Sunday June 5th

Hello friends and family!!!
I want to start by saying a BIG CONGRATULATIONS to my consin Brandon and his new bride Jessica!  They married yesterday and although we were not there, we were thinking of you.  Many, many happy years!

Today has been a quiet day for us.  We slept a little later than our usuall 7am breakfast call, which was ok with me since the heavens opened last night and it POURED!  Did I mention before that it rains more than I have ever seen it rain anywhere here?!?!  Yes, it is rainy season and they are not exagerating!  Needless, none of us slept much.  It was also very windy and the "zinc" on our roof kept rattling around and making noise as well.  I honestly was waiting for the tornado siren to go off, a bit apprehensive now I guess (they assure me they do not have tornados here Dorothy!)  Try to go back to sleep.

Mom woke to find the laundry she started yesterday and left to soak needed a bit of tending to.  She found that Brian's red fancy panties had turned his white tee pink in the overnight washtub.  She tried bleaching, but that didn't help much.  Guess mom needs to keep working on hand washing skills or Brian needs a different color of fancy panties!  Oops!  Good thing it really doesn't matter what you wear here, it's kinda just what you have is what you put on.  Pink will work ok.

Started the morning rallying the troops to sign the Father's Day card I so proudly remembered to pack.  Only to find out later that Father's day is not for two more weeks!  Not sure what I was thinking,  Brian's  Super Dad sticker from the kids sure looked nice in church though.  Oh well, better early than never?!?!

Went to church and once again moved by the Holy Spirit in me when we started singing, "What a Mighty God we serve"!  An ocean apart, other side of the world, different culture, different people, different church, but we all sang from our own hearts the same song, "What a mighty God we serve".  We all serve the same God.  Again the people here have me in awe of them and their child like faith, because that is what they have, that is what they have to have, that is what they choose to have!

After church Brian and Grace went to visit our friends the Palmers'.  While there Grace climbs the tree in their yard, picks some fruit, and starts eating it.  Daddy has to ask her what it is,  "Dad...it's guava!!"  In her gracie way!  She is taking to the African way quite nicely.





Monkey Grace and her Guava snack

The kids and Brian went to a gathering at one of the other Dr. house, to my surprise brought home some ice cream for Grandma and myself.  Yummy!  Homemade icecream never tasted so good.

I got a nice surprise from my amazing friends today in Joplin.  They snuck a care package in Brian's luggage for us to open when we got here.  Wonderful goodies inside.  M&M's, books, card games, bubbles, colors, lip gloss (not sure who liked them more Grace or Toby!), a battery fan (very handy), all sorts of great stuff.  They are so awesome and thoughtful!  I love them so much.  Thank you friends.  It truely made my day!

Speaking of friends, we're are making many here.  Yesterday we met a couple that are here doing same as us.  Melissa is a pediatrician and her husband Jeff is here with her.  They are from Tennessee.  We invited them over for a fun noncompetitive game of farkle this evening.  Oh the fun!  Unfortunately Jeff won (beginners luck) so we will have to invite them again for a rematch!

While we were farkling, Joe decided he wanted to play chess.  So, he (with little help from daddy) built chess pieces out of his legos and daddy made a board.  I was very impressed!  I think daddy was too, especially when Joe beat him!!!  They played after our guest left, it was fun for them both.  Grace then used the board to play checkers with the bottle caps she has been collecting.  Good times!

Don't know that I know too much more.  Update on Brian's patients... The baby with the compartment syndrome was moving his fingers on Friday!  The full arm fasciotomy procedure looks to be a success!

Not so good news, the girl that came from away to see Brian with the spinal injury that developed into hydrocephalus passes away last night.  It is very sad to hear, but she was in pain and too ill to heal here on earth.  We pray for that family, I was told that it was very traumatic for them. 

This week will be busy.  Surgeries scheduled, dinners to attend, parties to plan, you know the typical day in Africa!

Here are a few other pics from this weekend, just interesting stuff. 



Boy playing with wheel




Lychee Fruit




Grace eating Lychee fruit



50ish people crowded around 1 TV to watch Cameroon vs. Senegal "football" game.  You could hear them shouting all over campus.

Our view of hospital walking from our house

Farther up road, same view

   Hope you all are enjoying the blog.  I changed the settings cause I heard you were having trouble posting comments.  You all should be able to now.  It is nice to hear from you.  We check back for replies probably as much as you check for post.  This and FB are about the only contact we have to you!  Love to you all!

                                                                                                  -al

Just Pics



Army men inthe dirt.





Shepherd's shack



Grace rallies after the big hill!!!

