Malaria and necessary friends

Well, my last post mentioned how sick I was of traveling, turns out I meant it literally. Since Sunday I'd been feeling like I was on the verge of vomiting but as we were traveling all day through the mountains in Western Uganda I just blamed it on being tired and car sick. Well, I'm an idiot. I finally got back to Soroti late Tuesday afternoon still feeling extremely car sick, carried my bags through the door and literally collapsed into bed thinking I'd just rest a bit then feel well enough to open up the house, unpack etc... (I'd been gone 10 days). Well, sometime after dark I woke up enough to go the the bathroom and give myself a panic attack. My urine looked all wrong and suddenly it hit me. I had malaria.  I went to grab a rapid test and treatment pack and discovered I locked my med room when I packed up and I couldn't remember where the key was. I called my good friend Rachel before I realized how late it was. But she called back and happily came over with a rapids test and poked me. It took less than two minutes for it to come back positive. Oops. Started treatment and fell back into bed. I did have the presence of mind to set an alarm for the second dose. I got up and took it but sometime in the night I started vomiting and I'm pretty sure I didn't retain much of that dose.

Tuesday Rachel came back to check on me, which was a good thing as I thought it was still morning but turns out it was late afternoon. I also thought I'd been taking fluids because my mom had been bringing them to me but upon trying to explain that to Rachel I realized that it was probably pretty unrealistic and most likely I'd not been out of bed at all except to vomit in almost 24 hours. She gave me my next dose of meds which I think I waited a whole four minutes to throw back up. So, wonderful friend that she is she didn't really give me a choice, packed me some clean clothes and took me to her house. My vet (her husband) gave me a liter of fluids and but unfortunately I still couldn't stop vomiting and didn't keep down Wednesday morning's dose of Lumartem either. So (despite my protests) Rachel took me to the hospital where it took them three blasted hours to put a new line in and give me a single dose of IV malaria meds. I convinced them I could keep getting fluids at home and if they would send me with a dose of promethazine I would be able to switch back to oral meds and take care of myself. Thankfully, they know me there so they gave in.  But there was no way Rachel was actually letting me go home. So back to her house where I did nothing but sleep and get more IV fluids for another 24 hours.  Anyway, here it is Saturday and I've been discharged from Rachel's house. I still feel exhausted and have one more day of Lumartem ahead of me but I'm feeling human again.
Thank you Rachel, that even thought I'm stubborn and not easy to care for you persisted. You're a great friend and I'll happily return the favor if you need it.  Oh, appreciation also to Daniel who was willing to poke me five times to get lines in. Thanks, I think. And also mixing meds and running to the pharmacy repeatedly. Thank you.

Headed home....

Have started the several day journey back to Soroti.... am more than sick of being on these Ugandan roads but had a good time in western Uganda.
 You might get a blog post someday......

At least there were lions!

Well, you all must have been praying. The final step of getting my work permit was relatively painless. There were several hitches and it took several hours but for a day in Ugandan government offices I’ve had much worse. I now have a three year work permit!! 

The truck is still in the mechanic so no updates there yet. The mechanic will get several more days with it before I go pick it up. 

Several days of travel across Uganda has left me tired but on the road on the way we got to see tree climbing lions! So that makes it so much better.

Five lions just hanging out in this tree visible from the main road! 

Time to get out of Soroti for a little while.....

Ok, in all seriousness, I'm headed out of Soroti for a bit. I'm going for several reasons and most of them you can be praying for:
1 I'm going to the Immigration offices Monday morning to HOPEFULLY get my much needed (and long awaited) work permit. There have been many hurdles and I'm a bit worried but I'm trying to trust God that I'll be leaving with my passport in hand and legal permission to be in this country three more years.
2. My truck is falling apart. I need to leave it in the hands of a good mechanic for a while. So I'm limping it up to Kampala. This one needs prayer because Friday evening it was suggested I not drive it that far. Soroti's mechanic had it for 11 hours Saturday and he thinks it is now good enough to get it to Kampala so we're giving it a try.
3. I'm following up on some of Fuel Uganda's ministries in Western Uganda. I hope to be an encouragement as well as have a quick break from Soroti. Unfortunately it is three days of tiring travel (not on interstates!) so it is hard to get super excited about it.

Anyway, thanks for praying!

don't want to

I just don't want to do this anymore....

I just don't want to have my truck break down and have no idea how or when it get it fixed because I had the same problem dealt with just a few weeks back. But I need it ready to go to Kampala in 24 hours. Do I take the risk?  Find other transport? Wait?

