Iraq Week 2

This week was a bit tiring, as we had some very sick kids in ICU and we also worked to graduate some of last week's cases who were giving us extra work to do! 

This boy was the very first case done on the day we arrived in Najaf. Now 8 years old, he should have been operated as an infant, and he experienced significant complications from his system essentially being shocked by his suddenly corrected heart. He was very sick for a few days and spent extra time on the ventilator, but he made a full recovery! It was really encouraging to see him steadily improve, though he did keep us very busy while he was in ICU!

Here he is off of the ventilator. He left ICU a few days after this photo, walking and doing well! 

This little guy was my favorite baby while we were there. (there's always one!) He was operated on the last ICHF trip, and was recovering well but then suddenly became sick and was admitted to another children's hospital in Najaf, where his condition was rapidly worsening. When our team arrived, he was transferred to our ICU in severe respiratory distress. Both of his lungs had filled with fluid, which collapsed his entire right lung and most of his left. We placed him on a ventilator, put in chest tubes to drain the fluid collecting around his lungs, and he quickly improved. He came off the ventilator the same night and was doing well for awhile, until one chest tube stopped draining and his right lung collapsed again. He needed surgery to clean out his lung and have a new chest tube placed, but there was already a case in surgery, so he had to wait more than 8 hours. I'm really grateful to all my RT friends back home who donated some supplies to me in May - they definitely saved this little guy! I was able to put him on a form of NCPAP that relaxed him enough to breathe on his own for a few more hours until he got his surgery.

 Afterward, he did very well! One of his chest tubes was removed before we left, the other continued to drain. He is only partially corrected, so hopefully he can have his final heart surgery on one of the upcoming ICHF trips. Love this baby!

For my RT friends - how to make emergency nasal CPAP with just a flow generator: Use a HFNC adapter to connect oxygen tubing directly to the flow line. Pry a disposable manometer off of an Ambu bag (pull HARD - it will come off!) Attach a pressure line or cut O2 tubing and create your own, the manometer fits perfectly. Connect your O2 tubing to a flow source, or wye an air line and O2 line together to make a blender, and - voila! NCPAP for the third world!

This baby was too unstable immediately after surgery to have her chest closed, so her sternum was covered with a special bandage and her chest was left open for 2 days until she stabilized. Then, the ICU became an OR and the surgical team closed her chest at the bedside! She tolerated the surgery very well.

Ready, set, levitate! Some of our local Iraqi nurses in action, lifting a patient so his bedding can be changed. Go team!

 Remember the jumper? He came back to ICU on the last day so he could have his pacer wires removed. He didn't really like us very much, but he did like the two DumDums he got as a reward! 

So, sad news - the rest of my second week photos got accidentally deleted when I arrived in Tanzania - I thought I had already transferred them to my computer - FAIL!  In total we operated on 13 children in 8 surgical days. 5 were still left in ICU when we left, which was really hard - please keep them in your prayers. Two were stable and going to discharge, but three were still sick and needing continued care. Pray that the local team is able to put their new knowledge into action and that these children recover well. 

Until next time....=)

Iraq Update - Week 1

After a few unexpected days in Istanbul due to delays in acquiring our visas for Iraq, we finally arrived on Wednesday and went straight to work! We have a really great team, and everyone works together very well.  

Just for fun, I came up with some future career ideas for these first few kids we've operated on. Without ICHF, they would not have lived into adulthood, but now, with fully repaired hearts - they have a whole new life ahead of them! Since they've spent their early years suffering from congenital heart disease in a country with no means to save them, maybe they haven't had a chance to think about what they want to be when they grown up. Now they'll have a few ideas! =)

First patient to leave the ICU - everyone was trying to get a photo before she wheeled out the door! Future career: Race car driver, Olympic speed skater 

  This little boy is five years old and he was the third child to get surgery this week. He's a bit drugged on morphine in this photo, but that didn't dampen his personality much at all!  He's very bright and talkative, and was constantly telling us hilarious things in Arabic which our translator couldn't help laughing as he translated! My favorite: "I give you my word, if you take these tubes out of my chest, I will do anything you say."