Joe and his new friend.... Joe

Toby says, "its to high, its to high"  grass above Daddy's head.



Creek crossing



Ipsen at waterfall



Hospital cows, skinner than Grandpa Don's





Cow stalking Grandma!!



Day of Rest....Kinda

This is Brian checking in....  Just got back from a 4.5 hour hike to the top of the mountain/hill beyond the hospital.  We hiked about 7 kilometers back to a beautiful waterfall that is only accessible by foot or horse. 

We (Steve Sparks and I) hiked back home, rest of the family rode... which I think was a bigger adventure than the hike, well beyond a class C road.  Yes,  the kids did ride home on the roof rack, on a road that would make rock crawler trucks work.

View from top.

Dr Sparks Patio Views..

Africa has been again an extremely powerful experience, its educational, rewarding, depressing, enlightening, frustrating, amazing, scary, beautiful, simple and many more adjectives I cannot currently think of, that all occur in the span of minutes to hours.   It's bipolar in its mood, with great highs when you are able to help, and great lows when people come in with nothing, and you are their only hope and you have to tell them you have nothing to offer... or you or they are just to late.  People wait so long to get help here it is unreal.

We had a nice dinner party last night that Amy, Grace, Joe and I attended at Dr Sparks house for one of his surgery residents who was just back from getting married in the Democratic Republic of the Congo.  At the reception all the residents, wives and children attended was very nice.  There were multiple countries represented and we discussed marriage traditions/customs...it was very interesting.  The current groom's family did pay 3 cows for the bride.  Cameroon, Niger, DRC, Liberia, Singapore and USA were present.

The past week had the first spine surgery performed in Mbingo on Monday, T11-L3 posterior spinal fusion for L1 burst fracture, second on Wed, T11-L3 PSF for L1 burst fracture, third on Thurs, L4-5 laminectomy and fusion and fourth ever spine surgery on Friday... A T10 corpectomy/instrumentation through a thoracotomy in the chest.  Each and every case brings its own challenges, and just when I think it can't get any harder, it seems to.  I am physically and mentally spent after every case.  Was wishing I had Dr Coy here to open the chest for me yesterday, it would have been nice to have that uncontrolled bleeding be his problem instead of mine.  Its a bit of a lonely feeling with your patients chest open, bleeding, asking for things they'd just pull off of the shelf in America and having them look at you like you are speaking a foreign language.  I was only really worried for 20-30 minutes that I might have killed him.  However, in the next breath, one of the residents brings me over to their rehab ward where a patient had been transferred from their capital city of Yaounde, having spine surgery by one of their renown surgeons and I am appalled at what is considered the standard of care.  And again I'm reminded that the man who I thought might die on the OR table, with TB of the spine, would otherwise not have had any chance...  I hearken back to the highs/lows (bipolar) nature of living/practicing medicine in Africa.  Now there are four people on the mend from their spine surgeries, who otherwise wouldn't be!!!!!

Not my work, but for those of you non-spine surgeons, this is not adequate... Cost 1.5 million Francs

Had the worst kyphoscoliosis I've ever seen walk in Friday afternoon.  Worst ever from Children's Mercy, worst ever seen at a conference, worst ever in a book.  Was the worst single most curved human being I've ever seen.  And the irony of it all, the next girl into clinic was a girl with about a 65 degree curve I was going to tell there was nothing we could do for her, but after seeing that, Dr Nana (orthopaedist) and I decided we need to try.  So next week the lesser of the two curved girls is going to have her scoliosis corrected with a T3-L2 PSF. 

This picture does not do justice!!!

Thankfully, Dr Nana is a excellent surgeon and a quick study.  I really think that we will be able to make a real change in how spine care in Cameroon is performed or currently not being performed.  A few more spine cases and we will be well on our way.

We are all good, everyone is healthy and happy and tired from our hike.

Later,

BI

Pictures from today

Ok, so here are some pics from what we are up to today.  The bottom pic is from the other night after it rained.  The kids always hang around and like to look in our windows.

The baby is mom's new friend.  His name is Bless.  He and his mother, Lovely, came and visited with us this morning.

The kids as you will see in the other pictures were trying to tie a rope onto the closeline to make a kinda swing.  It worked a little, but kept breaking.  Then McGyver daddy to the rescue!  He not only made one, but two new swings for the kids to use.  They loved it and had never had a swing before.  Grace had to teach them how to pump their legs so that they didn't have to push each other.

Joe is getting private football lessons from one of the boys.  He is learning a lot.  All the boys here are really good at soccer.  I think Joe is like the attention and I think the older boys like to teach him, they are very patient with him. 

