I really do love the ICU!!!

Last week I worked 3 nights, Tuesday, Wednesday and Thursday. The first 2 nights were completely normal night shifts...busy with random tasks, but not overwhelming. 

We had a patient(LC)that had been admitted for several days so we could do some more extensive testing prior to surgery. Last Thursday he had his surgery completed. 

This is someone in their mid-20's with a tumor growing inside the mouth and throat. If you looked at him, you never would have guessed...his face looked completely normal.

He was the only patient scheduled for our maxilla/facial OR that day as he had an estimated 8 hour OR time. He was in for major surgery!!! Because of the extensive nature of the surgery and the post swelling that was going to happen, the first thing the surgeons did was to put in a tracheotomy just to protect his airway. 

Thursday night, I was in the ICU with him. They left him on the ventilator and sedated overnight just to let his body rest. The next day (Friday) he was weaned off sedation and the ventilator. By Sunday, he was back in the ward with all the other patients. 

I didn't realize how much I missed the ICU until I was back in it. It felt so good to have a vented patient with drips, (morphine and midazolam for sedation), with an a-line while managing fluids, antibiotics, I&O's, neb treatments, changing vent settings as needed, and mixing up my drugs. This may sound strange, but I think that was probably my favorite shift I've had here.  

Even more than that, what I found most interesting is that throughout the night his sister would come over to the ICU just to check on him periodically. In the morning one of the day-workers (translators) told me that she was surprised/impressed that I stayed away all night taking care of her brother. 

That shocked me...what I learned through asking more questions is that isn't the normal practice of nurses here. No wonder the people here have a hard time trusting us as doctors and nurses. You don't get treated unless you can pay and exorbitant amount of money first, and then it sounds like nurses here haven't been taught what to assess and look for (that's one reason we focus on education, and have local nurses that will come to education classes and shadow in the ward). 

The other thing that stuck me, was that night ever so often when his sister would come in to check to see how he was doing, she would ask me some questions in French and I would answer in English...between the little English she knows, and the little French I have learned we could have simple conversations. 

Language can be an interesting thing sometimes...I often joke that I've learned French sign language, or it could be Kituba sign language (the local language).

As for the LC, he is doing well and once the swelling goes down enough that his tongue isn't blocking his throat, the trach will come out and he can talk to us again. Yesterday, it looked like the swelling was starting to decrease just a little...but he still has a ways to go.   

Cloudy Skies + Water = Sunburn (but a fun day!)

The last three weekends I've had to work and so I wasn't able to go out exploring since my Angola adventure. Yesterday, I had the opportunity to go with some people the river where a local guy (Boris) gave us a ride in one of his boats. It was fun to be out on the water and to actually see green and breathe in air that doesn't smell like dead fish and diesel fuel.    

Here are some pictures detailing the adventure...

Another group found someone to take them too...both boats were looked like large hollowed out trees with a motor attached to the end of the boat. There were times it was just a little tipsy...kind of like a canoe :)

This is where we got on and off the boat.

I don't think I need to explain this pic...but it's me

We passed by many local village houses, and it was fun when there would be people sitting out that we could wave too, especially the kids, they would get so excited!!

Another house on the riverbank

The bank

As you can see it's a fairly large river, the island on the left has a chimpanzee reserve that is currently closed because apparently a chimp killed somebody recently. I know this reserve has something to do with Jane Goodall, I don't if she started it but I hope it opens before I leave. I think it would be fun to check it out sometime.

I was playing with my camera here...but I think it turned out pretty cool

I was sitting toward the back of the boat..

There were several little side canals (for lack of a better word)

Traveling up a side canal...it was so calm and peaceful

Boris stopped and let us explore some woods/jungle...I'm not sure what this fruit is

 Suddenly, I was wishing I could eat fresh pineapple...

At the end of the boat ride we still had some time before our taxi returned to pick us up and so Boris took us to this beach to relax until it was time for go back a meet the taxi bus

Watching the waves

It felt so nice to walk barefoot in the sand :) 

We left the beach, paid Boris, and then went to get the taxi and it wasn't there...we stood there waiting for 45 minutes and then we had someone with us that knew french and asked if there was possibility that we could borrow a phone to call. Finally, our taxi arrived and took us back to the port gate. At the port gate, we happened to come across a Mercy Ship shuttle that took us to the ship...other wise you walk the 1/2 mile from the port gate to the ship.

We made it back in time for dinner and then, I talked with some friends for awhile before going to my cabin to shower. The day couldn't decide if it wanted to be sunny or cloudy so it went between both. I know that me being by water on a cloudy day can result in a sunburn and so I but on my sunblock and drank the water I had with me (1L).

Somehow, I still managed to get a little more sun than I was expecting and so after my shower when I had a pounding headache and felt nauseous because the ship felt like it was being tossed by waves (when it really wasn't), I went to bed. 12 hours later I woke up and I feel better...but I can tell I was burned...even though part of it seems to be going away there are parts that I can still feel. 

The only thing I can think of is how much worse it could have been had I not put on my sunscreen! Then I would really be hurting!!! The plan for today is lots of water and rest, that's what I feel like I need, and so that's what I plan on doing. :)  

Overall, I really did have a lot of fun yesterday. 