Second day post-op: smiling for his chest x-ray!               Future career: Actor, Comedian, and/or Lawyer

This gorgeous girl woke up and REALLY wanted to come off the ventilator, then had to wait a few extra hours due to some bleeding complications. Those were resolved, and she finally got her tube out!! She got scared when we started to take it out, so she just clamped her teeth together and bit down on it hard. I put her hand on the tube and let her just pull it out herself - she did great! All the makings of an excellent future Respiratory Therapist. =)

 The first word every kid says as soon as they are extubated is "mai!" which means "water!" She desperately wanted water when she was still on the ventilator, and all she could have was a wet sponge in her mouth. After her tube was out, we gave her a cup with a tiny bit of water - and she still drank most of it by dipping the sponge before she realized she could just drink it! So sweet.
Future career: Respiratory Therapist, Ice cream tester, barista

This little guy is 15 months old, and several times throughout the day he would wake from peaceful sleep, yell, and then fly off the bed! Right in the middle of morning rounds, he was rescued by Kristin, one of our nurses, who caught him in mid-air halfway to the floor! We don't have the option of a crib with railings, and didn't want to keep him tied down all day - most of the time he was very sweet and easy to contain. So we just had to keep a close eye on him every time he woke up. Anytime he stirred, whoever was nearby would run and catch him if he made a move! Future careers: base jumper, skydiver, bungee instructor, astronaut

 

That's all for week one!! More to come during week two! =)

Baby Ted

Ted and Brenda Whiteman, my neighbors at Open Arms, run a community outreach ministry in the neighborhood around Open Arms. During one of their outreaches, they gave out clothes to some of the poorest in our community. One of the women they gave clothes to later named her firstborn son after Ted! Baby Ted was born with a partial cleft lip and full cleft palate, and when Ted Whiteman heard this, he learned that Operation Smile was coming to Kisumu and made sure that Ted could be considered for surgery! Since Operation Smile was coming while the Whitemans were away in the US, I got to be the one to take Baby Ted to Kisumu!

In Kisumu at Operation Smile

Mety rented a car and we drove 2 1/2 hours to Kisumu so Baby Ted could be evaluated during the Operation Smile mission. It was a long drive on a very rough road, but we finally made it and Baby Ted was then seen by nurses, surgeons, photographers, speech therapists, a feeding specialist, a dentist, and an anesthesiologist! The screening process took about 8 hours and by the end, all of us were exhausted. But Baby Ted was assigned Priority 1 for surgery and was scheduled for his smile repair the following week!


Accompanied by his mom and her neighbor, Ted went back to Kisumu and was successfully operated. His mom, Nancy, texted me when he was out of surgery and said he was awake in the recovery room and "very active!" She was so excited at how well he did and how quickly he recovered. He came home to Mlango the next day!!

Two days after surgery - just perfect!

Ted on Nov 3rd!

Ted still needs an operation to repair his cleft palate, so he will go back to Operation Smile again in May, this time in Nakuru (which is a much nicer road!). Please keep praying for him as he grows big enough for his final surgery!

Somebody's growing up....

Look who's standing up!!! Asha has been standing on her own a lot lately, and walking if you hold her hands!

Today I went to say goodbye before leaving for Iraq and she walked to me by herself! 5 steps!! Such a big girl now!








I just love love love this baby!! She's had a bit of an attitude lately -  she definitely has a temper! But she still just melts me every time I see her!

Her sweet smile...

Her mischievous smile....

Her "kind of freaks me out!" smile! haha. =) She does this really funny thing where she scrunches up her whole face when she's excited - but I can't quite get the timing right to get a picture!

See you again in two weeks baby girl!

Home Sweet Cottage

Were you you picturing something like this? =)

Welcome to my home-sweet-home in Kenya!

Here it is from the front! This one is a little misleading because I have more plants on the porch than usual. A lot of those got relocated, but I'm thinking about getting some back!