I just don't want to have to go to the bank and be treated like an idiot for something  immigration (or the bank) messed up. Especially when MAF in Kampala has the original paperwork and they are the ones I'm paying to deal with this.

I don't want to bring my patient to the hospital and have to fight for tolerable (not even good) care. And hear that they didn't do the ultrasound and are waiting another day. And didn't give blood. And aren't even sure what the treatment plan is. And don't even have running water for the patients.

I don't want to go to church for a 9am program and actually get started at 12:15 and then have to rush and do a poor job because we wasted so much time.

I just don't want to anymore.  I did it all yesterday and I'm done.

I'm in a great mood today. You should probably all be praying that this missionary can hold her crap together today.

Babies!!

Baby guinea pigs at four days old (the three little ones  in the back). 

I have a bunch of babies who were born almost the same day a few weeks back! I love having all these animals around!

Baby bunnies at four days old. 

Baby guinea pigs at two weeks old. 

Baby bunnies at two weeks old. 

Food distribution

A few days back I mentioned when I was at the clinic it was obvious the prenatal women were losing weight when they should easily be gaining.  It isn't just the vulnerable who are hungry in the community but they are just the easiest need to recognize.  My little village church felt they had to do something and with Gods help they did a huge food distribution. One of the missionary families I serve with wrote about it and the link to their blog is below.  I love my church in Obulle and love the amazing things God is doing through their servant's hearts.

Pictures and more of the story here

and more pictures and details here!

One of the things she mentions and it makes me excited is that several Karamojung families and even two S. Sudanese families benefited. This culture can be very divided down tribal lines but this church goes out of its way to be atypical in that regard.

Running the numbers

It was antenatal day at the clinic today. I almost never pay attention to the numbers but today the midwife was tied up with other things so I had to do patient's records and also the government record books so I interacted with the numbers more than I usually do. 

22 pregnant patients, 8 for their first visit. Of these, 4 were past 30 weeks (well into their third trimester). They just didn't think they needed to come to the clinic for anything before this. 

14 were there for their second or third visit. Of these 10 (!) had either stayed the same or LOST weight from their previous visit. This surprised me but I guess it shouldn't have. Parts of Uganda have had drought instead of the first rainy season and crops failed. Since folks eat what they grow, there is little food. They have planted again in this second rainy season but nothing is ready to harvest yet. Most people in this area are down to one meal a day. It was obvious in the ladies in the clinic today. 

1 patient had swelling in her feet and trace protein in her urine so got referred into town for lab work. 

1 patient was highly suspicious for twins so she got sent into town for ultrasound. 

2 patients had UTIs so got antibiotics.

2 patients tested positive for malaria so got IV lines with drips. 

Just your average Monday in the clinic...... I guess not completely average, no one came in active labor. 

Tired

Good grief! Has it really been a month since I last posted?!  I'm tired and just plugging along, getting through the days, one at a time. Please pray for increased energy and passion. I'm struggling a bit....

Oh, and someone stole my dog. He is pretty unique and doesn't look like any other dog in this city and all the people who live around me know him. They won't tell me who has him. This is a picture of him sitting on my cat. He actually spent a lot of time sitting on the cat.

Update on this: Eight days after he went missing I posted this on FB.

I just went outside my gate and gathered all of the kids who are old enough to speak English (about 10 of them): "You know my dog? The white one?" "No." "Yes, you do. The little white dog that you always see around my place." "We don't know where he is." "No, I'm not asking you where he is, I'm asking if you know who he is." "No". "Well, actually, I am asking if you know where he is." "We don't know." Five thousand shillings to the one who brings him back." "Truth?!" "Yes". All of them took off running....... I can't help but wonder if I'm going to regret this....

Less than fifteen minutes later he was back. So thanks everyone for praying!

A few days away

 Last week I had a wonderful (brief!) get-away to celebrate a good friend's 40th's birthday. We had some time to kick back and relax and eat some good food and laugh and enjoy a beautiful place.

 
 Oh, yeah. And we saw hundred's of amazing animals. I could post too many pictures and I know they just aren't as cool as the real thing. Up close and personal.

When we get to tell the stories of this trip in the coming years we will talk of being charged by a bull elephant, almost hitting a hipo, tracking down an invisible leopard and then finding a whole family of lions. 

I was reminded how necessary the support and encouragement of friends is. Here on the mission field they are family and co-workers and companions and confidants all rolled into one. Ladies, is it too early to start planning our next trip?!

I need to give credit to Rachel Graham for these awesome animal pictures!

July 2016

Wonderful friends....

Why is everything so hard here?!

