An hour in the Africa Mercy Operating Rooms

Got to go down to our OR's for a few hours this week, and WOW. Are all OR's as cool as this? (Or theater as my British friends call it). In the space of two hours I got to see pieces of 6 different surgeries in progress in 4 OR rooms.

In the first room, Dr. Tertius Venter from South Africa was putting back together a man's toes that looked like he'd stepped on a landmine - a "T-bomb" as the OR staff joked - he had localized macrodactyly - i.e., his toes were enormous. They hadn't stopped growing so Dr. Tertius was debulking them, taking out extra tissue, fat, muscle, and fashioning new toes for the chap that fit in shoes. Plump weird and way cool. Not a huge fan of the little basin of extra toe pieces though. Gag.

The second about broke everybody's heart around and what a priveledge to see her surgery. Sweet little eleven year old girl who was flown in from Nigeria to have her surgery. I had seen her quite by accident before her surgery. I'd gotten up late one morning, went for a cup of tea on the 5th deck cafeteria, looked down and choked on my tea. This little girl, calmly waiting in the admissions tent had a bone tumor the size of a melon right below her eyes. A massive bone tumor. Solid as a rock made of enamel and calcium. You couldn't discern a face because all there was is a huge tumor. I wish I could show you picture, but i'm sure that the Mercy Ships will be writing an article on their website about her in the near future, so keep your eyes out. When I walked into that OR, Dr. Parker had been at it for about 3 hours already. The tumor was sitting on a side table with a couple of teeth sticking out of it, and the little girl didn't have a face at that point, just a bit hole.

It's a fascinating surgery and what a miracle that we have this awesome team who can do this surgery. It involves taking out the tumor, opening up a flap on the side of the head, bringing down the temporalis muscle to swing down and create into a barrier between her nasal and bucal cavities, then sewing that flap back after placing some drains, and then creating a face out of the hole that is left after the tumor is out. All I could identify was the child's tongue. And guess what, apparently she's doing just fine two days after surgery. I can't wait to see what she looks like.

The other four surgeries were cataract removals. Super way cool 'cause one minute they can't see and the next they can. They're awake for the surgery, with local anesthetics deadening the eye and (I hope) something to chill the patient out. I got to watch the eye surgeons slit into the base of the squishy clear stuff, scrape out the cataract, replace it with a lense and then suture it back shut. And the blind shall see.
One dude needed a bit more anesthetic as he flinched... they were asking him, "Are you feeling pain, do you hurt?" and he wasn't answering.... I busted out my sucky Krio on him, being a nurse, I do know how to ask a patient if he's in pain. The surgeon looked up at me wide-eyed and said, "Welcome to the Eye Team". heehee. yeah right.

Lionel just became way even cooler in my eyes.

Seventy two hours of prayer

I am unbelievably blessed and so completely not worthy to be working alongside such fabulous nurses as they have onboard the Africa Mercy. I will maintain it as long as I live. Caring, like, for real. Hearts full of compassion and brilliant ideas for their patients, such as the latest scheme some great soul has cooked up. As the nurses we're doing a 72 hours of prayer for our hospital, the ship, our patients, time of personal reflection, confession of sin, dedicating our steps to the Lord, using the time for worship and communion with the Lord. We're praying for the physical recovery of our patients and so much more importantly for their souls, that they may come to see and know the Lord while onboard. That those who know Him may know and see that He has not forgotten them.

E Ward has been redecorated by creative minds to be comfy and cozy. There are dimly lit lamps around the room, pillows on mats on the floor, somebody found a carpet! There are corners for creative expression and words the Lord gives us during this time. Journals to write reflections in. A map for us to pin requests on in the world. A cross for us to confess sins at. We are signing up for hour prayer slots, yes, even though the wee hours of the morning and I am so proud of everybody 'cause there are only three or four slots left open. I must admit that my rather skeptical self took a look at this loooong signup list and I did really doubt the nurses alone would fill it, but there they go... with help of a few ancillary staff as well.

I was talking with one of my roommates and she was telling me about how her colleague had visited the mother/baby hospital in town and was horrified by some of the stuff, mainly the sterilization room (chlorine in buckets for O.R. utensils, washing and reusing gauze (!!!!!) and that intubation equipment doesn't get even washed between cases... yeah, here's some TB for you, for you and for you). She was mentioning just a real need to pray for all of this stuff and start doing something about it, where I took her hand and marched her up to our prayer signup sheet... I love it when I see people's eyes light up about something cool like that.. isn't that just the way the Lord works?

So I'm just praying as the Lord pours his mercy out on the people of Sierra Leone through us, that He would have mercy on us too while He's at it... healing those wounds, healing hearts, mending broken lives, restoring individuals to their families and communities.