 One of my pet "ducks". =)

My awesome kitchen, complete with refrigerator, microwave, and gas stove! Love, love, love!!

 This is the bedroom/dining room/kitchen area! The white things hanging over the beds are mosquito nets.

Here's the bathroom. The floor is tiled straight across to the shower area, which makes cleaning pretty easy! Except the drain is not the lowest part of the floor. Oh well, can't have it all!

The view out my kitchen window - pine trees! I love this - it reminds me of my home in Spokane!

The view out the side window - the cottage community clothesline.

Part of our running water system. 

 I have running water, electricity, and internet! Except when I don't... Ha.

 There's a spare bed in my cottage that is vacant right now - come and visit!!

Lake Baringo

 Lake Baringo! Two matatus and a taxi ride later, Mety and I arrived in Baringo.
Our accommodations changed at the last minute, so after our taxi dropped us off about
3 kilometers down a "road" (ha. hahaha. hahahahahaha - NOT a road.) We changed our minds
again and called for a motorbike to take us back to a different hotel.

Cooking catfish

After checking in, we had our new motorbike friend take us into town to buy fish for dinner.
It's quite the experience!

Pick out your fish!

There's a fish market on the side of the road where they sell
smoked or fried fish - Catfish or Tilapia.


We picked a piece of fried Catfish since neither
of us had never tried it. You take your cooked fish to a nearby hotel and they warm it
for you while you wait. We ordered some chapati and about 30 minutes later, dinner was served.
yum! The fish was too much for us to finish, and it only cost 100ksh ($1.20). The hotel charged 90ksh to warm it up with chapati. Now that's vacationing on a budget!

 Good morning Lake Baringo! We woke up to three ostriches strolling around the grounds having breakfast.

I've never gotten this close to a Crown Crane! These birds are all over Kenya, and there are lots of them by the village, so beautiful.

The hotel as two blue tailed monkeys in a cage. Right after I said "sad! that cage is too small!" one of them gave us this look! I think he agrees. Let him out.









This little guy seemed pretty happy swinging around in his cage. But I think he really wanted my camera!

Lake Baringo is a bit flooded right now from the rainy season, so the water is a lot closer to the hotel than it usually is. 

For those of you who are only reading this to find out what we bought the knife for - that was just for cutting up our fresh watermelon! Our first hotel was supposed to have a kitchen, but now we're stuck with two glasses and a bottle of water, which doesn't do much to a watermelon. Made for a great Facebook post though! =)

A Very Great Friend

Earlier this year I was blessed to become friends with Emily Keese. I met her last year when she came on one of the short term teams, but this year she came for a whole three months - she was here for all three medical clinics and we had an absolute blast working together in the pharmacy. We have a very similar sense of humor!

While she was here, Emily gave me one of the greatest gifts I've ever received. As you know, we lost baby Ian and baby Obadiah earlier  this year, shortly before I came back to the US. Before I left I planted flowers at the grave sites, but it was the dry season and when I came back everything had died and the cemetery was overgrown with waist high grass and weeds.  I made plans to go work on it but weeks went by and I just absorbed myself in working with the teams.

Emily heard me mention the cemetery and she went looking for it one Saturday between teams. It's tucked away in an untraveled corner of the village property, overlooking the river. She spent the next week getting up early in the morning slashing grass and digging weeds. The plot was fenced with barbed wire, and she salvaged scrap wood from the dairy and built a gate, then piled a  rock wall all the way around the inside perimeter. Just before she left, the headstones that were ordered in April finally came, and she moved them down also.

I can't really convey how much it meant to me that she put in all the time and effort she did. Once she was finished, the ground was ready for plants and flowers, and the place looks worlds better than it did. I bought more plants in town and then the rainy season continued more than a month past it's usual time - so everything was thoroughly watered and is growing well! 

Emily has an incredible testimony, which she shared at our medical clinics and again when she returned home after Kenya. Watch the video here - http://vimeo.com/49615777

Emily - thank you, thank you, thank you for everything!! You are an amazing person and very great friend! Hurry back to Kenya soon. =)