Work and Fun...or...Fun and Work

There are people who walk around here with camera and take pictures...that is what they do and so it was only a matter of time until I was 'caught on camera.' :) Anyway, just thought I would share. Enjoy!!!

Remember when I was talking about a 3 year old who just wanted to be carried around...well this is him :)

We got lots of time to play...but I think we both enjoyed it!

Yes, I do actually work.

This girl is K from my previous post talking about scars.

It's the Africa Mercy

One night we had a port side BBQ on the dock and then worship time with the crew and our day workers...the patients who were able came out during the worship time to join us.

Hot dogs, BBQ ribs, coleslaw, salad, lemonade...it was an all out picnic!! 

The kitchen crew hard at work...but many thanks for the delicious food!!!

Our 'head chef' or maybe he's the grill master...

Then there is always the random picture where you just take a bite of your apple and then are told to 'smile' such as happened in this picture. I'm sitting next to one of my cabin mates and she is from Belgium.

Time for worship!

Worship without dancing isn't worship! 

I didn't get to spend much time with the girl, but what time we did spend together we had lots of fun...the first day she was in the hospital we painted fingernails, colored, and just played together...she is a sweet and beautiful girl with an ever ready brilliant smile, she got to go home and so now I don't get to see her and that is sad, plus my other little friend there also got to go home...guess that means I need new 'playmates' :)

Hope you enjoyed seeing some more pictures!!! 

SCARS...

They can be physical...

emotional...

They can be hidden or visible, but no matter where they are located...there has been pain. 

or sometimes a physical scar or deformity can cause emotional scars.
(I will refer to the girl in the center as K) 

K made it through the big screening day in August. I never saw her that day, but I got to know her this weekend as I was taking care of her in the hospital. She was one that we got to say 'yes, we can help you' to. 

I took care of her for 3 days (Wednesday, Thursday, and Friday). That first day I had a hard time engaging her in anything, she was very withdrawn and reserved.  I wanted to spend more time with her, but there was another patient (a 3 year old little boy) who had me carrying him around most of the day. 

Thursday I was able to spend a little more time with her, but still was having trouble. I watched her on Deck 7 while we were outside, and saw her watching some other girls her age...but she wouldn't go over and talk with them. In fact she didn't talk to anybody, only her mother who was with her.  

Finally, Friday morning I was able to sit down and teach her how to play memory. We played for awhile, until I had to give some more meds. Then some other people took the Memory game and started playing, so when I had more time we played Jenga. 

Now, it may not sound like much, but it was the first time I saw her interacting with anyone, and out of bed except for the times she had to be up. That day we took Jenga outside to Deck 7 and continued to play for the hour we were outside. I could still see her watching the other girls, and at one point I asked her if she wanted to go join them and she said 'no.' 

I didn't ask if she was still in school, but I can guess that she would have been teased for being different...creating those emotional scars. What she didn't know that I knew...those girls who look beautiful, seem to have nothing physically wrong are actually burn patients. They have physical scars which hide silently under their clothing. 

That's when I started thinking about scars and the different types...I have my own scars, but they are hidden deep in my heart, where nobody can see them. Everyone has them, and nobody what's to let other see them.

As I was thinking about it, I thought about Jesus...he had scars on his hands and feet from the cross. He shared those with his disciples, He didn't hide them. He truly understands our scars, the pain of rejection, the pain of cruel teasing and ridicule, and the physical pain of beatings and death. 

I haven't gotten this all figured out, but I know that I must trust Him with the pain of the past, present, and future. Through Him I will have the courage to love and forgive those that hurt me...following the example of Jesus. 

I love the saying here on the ship, "For hope to be believable in the future it must be tangible in the present." 

Hope

Healing

Love

Joy

Peace

What do these words really mean? Not the definition, but what does the essence of these words mean?

Coffee Break!!!

I'm not quite sure what to write...so this blog update is going to be a random one. 

So, there is this cold that's going around the ship and then on Friday I felt like I was starting to come down with it. It kept getting worse as the day progressed and then because it wasn't a busy day I was able to leave work early to sleep. 

Sleep did wonders, but so did eating lots of oranges, and getting some sunlight...unfortunately   I got just a little to much sun resulting in a minor sunburn. Now the sunburn is gone and the cold is gone and so I feel much better! :)

There was a day last month that I went to a local orphanage and got to play with some cute kids...some of which are skin and bones.

Today while I was working we had some pictures taken with patients and caregivers. 

These 2 little boys are lots of fun!

The little guy on the right (with the blue towel) was one of my patients for the day...yes, I now have pediatric patients mixed with adults. It's really not bad and actually kind of fun. The people in the ward joked that 'he liked me to much.' I think I carried and played with him for 3-4 hours of my 8 hour shift. It was great, I loved it and at the end of the day when I had to hand him back to mama he cried.  :(   

When I'm not working it's fun to sit out on the top deck and watch the port. I've watched other cargo ships come in dock, unload, leave...it's all very interesting. I must say that I enjoy watching the tug boats help maneuver these huge ships around. 

This ship was leaving the port.

Okay, those are the few pictures I have to share now. Leave me a comment if your interested in hearing more about a something I've already shared, or if there is something else you are interested in me sharing.

That's all for now! Hope you enjoyed this random blog...lol