Catching up...

After many months, and many life changes… I’ve decided it’s time to revive this blog.

The past few years of my life have been full, very full.

Full of exciting and memorable moments. Full of life-changed experiences.

 

Full of lessons learned, foundations laid, friendships forged, and relationships built.

 

 

Full of change, and moving forward; new jobs, new careers, and new schedules.

 

Full of challenges and tests, and opportunities to learn patience and contentment.

 

 

 

Full of prayers prayed- and learning to wait for God’s perfect timing to answer.

 

 

 

Full of life. And full of love.

 

And now, there is today.

And a bright future, full of tomorrows...

 

Help Me Find It

I don’t know where to go from here
It all used to seem so clear
I’m finding I can’t do this on my own

I don’t know where to go from here
As long as I know that You are near

I’m done fighting
I’m finally letting go

 

I will trust in You
You’ve never failed before
I will trust in You

 

If there’s a road I should walk
Help me find it
If I need to be still
Give me peace for the moment

Whatever Your will
Whatever Your will
Can you help me find it
Can you help me find it

 

 

I’m giving You fear and You give faith
I giving you doubt
You give me grace
For every step I’ve never been alone

Even when it hurts, You’ll have Your way
Even in the valley I will say
With every breath
You’ve never let me go

 

I will wait for You
You’ve never failed before
I will wait for You

 

I lift my empty hands (come fill me up again)
Have Your way my King (I give my all to You)
I lift my eyes again (Was blind but now I see)
‘Cause You are all I need



If there’s a road I should walk
Help me find it
If I need to be still
Give me peace for the moment

 

(~by Sidewalk Prophets)

 

 

 

 

 

Experiancing El Salvador- Clinic Day #2

Tuesday, January 31st, 2012- Clinic in Las Mesitas
Our second clinic was hosted in a school compound, with the providers set up in the classrooms. This village was in the area affected by the flooding last fall. Due to the increased need for healthcare in this area, members of several surrounding communities were invited to come to the clinic. Interestingly, an increased number of pediatric patients were seen at this clinic.

Prior to going to this clinic site, the national doctor we were working with informed us that there was an increased incidence of renal failure in this area of the country. Recently, she has been working to identify the causes of this condition, as well as things that can be done to identify and slow the progression of the condition in the affected patients. To promote early identification, she has increased her focus on screening patients for diabetes and hypertension. Consequently, she requested that we check finger sticks on all of the adult patients we saw at this clinic.

In looking for causative factors, she has found that parasite treatment medications can become renally toxic if taken frequently. This has become an issue of concern, as parasites are incredibly common and patients have a tendency to be treated frequently. This is also an issue, as patients have access to medications without prescriptions, and will therefore self- treat for parasites. Because of the concerns related to this issue, she no longer treats any of her patients for parasites, unless they have a positive lab slip, and have not been treated within the past six months.

Again, a variety of conditions were presented at this clinic. A number of patients presented with a chief complaint of headaches, while others had chronic cough and cold symptoms. Several patients, both adults and children, were seen and treated for parasites and anemia.
One of our first patients this day was a five year old boy, who weighed 11kg (24.24lbs). He presented at the clinic with his mother with complaints of stomach pain, intermittent fevers, and fatigue. Additionally, his mother had a positive lab slip from a stool sample she had taken to the lab the previous week. The lab slip was negative for any parasites of amoebas, but was positive for a bacterial infection.
As we talked with the mother, and then with Dr. Danielle, we were informed that this child had been severely malnourished last fall, and was actually looking much better. He had been so weak last fall that Daniella had started him on Ensure/protein drinks, and was impressed with how much better he looked. When we charted his height and weight on the growth charts, he was in the 50th percentile for height, but less than the 5th percentile for his weight. Because of his mother’s complaints of him being frequently fatigued, we checked his hemoglobin level, which was 11.4.

