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.

This remains one of my favorite posts by another missionary writer. Check it out while I recover and figure out what I want to write about.

10 reasons you should be a missionary. 

How to build a house in 10 easy steps....

Here is a funny post from my brother. He lives in a different part of Uganda so their houses look a bit different (square rather than round and tin roofs instead of grass but mostly the same idea.)

How to build a house in 10 easy steps 

Check it out. It is funner than my rather boring, depressing stuff lately. 

And another great post by another missionary writer. Mostly I want to share it to keep myself honest. I don't want to ever use facebook or my blog to misrepresent myself. I want to always post truth, and God's truth, not my perception of truth. I don't want to mislead, even by omission. (Which isn't actually a lie, right?  It just isn't telling all of the truth? Wrong.)  Even if you are not a missionary I want to challenge you to also read this post and see what you think. And also, I'm giving you permission to call me out on something, anything, you read here or on other social media that doesn't seem honest. Please help hold me to integrity.
Facebook lies and other truth

Prayer requests

I was going to start this post out saying I think I need prayer for this week, but on second thought I'm sure. I need prayer for this week. Where to begin? Well, first (because of this stupid picture) I have some sort of painful inflammation on the left side of my face and neck. It feels like a burn and without ice every few hours my eye swells half closed. Also, I think I have a stress fracture in my foot. It has been painful for weeks now. I took it easy the end of last week but probably over did it this weekend and now I'm paying for it again.

And malaria..... that season is well upon us. The clinic is overflowing. It seems like very few are having a response to first line treatments and everyone is needing IV.  On top of that there are lots of diagnosis of other things like typhoid which just makes me frustrated but that is for another post.

Lastly, I still have no idea where I am in the work permit process. I haven't heard anything. So I need your support:
Please pray that I can be the hands and feet of Christ in the clinic this week.
Please pray for healing and strength.
Please pray that in the busyness I can be patient, loving and kind.
Please pray that I can just get my permit and not need to worry about it for 3 more years.
Thanks everyone!!!

Work permit update

Please keep praying for my work permit. It seems nothing can be simple. I've learned this week that my permit request was "deferred" because there is an error on two of the letters that needed to be submitted. I was told that in the letters it states I'm the director which can't be because it is a local NGO. However, I went back an re-read the letters and, even if English is your second language, it is clear I am a volunteer and the person who wrote and signed the letter is the director and obviously Ugandan. (Which he even states in the letter.) When asking for clarification I was told (please ignore the poor English):

The Board members need direct letter that states your position and you are doing and it should be only three paragraphs.So let letter be rewritten and scan and send to us this week so that we can filed it.

Which is EXACTLY what I sent last time, three paragraphs, position, I'm a nurse, etc...... So I need to figure out how to re-write these letters, get them re-signed and sent in to Kampala before the end of the week.  On something that was already done weeks ago. Ugh.

Please pray for Melda

 The girl in the far right of this picture is 12 year old Melda.  She has had osteomyelitis in her leg for at least a year, probably 2 years. Her family tried to get treatment a few times but every time got sub par treatment or denied treatment all together. So I've been involved for a few weeks now. I took her to an orthopedic hospital yesterday. We'd been told repeatedly that all that could be done was a BKA amputation before it became sepsis. But yesterday's surgeon agreed to try something else, he will attempt to clean up the bone and see if it will heal. She heads into surgery next week Monday. The girl in the middle of the picture is actually her sister. Her identical twin. But she has been sick so long he father (man on the left) said they don't resemble each other anymore.

Will you pray for Melda and her family?  They are in a tough situation and Melda has a tough few weeks ahead of her. 

Just more clinic stuff

I seems to spend lots of time at the clinic lately so just a few more pictures....

Templeton’s Holiday

When I was growing up I remember doing this thing mom called Templeton’s holiday. It was named after Templeton the pack rat in Charlotte’s web.  The idea was that we could pick any fast food that we wanted and we would get it and bring it all home. So if you wanted a frosty from Wendy’s and nachos from Taco Bell then it is fine. Between the brothers and I we could stop at least six different places. I only remember doing it two different times. Once when Dad was in Africa and one other time but I can't remember the occasion. We never got to eat fast food which made it that much more special.  Anyway, the whole point of this silly little walk down memory lane is that today I really wanted a chocolate frosty from Wendy’s. But more than that, getting medical care here felt like trying to get a 12 piece chicken nugget from Arby’s.  Unless Arby’s actually has chicken nuggets.  Then this isn’t a good comparison.   

I had several patients today that I’d encountered over the past week in clinics that needed further testing in town. That meant I was trying to get an ultrasound, blood work , x-rays, Augmentin (very hard to find in Soroti), and a consult from a pediatrician. Today that meant five different places. Turns out the hospital I started at could order the x-ray, I could go to Joint Clinic to have it taken and then took the film to Community Clinic to have it read by an actual radiologist. Then back to the hospital with a definitive diagnosis of Osteomyelitis. But we were told we would need to go to another town to find an orthopedic surgeon.  And that was only one of my patients. Now you see why I wanted that Frosty? 

Swimming in Soroti

 The kids are now back on school holiday and have been continuously begging me to take them swimming. Last week I caved. I love to swim and taking them gives me an excuse. Though I have to watch them all pretty carefully.

 The pool is a bit aged but functional at the flight school here in Soroti and the kids that I sponsor  can't seem to get enough of it.  None of them can swim but you couldn't tell from these pictures. The shallow is only about 3 feet deep.  Also, none of them have swimsuits but the pool doesn't have any rules about swimming in your underwear or clothes.

Following up on a femur fractur

Praise God!! I finally managed to find Righard. He is home from the hospital, has all his stitches out and is breathing without difficulty. It took me more than an hour to get all of his stitches out as he seemed to miss the memo that he was to have them removed shortly after surgery and he had more than 20 of them that were rather grown in. He has a fourteen inch rod in his leg now and is hopefully a more cautious driver. Other than that he is back to normal.

The (painfully long) story of his accident here.