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Shanksteps #91

Up and down. Lives won and lives lost. Each day is filled with various happenings. The woman of Shanksteps 89 is doing well. Today another life is lost. In these past two weeks, two children lost to taking off of oxygen to soon. Two transfusion reactions with loss of life, one child, one adult. All four likely could have been saved if the nurses involved would have followed the patient well. Today will be another difficult day for Audrey. Her cat has been sick these past few days havingcopious diarrhea. Ive been giving him antibiotics for his size based on human child weight standards. He had become, what appeared to be, dizzy and fell down often with head wagging back and forth. This morning diarrhea was everywhere in the bathroom. He was covered in it too as he fell down often. I forced some antibiotics in him and some infant formula in a small amount. Up till today he has had a good appetite and drank lots of water. This evening when I got home he was laying still andhadn’t moved for a couple hours my house help told me. He was sprawled out and breathing very slowly. I pet him and he didn’t budge. I pinched him and he didn’t move. I called the only vet in Koza there is. He works only with cows. Im hoping he knows more than me about cats. While he was on his way I got an IV and IV antibiotics from the hospital. He struggled with getting a venous access. With his help I was able to place and IV line and started liquids. The cat moved all over so we sedatedhim. He used the dosing he new. Unfortunately it was to much. The cat stopped breathing. I did mouth to nose respirations. And after about ten minutes he started breathing again. I was very relieved. As the IV went in we listened to the heart rate and breath sounds (similar to human but faster). He left and slowly the breathing got deeper and slower. I started mouth/nose again. This time without success. His heart stopped as I did this. I am very sad and know Audrey will be too especiallyafter just loosing her mother and now her favorite cat. Please pray for her as when I tell her when she gets here that it will be very hard for her. On the up side, I am looking forward to Audrey and Sarah being back with me in a couple days. I am very blessed with a wonderful wife and daughter and am anxious to have them back with me. Thank you all for your support during these difficult last few months.

Sincerely, Greg

Shanksteps of Faith #90 Mar 26, 2008

She lay on the table, drawing in short, shallow breaths. Blood pooled on the floor all around. Her cloths were soaked. The nurse couldn’t find a blood pressure or pulse. She was oblivious to her surroundings. Her husband, mother, and some neighbors stood by shaking their heads and “clucking” the way they do when something is to bad. She had been having her first child at home. Her water had broken about 12 hours before she made it to the hospital. She had bleed a lot at home then went unconscious as blood covered the floor of the house. She was brought to the hospital about 3 hours later. No fetal heart rate was found, the child had died and mom was following. I came into the delivery room where this was happening and ushered all the gawkers outside. She had received a little fluid and her blood pressure was 55 and her pulse only 80. She was dying in front of us. The nurse started a second IV and we gave more fluid while waiting for the lab technician to draw and find blood from the family for this woman. Her blood pressure slowly climbed and the pulse climbed also, up to 140. The bleeding had stopped. Fortunately not because she was gone. Probablybecause of the low blood pressure. As liter after liter poured into her she started to stabilize and became conscious. After much discussion the husband and mother both gave 500ml of whole blood for her. There seemed to be sufficient space for the baby to exit normally, so using forceps I delivered the stillborn. Liters of blood and the placenta and about a liter of blood clots gushed out after the baby. The mom had a condition called abrupto placenta. Over the next 24 hours the mother stabilizedand was week two days later but requesting to go home. I know that God is watching over this hospital. While I was gone at my mother-in-laws funeral there was only one surgical referral out to another hospital. Another, likely appendicitis, refused to go elsewhere and the nurses treated them with antibiotics and the child went home two weeks later. Since Ive been back these past few weeks, I have had 1-3 surgeries every day except Sabbaths (Saturday). There are still times when we don’t understand why some things are allowed to happen. Like thechild who died because of lack of oxygen as the nurse took them off unmonitored. Unfortunately the same nurse did it again a week later with the same result. So we have had to change oxygen “policy” and termination. Though there are things we may not know until heaven, I choose to trust in God. He has made Himself very evident in many ways to me in living here and in the nature around me. I hope you also have had that same experience. If not why not ask Him for it. He enjoys helping us. I hope that you feel His power and love in your life today.
In His Service, Greg

I’m suctioning out his mouth as he vomits all over everything. He has it caught in his throat. His blood oxygen plummets. “Where is the oral airway, why isn’t it here!?” He starts breathing again. But his oxygen reads in the single digits. I suck out his mouth, then bag, bag and suck. His oxygen slowly starts to pick up. We have been in the OR 3 hours and have still not gotten his Achilles tendon repaired. He has been moving all over and I cannot get a good enough view of the back of his
leg to hit the moving target. The nurse giving anesthesia is giving repeated doses of Ketamine and some valium. That’s when he started vomiting. Meat and corn mush are coming up. I feel nauseated as he vomits on my arm and I feel some hit my face. The smell is impossible to avoid. I feel like joining him in the vomiting frenzy. He stops breathing and his saturation drops to single digits. Finally I’m able to clear his airway and it comes up to 88 (still below normal). He starts moving all
over again. Then vomits, drops to low digits… we repeat the cycle many times. He vomits probably 15 times. Nearly dies 3 times. At the end he is not fighting any longer. I hope he is not brain dead. He is stable enough that the nurse takes over bagging him. I decide I might as well repair his tendon while he is still and we have to keep bagging him. I repair his tendon and skin in about 10 minutes, now much easier with a still target. He starts breathing enough to keep up his own saturation
with a mask. We clean off a lot of vomit off of him and transfer him to his room with the oxygen concentrator. His family chose a private room so there is an electrical outlet in the room. I come back home at 3AM. Not at all tired. I shower off trying to rid myself of that odor. Finally with writing this I’m tired enough to go to bed, 4AM. Guess Ill get two hours tonight. Tomorrow I’ll wish I had a partner to take call.
This is a Koza business man and 8 armed thieves came into his house and beat up everyone, stole approximately $8000 and then before leaving cut his Achilles tendon. I guess so he couldn’t chase them. I don’t think I would chase 8 guys with guns anyway. I’m surprised that there is even that kind of money here in Koza. As everywhere there is the very rich and very poor.
Now two days later. He is doing well. He is not brain damaged. I put a splint on his arm where he has some ligamentus injuries. He removed this and the traditional bone setter put wood splints on it and wrapped it in a elastic bandage. More trust in them it seems, at least for bones anyway.
The population has apprehended 3 of the thieves and dealt with them in different ways. One was brought to the hospital for treatment and was released a few hours later. They were from a few hours away and had local accomplices. This is apparently the first large robbery in Koza. Before its been for cows, sheep and goats. Large city violence in a rural town. We thank God for His protection once again. Greg