Yes, I'm on a ship

malaria, disappointment and Uncle Peter

It's the rainy season and malaria is spreading rather rifely throughout the population of Freetown and my guess would be the rest of Sierra Leone right now. People are going down with it rather all over. Yesterday's surgery admission's sheet was a grim reflection on the matter. Surgery cancellations were marked in orange, and of the list of 15 people or so, every other person on the list was in orange, had malaria and had to be sent home without their operation. My heart just goes out to them, to look forward to having your operation and to be sent home must just be a cruel blow. Their disappointment so keen. As it is i'm covered in mosquito bites and here Randy Nabors told me to watch it at dusk and that was my own fault. Yes, I'm taking the doxycycline so I won't (hopefully) take a hit of the bad mojo. (sorry mom!)

It happens a lot with our pregnant patients as well. Standard protocol is to check for pregnancy in women of a certain age and you just don't do it if they're pregnant. They get sent home in keen disappointment - and then the admissions team goes all aghast when they show up the next day, "I'm not pregnant anymore."  This has happened quite a few times already that I know of... and it's just through the grapevine. Heartbreak.

And yet as nurses we have all remarked at one huge difference between nursing here and nursing at home. No matter how bad the news we have to deliver is, the patients here never take out their frustrations and anger on the staff. At home you just brace yourself because you're about to have your very existance belittled if you so much as inform a patient that their surgery has been delayed a few hours. It's not a grim resignation here, although I'm sure there is a measure of that, they just channel it differently. They do cry, they might even yell, but it's not at you. Very interesting and it's been part of why so many of us nurses have enjoyed nursing here... you're allowed to just take care of people and have them appreciate it! Imagine that.

Thank you to everybody who enquired about my grandfather in the last few days. My mom called me this morning to tell me that Uncle Peter has gone to be with the Lord this morning. Please pray for my grandmother today. What a bittersweet joy to know he is in that promised place, he's no longer in pain, he's no longer suffering, no longer fighting for breath, but in the sweet presence of Jesus. I'm crying but so relieved it's over.

Oh, we call him Uncle Peter because although he's really the only grandfather we've ever known, our blood grandfather passed away in 1989. Uncle Peter has been in our family's lives since my mom was a little girl, and Granny and he were married around 15 years ago.

Toilets on the wards

So toilets are sometimes a new concept for a culture long used to holes in the floor. All new patients get a "this-is-a-toilet" lecture when they arrive on the ward, with a demonstration on how to flush, to use toilet paper (and not the showerhead please). And don't wee in the shower either. It doesn't always sink in, but the artwork on the bathroom walls helps. :-)

A moment on night shift

It's 2:30 am, GMT and A ward has finally settled into a bit of a quiet lull, with an occasional cough or baby's cry disrupting the peace. There are 20 beds in this room, however many of the patients are children, so their parent or caregiver sleeps on a mattress literally under the bed. Sometimes mom has another baby, or mom is the patient, so there are two people under each bed. There are a lot of warm bodies packed into this hot room right now!

Some nights it gets complicated when mom decides to sleep on the bed and your patient gets relegated to the mattress below, baby brother is in your way too, it's 3 am and you can't reach your patient to check vitals- 'cause he's buried too deeply in the little cave under the bed. :-) That's when imagination and perseverance kick in - clambering over their bags, pulling at the mattresses with all your might at an angle through the bed's legs, trying valiantly not to land on your own rump, giggling at the situation and wondering how you're ever going to describe this one to people at home. And how that would so not work at home - could you imagine the look on people's faces? "Sir, here's your bed, ma'am, you go right under the bed."

We've switched from general surgery to plastic surgery now, for the simple reasons that those are the surgeons we now have onboard. No, we're not doing boob jobs and facelifts! I would encourage people to check the Mercy Ships website, http://www.mercyships.org/ for pics of what we get up to- crazy facial tumors, burn contracture releases, etc., that we're up to now. I'm learning so much and feel quite a fish out of water, mainly because I have no clue about plastics. Cardiothoracics, all the way. (Go CTSU!)

For example, I have two patients who have seizure disorders and have fallen into fires, whose limbs have shrivelled up and are now useless. So, what our surgeons are doing is releasing the taut skin, the scarring,  stretching out limbs, covering wounds with grafts of their own skin shaved from a healthy spot on a leg usually. So these patients have a graft site and a donor site, sometimes a few sites if the burn was not contained to just one part of the body. It's all very painful as  you can imagine and prone to infection, so we nurses are being a bit overly neurotic about infection control right now. The difference between a clean wound and an infected one can mean a hundred days onboard as you wait for it to slowly heal- with daily painful dressing changes - and we're only here for another 3 months then the ship sails away. Well, there's your motive for prayer for these next few months! That wounds will heal!!

A surefire way to make my heart explode

So this is a shameless plug for my beautiful niece. I have the two sweetest sisters in the world, is all I can say. They sent me this video a few weeks ago, and i'm sharing it with you all 'cause Elie's so stinkin' cute!