Although this particular child was doing better, it was sobering to realize that he represented so many children. Children who are not experiencing life to the fullest. Children who are literally too tired to enjoy their childhood, simply because they do not have access to the nutritious food they need.
One of the other patients we saw at this clinic came in complaining of pain in her right leg and knee. She stated she had been experiencing the pain for about two weeks, but denied any recent trauma to the area. She described the pain as aching, stating it got worse throughout the day. She also noted at times it was difficult to bend her knee. Musculoskeletal exams were difficult due to the setting we were working in, however, we were able to perform a (slightly modified!) anterior drawer test, as well as a Varus and Vulgas test, each of which was negative. The patient did note tenderness on lateral portion of her thigh with palpation, with some areas more tender than others. Based on the exam, it appeared to be a muscle/ligament injury, and not a joint/skeletal injury. Unfortunately, we did not have access to any imaging studies, and could not perform a more extensive exam. Additionally, our treatment was also limited, but we were able to give her an anti-inflammatory for the pain, and some instructions on stretches and exercises that will hopefully strengthen the muscles and help the area to heal.
As we were developing our plan for this patient, I found myself thinking about what we would do if this was a patient we were seeing in the States. Most likely, imaging studies, such as an MRI, would have been ordered. Additionally, a Physical therapy evaluation would have been recommended, and the patient probably would have done physical therapy for the next few weeks. Although access to these additional resources would have been reassuring, we felt confident that our diagnosis and treatment were correct.

Experiancing El Salvador- Clinic Day #1

Monday, January 30th, 2012 – Clinic in Izalco

Our first clinic of the week was in the Village of Izalco. Our clinic this day was set up in the church, and two of the nearby buildings. A variety of patients were seen at this clinic, varying both by age and medical condition. Although we saw only adults at this particular clinic, each of our patient’s came with a unique concern.

A variety of health conditions were seen at this clinic, ranging from a middle aged female complaining of headaches, GERD, and a yeast infection, to a 65 year old female with new onset hypertension and a new cataract. We also saw a patient with severe Glaucoma, who appeared to be nearly blind. Both of these patient’s seen with ophthalmic conditions were transferred to the vision center for evaluation. Another patient seen had severe deformities of the right hand and foot from a burn as a child, however had adapted very well and had no residual issues.

One of the male patient’s seen at this clinic was in his mid-thirties, and came with concerns about a history of a seizure disorder, as well as increasing issues with insomnia, anxiety, and anger. This patient was being followed by a neurologist for his seizure disorder. However, he was noticing an increase in the psych issues in his own life, and knew he needed help. He also noted they were starting to have issues at home with his family. We referred this patient to talk to the psychiatric nurse practitioners. Later, we were told that this man was the president of the community, and had been open to a very effective session by himself, and with his young daughter. While we were glad that this man had been given help and hope for the issues he was experiencing, we were also excited to know that he had set an example for the community by opening up about his issues, and accepting help from foreigners.

One of our most memorable patient’s from this particular clinic was a 40 year old male, who presented with concerns about a rash. I did not initially notice the rash on his arms, but as I approached this patient to obtain his blood pressure, the large open lesions on his arms were impossible to miss. Although the patient was wearing long pants, and a dark colored t-shirt, it was apparent that this patient had a serious skin condition, as the exposed portion of his arms was extensively affected.
Initially, the lesions on his skin looked like Ringworm, as they were generally circular in shape, with raw, open interior areas. However, as we talked to the patient and obtained a history my differential diagnosis began to change. The patient told us he had had this condition for about five years, but over that time the severity had varied. At one point, about a year ago, the condition was almost completely resolved, with only small lesions on his forearm and in the crease of his elbow. He told us that over the past few months the condition had been gradually getting worse and covering more of his body. When we asked what other areas of his body were affected, he told us that his back, abdomen, and lower extremities were all covered with the lesions.
As we continued to ask questions, the patient told us he had seen a specialist several years ago, who had diagnosed him with Psoriasis and given him a cream for the lesions. After this diagnosis, the patient had changed his occupation to avoid exposing his skin to the direct sunlight on a daily basis. This change in occupation, as well as the use of the topical cream, had significantly improved his condition. However, ever since the death of his son six months ago, the condition had been getting progressively worse. He had used all of the topical cream he had been given in the past, and therefore was not treating the condition or symptoms in anyway.
Further exam revealed that his entire torso, both anteriorly and posteriorly, was extensively affected, as well as his bilateral lower extremities. The only body areas not affected were his neck and face; however, faint scars were visible on the patient’s head, indicating that in the past, these areas had also been affected.
Due to the limitations of the medications and services we could offer in this clinic setting, we strongly encouraged this patient to be seen by a dermatologist as soon as he could. Additionally, we prescribed him topical steroid cream, as well as Benadryl to help reduce the itching and discomfort. Lastly, we encouraged him to meet with our psychiatric nurse practitioner to address the stress component of the condition.