After attempting for two long days to get back to Soroti, even that was very complicated and I actually shed real tears in the process, I'm back home and trying to get caught back up. And it all seems overwhelming.
- I had some repair work done on my truck before all the craziness with my nephew started. I discovered after racing to Kampala that the "repair" actually made the problem worse. Some missionary friends took the truck when we flew to Kampala and limped it back to Soroti for me but now I need to deal with it. The missionary who confirmed that I needed the repair in the first place told me yesterday "tell him he made it worse. Now all the seals on that side and also the gasket need replacing." So I'm in the midst of deal with that.
- I used up every cent of cash that I had in the craziness of last week so I really need to get some and here the only way to do that is from the ATM. However, the ATM is out of money and won't be filled again until Monday after 9am.  So no groceries (or anything else) for me until that happens.
- I still don't have my work permit.... but by the God's ability I was able to get my passport back from immigration to use it this week (as it has a three month special pass in it which was supposed to get me through until I have the new permit) but that pass expires today. Which means, because they still have not issued me a work permit I have to pay to get a new pass and keep waiting for immigration to do their thing. But the issue is I have my passport with me in Soroti but it needs to be in Kampala.....so I packed up the most important document I own and put it in the hands of Uganda's incredibly reliable public transit system. I really hope I'm not writing about my missing passport in a few days......

More about this past week

I know you have all seen lots of pictures of Izaac lately. But we are just so happy he is well. Here are some few glimpses of our last week.  This is while we were still in Kampala. Nurses, how do you like these oxygen tanks?  And that monitor? Just thinking about this hospital stresses me out again. They didn't know normal ranges for pediatric vitals. Until we got the monitor, they they didn't even check vitals very often.  We spent hours (days?!) stressing about how to get him out of the country.

 This is Izaac's favorite memory. I think he had never been introduced to vending machines before. He loved putting money in, pushing the buttons and getting out something new. I'm glad that it is so easy to keep a 6 year old happy. (look at how much better his color is in this picture!)

 He also was very happy when his sister arrived. Aren't they cute? 

After Benj and Ellie arrived in Kenya my accommodations took a huge step up.  I don't really want to talk much about the two places I stayed near to the hospital but they can be well summed up with words like terrible and frightening.  This was the Amani Guest House, very nice and family friendly. Ellie made friends within two minutes. 

Then there was my trip back to Soroti.... it was supposed to be a twelve hour bus ride from capital to capital. (Nairobi to Kampala) But the bus got in an accident and it became a 15 hour ride only as far as the border. At 10:45 at night I baled to look for a place to sleep to attempt the border crossing after a few hours of sleep rather than after 15 hours on a bus. You know the place you are staying is classy when they offer free condoms with your registration. (If you look closely at the picture you can see the boxes of condoms over the receptionist's right shoulder.)

Update #3

Have we really only been in Kenya 36 hours?!  First, lots things to praise God about. The nursing staff here is great. (It is a pediatric hospital so they only do kids but having come from places that were terrible with Izaac is very refreshing).  Even the support staff is very helpful with things like helping me get to a hotel and get transport. Izaac is doing SO much better. A few times we have had sats in the high 80's but overall he sits about 90% on room air. Which means he got to have the mask off for a while yesterday which he was really happy about. There was even a time when we were going for a walk in the hall and he couldn't contain himself he just had to run. He is quickly regaining his normal, talkative, precocious self. The obvious highlight of his day yesterday was that we found a vending machine and he was allowed to pick something and put the money in and push all buttons himself. After getting his bag of pretzels we just HAD to get something else so he could do it again. Then he had to talk to Ellie (his little sister) to tell her all about it. He has already talked about doing it again today.

Very happy about bacon for breakfast!

Today's plan is to meet with the pulmonologist and see if he has any further ideas for us. So for now we are still waiting and wondering what to do next. But that is much easier when he is better and we have had a few nights of better sleep.

Update #2

Ok, I know all you lovely people would like an update and you deserve one but honestly Christina and I are pretty much running on fumes so we have pared down to the bare necessities.  You will get good blog posts in the future about this whole adventure because we have had some experiences, let me tell you. Like lights and sirens through Kampala during rush hour traffic?! Being delivered to the runway of an international airport in an ambulance?!
It was a very, very long day yesterday but the great news is Izaac is sleeping soundly now. He is also at his wit's end. Last night in the ER he kept telling the Dr."I can't." As in- Dr: "Can you stick your tongue out and say ahhhh?" "I can't." You get the idea. Poor kid has been through the ringer. But we met his new Dr. last night. She hasn't rounded yet this morning (it is still 6:30) but she is looking at all of this with fresh eyes and we are very hopeful.  Unfortunately, I expect today will be a day full of tests so we need to pray for endurance for Izaac (and fortitude for his mother. It is a terrible feeling to hold down your screaming child while they draw blood or give IV meds.)
Anyway, internet is too limited for pictures or too much more but we will see what we can do today to get more access. We are finding that our Ugandan phones will connect but at very diminished capacity. So I will apologize for the decreased communication and do the best we can. Thanks!!!!

