases for the ministry, so a day or so later won’t be tragic but we are doubly thankful that it wasn’t us as I have had a bit more of a fever and chills in the night and was thankful for Tylenol, warm fluids. heated throws and my warm house to struggle through the grief with. I also started some Levaquin antibiotics again and will check blood tomorrow, including cultures, if needed to sort this out again as best we can, with God’s help and direction. As always, we greatly appreciate your prayers for wisdom in trying to keep healthy enough to do what we can for the Lord while we still can.

In His Service,

Bill, Dan, Evert, Karen, Petra and Tabitha