One year ago (#3)...

Haiti bound!
We finally had a charter flight…as well as a scheduled landing slot in Port au Prince! We headed to the airport …our team of five, an anesthesiologist, a pastor, and an engineer. And our luggage… 600 pounds of supplies that we had flown in with, as well as medical supplies from the hospital in the DR.


There was nervous anticipation as we landed in Port au Prince as we all braced for the unknown before us. We had tried so hard to prepare ourselves…but were we ready? Later that week, I wrote about my initial thoughts and emotions when we landed…


We landed in Port au Prince, taxied close to the door, and jumped out to unload our luggage. As we made our way across the tarmac to the open door, things looked so much different. There were planes parked everywhere…along the edge of the tarmac, in the grass, and close to the airport building. An area in the shade of the building was roped off, and filled with chairs for people waiting to get out of the country. Military personal were dispersed among the crowds of people. Although things seemed so different as we crossed the tarmac, if felt right…it felt like Haiti. We stepped inside, and my feelings were confirmed. A women sitting at a classroom desk took our passports and stamped them, not questions, no paperwork, just a stamp, and we’re in. We walk through an almost empty airport, and out through a door, that used to be the employee only entry. We stepped outside the door, and the reality of the change that had happened in Haiti hit me. The crowds of people who are typically surrounding the airport exit are all but gone today. The airport workers who are usually plentiful, at least one for every piece of luggage, have been reduced to a handful of men willing to help, hoping you’ll slip them a tip.



We were met by a member of the CURE team who had been in Haiti for several weeks, loaded all of our luggage into a couple vehicles, and headed across the city to the hospital.

As we pulled away from the airport, our driver told us we would be going down a street that had a lot of buildings that had fallen. As we drove past collapsed buildings, and piles of rubble, our driver told us that his mother had been killed, and his sister had broken her arm. I could see the pain is his eyes as he shared his story, and I wondered how he could be back to work. It was a harsh reality that hit me; he, like so many others, had no choice. He had to move on, despite the pain and loss. We continued to travel away from the airport and towards the hospital, and with every passing moment I fought back the tears. We had been warned it was bad, but to be driving through the streets brought it to a new level for me.



We arrived at the Haitian Community Hospital, and I knew I was supposed to be there. There was tragedy, pain, and sickness all around…and everything within me wanted to reach out and offer healing and relief. We headed towards the main doors of the hospital and I braced myself for what would meet me inside- the sights, the smells, the sounds.

We had a brief tour of the hospital, and within 15 minutes of our arrival, Jen and I were being given a room assignment. There were two American nurses, on a floor with about 50 patients. The room we were assigned to had 10 patients; slightly overwhelming, but we were up for the challenge. We made our way around the room, and gathered what information we could- the charts were a mixture of English, Creole, and French. Oral medications weren’t being charted, as family members were administering them. We went back to find the nurse that had been named “charge nurse” to ask her for some direction, and tell her which patients had been told they were ready for discharge. By the time we got to the desk, the news had gotten out that I could translate, and my assignment was being changed… the orthopedic surgeons were doing rounds, and needed a translator!