brief update

Ok, trying to do a more detailed medical update in the midst of the crazyness:  Our major issue is respiratory. This morning, Izaac's oxygen saturation seems even lower than it has been the past few days. We took him off the non re-breather while he ate and he hit 72% after less than ten minutes on room air. (They don't have a nasal cannula to supplement). His chest x-ray from last night actually looks almost normal and is way better than the on of three days ago. The doctor here keeps talking of bronco-spasm but he doesn't respond at all to any neb treatments.  

Now, in the hours since I started this blog post we have a whole new problem. We know we need to get to a place with more medical resources. So there is a Children's hospital waiting for us in Kenya and we have an air ambulance lined up. But Kenya now does not allow visas at the airports. So there is a two day wait to get permission to enter the country. 

It is 9:30 pm here. These guys have had some very long days and are beyond tired. We need to get this kid some medical help. He is constantly tachy into the 130's and beyond. He never has a sat more than 88% on 15 liters. We can't get blood gasses. The pediatrician here practically admitted that he has no more ideas and has tried everything he can. No one likes to hear that. 

Terrible and short but I'll try to get more up shortly.

Izaac

Every few years I just hit this wall where I hate this job. When I feel like I've been making these huge decisions that have serious impact (either good or bad) for people. I get to this point where I want to scream that I can't make any more significant decisions. I'm not a doctor. I'm not trained to diagnose and prescribe. I'm trained to follow a doctors orders. My job is to watch patients and identify abnormalities and problems. Then report them. Not decide what needs to be done about them.
Yesterday I hit that point. Right around 10am. I'd been trying to help my family members get good treatment for their sick son. Which is really hard here. Really, really hard. This has been a hard malaria season with several unnecessary deaths and miscarriages so I was already feeling the strain.  Then trying to help them get the treatment they need was like the straw that broke the camel's back. Attempting to get a chest x-ray in a city that has not a single functioning x-ray machine. And oxygen. Practically a joke.  Though we did find the ONLY oxygen condenser in the city and borrowed it for 10 hours.  Conclusive lab work?  Not going to happen. So what is wrong with the child?! And what treatment should I recommend?!?
Anyway, yesterday morning my nephew seemed to finally be heading the right direction. And they had a doctor that seemed to be taking them seriously.  So I headed the 4+ hours back to Soroti. Now I'm regretting it. He is still very sick and having complications. My brother is calling asking what to do. And I really want to help. But I hit that wall. I can't make a single other decision. I doubt everything I suggest.  "Get on an airplane now and get your sick child to a good hospital before he gets even sicker!" "Well, you could change abx and give him 12 more hours to see if there is a change." "We could try to find a hospital in Kampala that can give oxygen overnight." I just can not be decisive. And they don't know what is best for their child so they don't know if they just keep watching him, worrying that he will get sicker or if they need to drop everything, purchase airline tickets, pack, find a guesthouse and rush out of Uganda.

So, I look at these numbers and try not to think: "For a healthy person, the normal blood oxygen saturation level (SpO2) should be around 94% to 99%. For patients with mild respiratory diseases, the SpO2 should be 90% or above. Supplementary oxygen should be used if SpO2 level falls below 90%, which is unacceptable for a prolonged period of time."
 I'm heading back to Jinja as soon as I've had enough hours of sleep to be safe to make the drive. I can't promise I'll be able to help them make a single decision. But I'm going back as an Aunt who cares rather than a nurse who knows we have to do something.

I didn't mean to make this whole post about me. Please pray for healing for Izaac. Please pray that God shows Himself as the healer and provider that He is. Please pray for all of us to trust Him. Please pray for peace and wisdom for Izaac's parents. This kind of thing makes you questions why in the world you would drag your children into rural Africa.

I'm still processing and I guess this kind of thing reminds me of that saying:

Which I'm going to say I actually think is complete BS.

Right now I'm at the end of myself. I was in the clinic for three hours today. I really want to be a good missionary nurse.  But I'm weary. And I'm finding it impossible to make medical decisions for people. I really, really believe this is actually true:

And so I need him to handle it all right now. So I'm praying. Because that is really all I can do.