Reflections

This young bald eagle greeted us to the states from a large fir tree outside Kristina's parent's house.

Well, we're back in the US now, enjoying family and getting accustomed to the cold weather.  The fall leaves held on just a bit longer than usual this year in Ridgefield, which was a special gift for Kristina from God.  We had a safe, uneventful trip back to the US, and the kids were really well-behaved.  We've been blessed by family and friends here in Ridgefield, who have welcomed us with open arms.  We're especially thankful to Kristina's parents, who've opened up their home to live until we find a place of our own, and we'll be spending most of December enjoying the hospitality of my parents in Idaho.

Stopping outside Papa and Grandma's house to shoot a picture of the fall leaves.

 It will take us awhile to fully reflect on our time in Shell.  Please be praying for us as we adjust to life back in our home country and look for a place to live.  In many ways, it will be very challenging for us to be living in the US.  Of course we already miss all of our good friends in Shell.  It was a true blessing and honor to live and work with those missionaries for a couple of years.

A couple of weeks ago I blogged about Baby D, a precious little 1-month-old baby who had suffered bleeding in her brain.  I wanted to give an update about her status.  After spending about a week in intensive care in Quito, she made a full recovery.  She was seen by Dr. Tacheny in clinic last weekend and appeared to be completely normal!  We thank God for the miracle of this little baby's life.  This was an especially critical case, but in our prayer times as a family, we felt a peace, as though God was telling us that she was going to be alright.

We thank God for a great time in Shell, and we're looking forward to this next chapter in our lives.  It's scary but exciting, and we're content to be in His will.  Thanks go out to all of you who have been alongside us the whole way!

Dan didn't wait 24 hours to go out fishing on the Lewis River and brought home some wonderful chinook salmon for dinner.

Weekend Call and Packing Craziness

As I pack up the house for our move Dan is busy with his last weekend call that he'll have here.  So far it's given him a run for his money as he not only has had clinic on his own this morning but there was a bad car accident in which he's had to admit eight people, four of them going to the operating room for huge fractures.  Dan and I are training for a race on Thanksgiving day that will raise money to dig wells in developing countries and have talked about finishing with a kick; I guess that's what he's doing today....Dan just ran into the house to get our pliers.  He needs to pull a large fish hook out of a boy's hands and the hospital tools aren't quite cutting it.

I've joked with Dan that this house packing is going to be a lot like packing for a family trip; he gets his own clothes ready, and I pack our luggage for all the rest of us.  So far it's been true in that I've packed up almost the entire house without his help, as he's been busy at the hospital.  However, I see it as a praise to ways that God has grown us over the last two years.  I remember getting ready to move here and being quite stressed about last minute details and bag weights as I took care of Caleb and Jael, even with Dan's help.  Now, two years later and one more kid, God's given me lots of peace about enjoying each day as it comes and understanding he's blessed me with the ability to organize well.  Instead of being bitter about not having more help I can use my "talents" (or maybe it's my OCD personality :) to help my family get ready for the move, and I'm actually enjoying the process.  Now I'm praying that this same personality can be at peace as we "drift" for awhile in the states until finding a home of our own :)

Baby D

I really enjoyed this young couple during prenatal visits. The mother always had a sweet smile on her face, and the father was always a little nervous like most Dads-to-be. It would be their second baby. As we approached her due date, I examined her and found that her baby was in the transverse position. (It is impossible for a baby to be born in this position). We attempted to move the baby into the head-down position, but with only limited success, and she ended up with a c-section. The surgery went well, and Mother and Baby D both went home without any difficulties. I saw Baby D in follow-up a couple of times, and she was growing and developing perfectly.

