17 March 2006
# 31
Shanks
So what do you get when you pray for more patients in the hospital and more operations? You get what you pray for. Over January and February we had a decrease in patients down to about 25. While this is great for our family time and other interests, it is not good for paying salaries (still a month behind).
So, last week we prayed for more patients and more operations. God heard us. We now are averaging 48 inpatients and I have done 5 surgeries this past week.
We do not want more people sick. We just hope that those who are already sick will come here. So, yesterday I did three surgeries. First was a woman who had broken her water about 48 hours before being referred here by a local dispensary. She had meconium coming out (a sign of fetal distress). And when I listened to the baby's heart rate it was not normal. So we took her for an urgent Cesarean section. Fortunately, Audrey was able to be there to revive the child. Both mom and baby are doing well.
The second one was one planned for a couple days. He has had stool coming out with his urine. I know that even all you non-medical people know this is not good. I took him to the operating room. He had a large mass in his pelvis and it was unresectable, so I diverted his colon to his abdomen. This allows him to have a more quality life rather than having obstruction in the near future. But it causes one new problem. We have no ostomy supplies. We have a few very old sacs but they usually fall off before leaving the operating room. So I modifed a glove and taped it in place. Not real effective, either.
Finally, Audrey and I make it home about 6PM. I then get a call at 10:30PM for someone who was stabbed (our third like this). I feel fortunate there are not many guns around here, so not many gunshot wounds.
The patient has a stab wound in his left upper abdomen. No other injuries found. So I take him to the OR. I explore his abdomen and find two holes in his colon near his spleen. Stool is everywhere inside. He is also hypotensive (low blood pressure). So, I decide to make him a diverting ostomy and resect the contused and injured area. He remains hypotensive in spite of fluid and not much blood loss. In the US there are a number of medication drips that are possible to deal with situations like this. Here we have one medication that can help. Epinephrine! So I give him some that helps for about 5 minutes.
Fortunately we have received our donated stuff in the container. We have dynamaps 2 that were donated to us. I know have one in the OR, so I can get regular BPs and Heart rates. I can see the result. No more asking the nurse constantly.
I cannot leave the decisions up to him because he does not know enough. They just accept SBP 60 as acceptable and chalk it up to him being tired or meds received. Well, with the hypotension we are getting frequent BPs and all of a sudden there is an electrical burning smell and the Dynamap quits. We are back to manual. So I had started a "drip" of epinephrine on this patient while I finished the operation. We did manual BPs to adjust the drip.
Also the power went out. But just as the nurse was getting my flashlight it came back on. Wow, electricity makes such a difference. Fortunately, when our last student missionary was here she gave me her headlamp that works better, so I use that now. So when the operation was done we sat there for about 2 hours until he woke up enough and his BP rose. He is doing well today.
God answers prayers! We are busy and doing surgeries again. We now pray for a slow Sabbath to rest. We are slowly installing monitors and equipment donations we received before leaving the US. It all arrived in our container. We are very blessed. We also hear that we have more donation money and a dermatome arriving with the next student missionary. Thank you all so much for all of your prayers and help to the people of Koza. We pray God's blessing on you for your help to His children here.
In His Service,
the Shanks
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