The next seven hours are a blur in my memory… I had the incredible opportunity of doing rounds with the surgeons- one American surgeon had been there for the past 10 days, but was flying out later that night; another surgeon had just arrived from the UAE and was taking over. Together, we went from room to room, bed to bed, discussing each patient’s condition. We talked to each patient, heard a little bit of their story, asked how they were recovering, and explaining to them what would need to be done next.
We helped deliver several babies that afternoon. The maternity ward consisted of two delivery tables, and a bed in the hallway. There was one American doctor doing deliveries, as well as trying to keep up with post partum care. It was a beautiful to witness the birth of the precious innocent babies. And yet with each delivery, I would ask myself what the future would hold for that child. I would find myself wondering what that child’s life would look like, starting life in the midst of so much tragedy.
The hours slipped away as we worked. We had come with a willingness to do whatever was needed…and welcomed every challenge set before us. We helped with transports to the x-ray department, cleaned beds after patients were discharged, sorted through piles of donations to find boxes of gloves, and took water to thirsty patients. I translated for several doctors, helped change bandages, gave medications, and hung IVs.

Seven hours later my team finally pulled me away. Everything in me wanted to stay…there was still so much that need to be done. But they insisted that it was time to leave the hospital, and go back to the house we were staying. I followed them out, and climbed in the waiting vehicle.

It was dark our, the vehicle was packed, people were talking… in that moment, my mind started to comprehend what I had just experienced. I realized that since we had arrived, I had not taken time to sit, to eat, to drink. The faces of the patients were running through my mind. I could hear each of them telling me their story. I could again see the looks of fear, pain, and desperation in their eyes. A tear slipped down my cheek… and I cried out to God for strength. And in that quiet moment, He answered! A soothing calm flooded over me…and I knew that He would be with me, giving me the strength to continue on, and be the confident smile that brought hope to each patient.

One year ago (#2)...

Day two in the DR…
We were still waiting to get our flight into Port au Prince arranged, so it was decided that we would spend the day visiting CURE patients in the DR. First on our list of priorities was to go to the CURE hospital, and see the Haitian patients that were being treated there! We were anxious to get to the hospital and see these patients, mainly because that is what we were there for- to help the people of Haiti who had been injured in the earthquake. However, there was also the added incentive that there were few Kreyol speakers at the hospital, and the CURE team was excited that I would be able to communicate with these patients.
The interactions with the patients that morning had a deep impact on me. I later wrote about the experience…

We were given a tour of the facility… but getting to see and talk to the different patients had the most impact on me…
We went upstairs to the private patient rooms, where they had a few patients who had been brought over from Port au Prince. The first patient, a young mother was stable, and very obviously thankful to be alive. She told us she had two children, one 2 years old, the other 2 months old, that she had left in Haiti with her family. She had somehow gotten to Santo Domingo to have surgery for a broken leg. As we spoke to her, she and the family members in the room shared over and over how thankful they were that God had spared her life. When we asked if we could pray with her, her face split into a beautiful smile. What a joy to join in prayer with this precious woman, thanking God for her life, and praying healing, protection, and provision over her entire family.
We entered the next room, and met Bernagene, a young girl, with a broken heart. Although her aunt was with her, neither of them spoke any English, so I was asked to translate. I went to her bedside, and immediately felt my own heart breaking. As I looked at her beautiful face, her eyes spoke it all to me…pain, fear, confusion, and loneliness. Bernagene’s right leg was in a large cast, and her right hand was wrapped in a large bandage.

We were told that she had been at school when the earthquake hit. The ceiling of the room she was in had collapsed, leaving only about 3 feet of space. Her leg had been fractured, and three of the fingers on her right hand had been severed. As she lay in the hospital bed, her world seemed to be crashing in on her. I asked her how she was feeling; she looked at me, her eyes brimming with tears, and said, “Li fe mal anpil (It hurts a lot.).” She took my hand, and as the tears started to spill down her cheeks, told me how she had almost completed secondary school, and was looking forward to graduation- but now, she wondered if she would ever walk again. I assured her that the doctors at CURE would take care of her, and that before too long, her leg would heal, and she would be able to walk again. “But my hand, what about my hand?” As we talked, she told me that she was right-handed, and without her fingers, she didn’t think she’d ever write again. As the tears slipped down her cheeks, Jen grabbed a tissue and wiped them away…Bernagene looked at her, and a smile played at the corner of her mouth. Someone suggested we pray for her, and asked that I lead out…I hesitated, afraid I too would cry, but then held her hand as we prayed for her, asking God to heal her, and allow her walk, asking God surround her with peace, and give her an understanding of just how much she is loved.
We left Bernagene’s room, and walked out onto a balcony. As I looked out over the city, my heart ached, and I found myself asking, “Why?” Why did this tragedy have to happen? Why the devastation? Why the pain? Why Bernagene? I walked away from the group as the tears began spilling down my own cheeks…