Just a few days ago, the father came to me frantically and said that Baby D was in the public hospital and that she had almost died. He said that he would like to bring her to our hospital for us to evaluate. For about a day, she seemed okay. She apparently had had a fever, so we performed a couple of tests to try to rule out big infections. Nevertheless, she was eating like a champ and looked like a pretty normal one-month-old. Then I received a frantic call from the nurses. “Come in now, because the patient in room 10 is bad”. Without further questions, I raced in. Baby D did not look good today. Her tongue and her eyes were moving in a way that made me believe that she was seizing. She was no longer awake, no longer eating. A lumbar puncture showed blood in her spinal fluid—she appeared to be bleeding around her brain. We managed to send her out for a CT scan, and this diagnosis was confirmed. Three medicines were needed to stop her seizing, and by that time we were breathing for her with the mechanical ventilator. Mission Aviation Fellowship flew her to the main pediatric hospital in Quito, where a pediatric ICU and a neurosurgeon will be available.

We haven’t heard yet how Baby D is doing. I think we will know within the next couple of days. In the meantime, we all (including our kids at the supper table) have been praying hard for this little baby and her neat family. We don’t know why she was bleeding around her brain, and it’s likely that we never will. I feel helpless as the doctor in these cases, but I was honored to be able to provide the spiritual and emotional support that this family readily accepted. Though I tend to try to fix everything on my own, I am doing my best to live my life knowing that we have a good God who is in control of everything.

Washington, Here We Come

Dan and I have spent a lot of time praying about our future move and considering the many details that a move would bring for our family. Dan spent a lot of time traveling around the Northwest for his interviews in Washington and Idaho and although we talked almost everyday while he was gone, we had decided to wait until his return to really discuss our decision.  We felt that we would both have singleness of heart with the job and location that would be the best at this point of our lives.  There was one job in particular that I had been on my heart often during prayer, and upon his return he shared about each place he was considering.  There were many great options in Caldwell and in Washington.  When he felt his first choice was the one I'd considered for so long it really became a clear decision.  We're so thankful that something that could have been stressful wasn't at all, and we're confident that we're headed in the right direction.  All that to say, we will be flying back to that United States on November 14th where we will move to Washington so Dan can begin working at the family medicine residency program in Vancouver.  During the time in Ecuador, Dan has really enjoyed being a teacher.  He is excited to begin work in Vancouver where he'll be able to continue to teach and mentor resident doctors, to work with a great staff, to maintain his skills in obstetrics and hospital medicine, and to be able to serve many patients who come from difficult socioeconomic backgrounds.

We plan to settle down in Ridgefield where I grew up.  We're going to miss our family and friends in Idaho, but should have the opportunity to visit much more often.  We are still looking forward to doing foreign mission work in the future, but are excited to be back on the "home field" for awhile.

We'll continue to blog about our work in Ecuador as I know Dan has some new medical stories he'd like to share.  Our next big step will be looking for a place to live in Ridgefield; God keeps us depending on Him, no matter where we are.

Jael loves playing with Tori whose father is the ophthalmologist at the hospital.

Caleb celebrated his 5th birthday with some new legos.

Anna loves to help Mommy cook (and lick the spoon).

Holding Down the Fort

Dan headed to the states on Sunday to interview for possible job opportunities in Idaho and Washington.  He'll have a busy schedule as he flies between the two states and visits several different locations.  Please pray that he'll make the best choice as he considers many different aspects of each job as well as their different locations.  We're excited to see what the Lord has for us next and should know within the next four weeks where we'll be headed.

In the meantime, I'm holding down the fort here in Shell.  It was a little harder to say goodbye to him, knowing he'll be in another country and not just at the hospital, but already I've had lots of offers of help with the kids if I need it and invitations to hang out with others.  Hopefully this can be two weeks filled with lots of laughter and fun in the house and not frustrations.  Dan may get BBQ steaks and corn on the cob in the states but we get to dine on Mac N Cheese, which actually is a treat.  We thought about sneaking the kids on the plane with him but decided it wouldn't be too practical.