Thursday in Africa

Sorry that is has been four days since my last post.  I have had VERY limited internet and now Brian took away my phone internet, after my day stranded yesterday extreme bordem led to an overage in my plan allowance already!

So let me see this week...
Monday, Brian did his first spine case and it went really well considering all the challenges here.  He also had several traumas come in, including a six year old who's arm got caught in an auger.  It was very hard for him to put him back together.  One of those cases that he came home sad and frustrated.  He had a lady who with broken leg and broken arm hobbled across the room and put herself on the exam table!  We are seeing and learning in amazement that the people here are TOUGH as can be.  They walk around this hospital with all sorts of broken limbs and ailments and just carry on without a word.  Would NEVER happen in the US!!!  As for the rest of us it poured all day, which meant more soccer (or football) in the rain!  Joe and I are catching up on the Star Wars Series, Grandma Roxy has been cleaning away and doing laundry, Grace has made several girl friends (no surprise there), and Tobs still just wants to go home.

Tuesday was an intersting day for me.  I went to observe in the dental clinic.  They put me to work the first patient in the door.  A cleaning, I said sure if it would help you out.  They only had one chair.  I cleaned and the "dental technician" and two "assistance" sat and watched me.  It was the worst cleaning I have done since hygiene school!  And dull, broken hand instruments was all they had to work with.  After about fifteen minutes I asked how they do it?  Their reply was, "You are too nice.  Our people tough people.  You just have to do it!"  Alrighty then.  I scaled like I would never scale anyone in private practice in US without anesthetic.  After an hour I gave up and handed it over. The assistant sat down and told patient, "She did not want to hurt you, now open we have to get it off, do not move."  I thought he was going to pull her teeth out!!!  Moral of story...get teeth cleaned in US!  They also so extractions and root canals if you are interested!  After that, I thought I'd just watch a bit.  And then a baby peed on me!  But, in Africa when a baby pees on you you are blessed so it was all good!  Brian had couple cases that went well Tues, but also had a sad case.  Monday evening a two day old baby had a tourniquet left on all night after an IV was started.  Due to lack of staffing that evening it was not found until morning.  The baby had compartment syndrom of him entire arm.  Brian was really upset.  He is holding on the the hope that kids are like salimanders and if you "cut of a limb it will grow back".  It wasn't looking good, but is still hopeful.  To cheer him up that evening we went to our new friends the Sparks' house again for homade donuts and coffee after dinner.  It was a nice ending to a hard day.  Oh and I have to tell you funn story our cook for the evening, Mercy, made burritos.  She forgot the beans!  We got to the table and had tortillas, guac, tomatos, and onions.  We sat for a while waiting and then she said that is it, just put it in tortillas.  Very strange we thought, ok.  Then Mercy reallized she forgot the beans!  Made us laugh, we've ate some strange things but that would have been the winner so far.

Wednesday, as you know Grace and I went to Bamenda to do a little shopping.  We got stuck waiting all day. Boys played with Grandma at house.  And Brian did more cases.  He actually has a good day till about 4:00 when a trauma came in.  It was a three year old boy who's grandparents brought him in, he had been beaten so badly that his arm had been broken.  Brian fixed his arm then had to send him back with his grandparents.  No DFS in Cameroon.  He said they did give repeated instruction on child abuse.  We are trying to learn some of the native language of "pigeon".  Brian is picking up some at the hospital.  Dr. Palmer taught me some on our drive to Bamenda.  Interesting, the people do not have an expectation for a long live due to high death rate.  Their tenses in verbage is all present.  If that makes sense.  It is all what is happening now.  They don't talk about the future or the past, very weird.  We are playing lots of games and cards and farkle.  Last night we all were thinking ice cream sounded really good.  So if you have a bowl, think of us!

Now it's Thursday.  It's a holiday today, Ascension.  The kids are out of school and the clinics are all closed.  Brian is doing cases but will be done early.  He has already run out of spine instrumentation.  He has a call in to his reps to fed ex more supplies to a student that is flying out on Sunday to bring them with them.  Crazy!  It is early, not much more has happened today so I will post later.  Will try to not go four days this time. 
Love to you all.  You can  still call on our cells, just remember we are six hours ahead!

Just messin' with ya!

No, the roaches have not gotten us yet! We have no interenet. They are working on it. I am currently stranded in Bamenda. Hitched a ride to do a little grocery shopping and now my ride has been delayed going back. Been waiting for 4.5 hours. Will hopefully return to Mbingo (45 min away) soon! I'll update post when I can.