I don’t think I will ever forget the heaviness, the pain, and the brokenness that overwhelmed at that moment. And yet as the tears streamed down my face, it was as if God whispered, “This is why I have you here. To show my love to those who are hurting, and to bring healing to those who need it most.” I was reminded of the lyrics to a song I love so much, “Lord, break my heart for what breaks Yours…” and in that moment I understood the broken heart of the Father.

One year ago...

Today marks the one year anniversary of the beginning of my trip to the Dominican Republic and Haiti to do Earthquake relief. A trip that broke my heart in so many ways… and yet was one of the most incredible and rewarding experiences of my entire life.
The first two days of that trip we spent in the Dominican Republic, waiting to get a charter flight, as well as an air-slot, so that we could fly into Port au Prince. I remember the frustration of having to stay in the DR, when everything in my wanted to be in Haiti! And yet, to look back on that time now… it’s incredible to see how God had us there, at the perfect time, to do His will.
That first day in the DR, we were walking through the tourist section of the city, looking at the various shops. We went in one particular shop, and Jen and I worked our way through the crowded shop, to a back room where we found a couple chairs.

As we sat, waiting for the rest of the group, and wondering what the next few days would hold… we were approached by a young couple. The young girl timidly asked if we could speak Kreyol or Spanish, and her eyes immediately brightened when I told her I could. She proceeded to ask if we knew of any missions, or aid groups, who were giving out scholarships. Jeanie joined us…and the conversation that ensued left us all feeling like God had put us in that store for a purpose….
...Mirtha, the young Haitian woman who wanted to know about scholarships, proceeded to tell us that she had been in Business school in the Dominican Republic. Her mother had been living in Port au Prince, working to provide funds for her daughters schooling. The earthquake had destroyed her mother’s business, and left her mother injured. The young man with her, a friend from Port au Prince, had always dreamed of going to Medical school in the DR. He had been living in the DR for the past few months, trying to learn Spanish. He too had family living in Port au Prince, who were helping fund his education. Sadly, his parents had both been killed in the earthquake.
Mirtha asked if we knew of any places that were giving out scholarships to students, and then proceeded to tell us that she desperately wanted to continue her school but she didn’t know how she could. She told us that she had written letters to several international embassies, telling her story, and requesting a scholarship. We were touched by the passion and determination she had to continue her education, despite the tragedy that was going on around her. We started asking specifics about her school, and tuition fees. Every question we asked, she had a quick answer, and often proof that her story was true. We were especially touched when she explained to us that she had lost just about everything at her mother’s house in Port au Prince- and yet she had her Bible and a Hymn book, and she was satisfied.
As we talked, Jeanie felt very strongly that she was supposed to pay for Mirtha’s school tuition. After praying, and agreeing as a team that this was something we wanted to pursue, we told Mirtha. Her face, that before had been filled with desperation, now split into a smile of joy and relief. We confirmed the name of the school, and explained to her that we wanted to go to the school with her the following day. We exchanged phone numbers, promised to meet with her the next day at the school, and went on our way.
…And the following day, we had the opportunity to bless Mirtha. We met her at the school, confirmed that she was enrolled, and then paid her tuition for the year.

It was an incredible experience to see the excitement, joy, and happiness on her face. Her world was still far from perfect, but despite all that was going on around her, she knew her school, for the year, was safe. And more importantly, she knew she was loved…by our small team, but much more importantly, by her Heavenly Father. He had rewarded her faithfulness, and provided for her in her time of need.
And so, our earthquake relief trip began…