Anna would have been Dan's checked luggage and Caleb and Jael his carry-ons/

Beautiful Babies and Parasite Paradise

The last few weeks have been busy at the hospital, as more people have been trying to get in for their regular check-ups before school starts.  Many new babies have been brought into the world as well.  Dr. Egberth and I performed a c-section on a mom with double-breech twins.  Everyone did great, and it was really fun to be involved with this family's excitement (even if she did need her surgery emergently at 3 am).  We had another mom who came in with her baby in the transverse position.  Working together, we managed to help that baby do several summersaults before she finally settled into a head-down position.  At that point, we broke the mom's water and induced the labor, hoping to keep the baby aimed in the right direction.  Unfortunately, the rascal switched back to transverse, and we ended up performing a c-section after all.

10.5 pounds of joy

We at Hospital Vozandes aren't the only ones who have been busy lately.  Apparently the worms in the jungle are also prospering and expanding their horizons.  Last weekend I took care of three babies in room 8 of our hospital.  One of the babies had Rotavirus (a virus that makes the patient have bad diarrhea) that had caused dehydration.  Another had been sick with a fever for weeks.  We ruled out the most common infections (malaria, dengue fever, tuberculosis and leptospirosis) and settled on a diagnosis of "Jungle Fever."  Patients like him come to our hospital every now and then, and we usually give them a kaleidoscope of antibiotics to cover oddities like brucellosis and Q fever.  The third baby presented with extreme weakness and pallor.  His hemoglobin, which is a measure of red blood cells, had dropped to 2 (normal for his age would be about 10-13).  He was diagnosed with severe anemia, which had evidently developed over several weeks.  Dropping a person's hemoglobin down to 2 acutely would cause shock and death, but the body can often make compensations if it is a gradual process.

The anemic baby was found to have an infestation of hookworms.  This parasite can burr through the skin of the feet to enter the bloodstream.  It's next stop is the lungs.  From the lungs, it climbs up into the throat and jumps down into the esophagus, with the goal of setting up a new home in the duodenum of the small intestine.  There, it attaches to the wall and drinks blood to its heart's content.  Our anemic baby with the hookworm infection quickly got better with a blood transfusion and anti-parasite drugs.  The other babies were also getting better, but their moms were concerned that they had persistently-bloated bellies and poor appetites.  We also treated them for parasites, and many interesting things were found in their diapers over the next few days.  In the end, all of them got much better and were taken home by their happy mothers.

Looking better after getting rid of Rotavirus and other critters

Addition of blood and subtraction of hookworms equals a fat, happy baby

After successful treatment of "Jungle Fever"

 (All pictures taken and posted with permission of the patients and their families)

The Past Few Weeks

We’ve fallen a little behind on our blogs lately, but we’re alive and well here in Shell.

We attended another very special wedding this past month when one of the couples in our marriage class decided to get married in a civil ceremony. In Ecuador the civil ceremony is the official and legal ceremony, sometimes followed by a church ceremony if it’s affordable. Unfortunately we can’t share our pictures from the wedding since our camera, telephone, and electronic reader were stolen on the bus to Quito one afternoon, but we do have a shot of our latest class.

Celebrating our last marriage class

 We were blessed to have our good friends from residency training in Idaho come and visit us last week. Ryan and Alanna were great sports as we showed them around Shell, they played with our kids, and were even (un)fortunate enough to share the flu with the rest of our family one day. We took them for a hike on the military base here (which always feels a little intimidating to leave your passports at the gate as you drive past camouflaged young men with large guns). Currently there is a baby ocelot that was confiscated from a family trying to keep it as a pet and we had the chance to hold the little guy.

Ryan and Alanna in front of the "Shell" sign

Playing with the tiger baby.

One morning while Alanna and I were talking, Caleb calmly walked in and told me there was a snake on the back porch. The kids are always pretending so I told him I’d be out in a minute to “kill” it. When we finally made our way outside we discovered Caleb wasn’t pretending.  I put an end to him, though it took me a shovel and machete to do it. Another missionary later told me that it is some kind of blind, snake-like worm that wouldn’t hurt anything….oops. It’s difficult not to be too judgmental when there are slithery creatures near your house.

Our slithery visitor

Dan will soon get another medical blog posted.  He's on a seven-day, four-call workweek, but should get a chance soon.