Shanksteps – Fasting
I had just finished a book by Paston Jentezen Franklin on fasting that morning. In it he discussed how the Bible encourages us to fast to become closer to God. I had decided earlier that week to start a fast, and was now on my seventh day without food, only taking water and juice. It really did make me more “tuned in” to the things of God. Greg and I woke up early that Wednesday morning because he had to leave to go to Maroua to attend a two day meeting for all the directors of the hospitals in the North of Cameroon. After he left, I read, and had my worship and prayer time. During that time I had a “feeling” that a woman would come in that day in need of a C-section. Now, I want you to realize that that has been one of my biggest fears since arriving in Cameroon; for a pregnant woman to come in distress in need of surgery, and Greg be gone. I had scrubbed on many c-sections in residency for this very purpose, but had never before needed to do one on my own – as I always “consulted the surgeon” when cases came in needing surgery. So, that morning, I told God that if He did indeed send someone my way, I would just trust in Him.
The day started like any other, with lots of kids to see. Fortunately, many of the kids had gotten better and I was able to discharge a bunch of them. I saw several people in clinic after finishing rounds on the rest of the hospital. All in all, everything had gone really smoothly. Right up to the point where the guard for the hospital came and said that he needed the key to the operating room. I asked him why he would need the key to the OR, but not the doctor, and he replied, “Oh, they need you there as well!” So, I went, not having any idea where the keys to the OR were. What I found in the delivery room was a woman who had just delivered a live baby girl, but the hand of the second twin was protruding from the vagina along with the umbilical cord of the first twin – the second twin was TRANSVERSE! I called Greg and told him to pray. There was no way of delivering this child vaginally, so we quickly wheeled her to the OR (through the nurses call room – as I still couldn’t find the key). Just as we got her on the table, Ganava came to assist me (he also had the key to the suture closet). Kalda gave her Ketamine anesthesia as there wasn’t even enough time to get sufficient fluid in her to do a spinal. As we were getting her prepped, I noticed that she already had a vertical C-section scar. “Oh great!” I thought, she’s going to be all scarred down, and I’ve never opened vertically. I called Greg a second time and he said to go in through the old scar and walked me through what to do, and again said he would pray. We prepped the woman, I said a prayer that God would get us through this ordeal, and started. I won’t give you all the details, just that EVERYTHING was scarred together. It was difficult to identify any normal layers. The uterus, which is usually paper thin, was already contracting after delivery of the first twin, and was almost 2cm thick. Even after doing many c-sections in residency, I NEVER was allowed to open the uterus (legal reasons), so this was my first time. I wrestled with my hand inside a contracting uterus, trying desperately to get the baby out. Finally I could feel it coming, a boy! A boy that was not breathing and floppy. I sucked out the mouth and nose, and stimulated the child until I thought I might rub his skin raw. Finally, the sound every OB enjoys hearing, a cry! I passed him off to Kalda to clean him up and weigh him. Now I had to deal with a very thick bleeding uterus. I put ring forceps all around the edge and did my best to close up the uterus, suturing through as much thickness as I could, realizing after closing the gaping hole in the uterus, that I would need to do a second later to include the true full thickness. Finally all the bleeding stopped. I then tried to approximate the fascia, but it was almost impossible to identify the layers with all the scarring. After checking and re-checking, I was finally satisfied with the closure. Finally, Ganava said he would close the skin for me, and I could write the orders and the procedure note.
When I finally got home, I was more tired than I can remember being in a long time. I was also very hungry. I spent a long time in prayer and thanksgiving to God, then ended my fast, on my 8th wedding anniversary, alone, but more at peace than I could remember being in a long time. I thank God that He once again “gently” showed me who was in control. Thank you all for your continued prayers for us and the people of Koza. -Audrey
Shanksteps #108