What to do, what to do??

So as you read from Brian, it has been a busy week here.  It went by fast and now it's Saturday.  One and a half weeks left here in Mbingo, and I think I can honestly say just in the nick of time (we just about have found our groove here!)  I think everyone would like us to stay longer from what I'm hearing.  We are going to have to have serious conversations about what path this adventure is taking us on and what it means for our future.  At this point I am not sure what God is thinking?!?!

So yes, you all heard right.  I spent three hours (only seemed like maybe one) in the OR with Brian on Wed.  It was amazing!  It hadn't even crossed my mind, as in the states you just don't do that.  But after listening to everyone talk at dinner earlier in the week and hearing what they were doing I decided to make myself at home.  This might be my only opportunity.  And man was it.  I got as close as I could without being scrubbed in.  I was a little nervous about passing out, but to my surprise I was fine.  I guess all these years of hearing the stories and seeing the pictures prepared me.  Although, the cattery was a little overwhelming at times and I had to look away.  Anywho,  I knew it was a big deal for them to attempt this case here in Mbingo and I wanted to see it.  Thanks to God's graces, it went tres bien!!  I was at her head and was able to hold her hand and pray over her and the doctors while they were torquing and yanking and screwing.  It was truly amazing to be able to see them work and see the moments that changed her life forever.  Our God is so GOOD!  Apparently I can go see a c-section too if I want, maybe I'll see about fitting that in next week!

As Brian also said we visited the children again after dinner yesterday.  I am not sure who it helps more, them or me?!?!  I feel a bit selfish in saying that in a way it is healing for me to hug the moms, dads, grandmas, aunts, and the children and see the hope in their faces.  The trust they have in the medical treatment they are receiving is inspiring.  Some of the kids are SO sick, but they smile anyway and it warms my heart.  I hope my smiles warms theirs too!  We also visited with the scoli girl.  Her mother was SO HAPPY!!  She said that her daughter after she woke up from surgery told her to call all of their families and tell them to pray for the Drs because they worked hard and changed her life!  She was so happy!  I didn't know what to say to that, again my heart was touched by their faith.  Monday we are going to take her and the boy with the rickets lots of gifts...for being so brave! 

Yesterday I ventured into Bamenda to do a little shopping with a few other people going to town.  By shopping I don't mean browsing for clothes or shoes, I mean buying flour, tp, veggies, everyday things that you will need for the next several weeks.  It takes 45min. to drive into town.   It was a zoo, that is the only way I know how to describe.  Didn't get many "snaps", apparently police will take cameras way if they see you taking photos in town.  Had to visit about 10 stores and an outdoor market to get everything we needed.  I am not a big shopper anyways, this day gave me a headache.  Was able to pick up a few souvenirs for my nephews and the Khloe Dog though in all the kaos! 



Rice on left, salt on right.  This is how all flour, sugar, salt, corn meal, beans, etc are presented.  You go to store or market and tell them how many kilos you want.  It is bagged for you and you take it home in plastic baggies. 

 



Boy selling eggs.  Walking up and down street at market with cart.

 


At market there are hundreds of vendors trying to sell.  You can buy all sorts of things at market.  All fruits (here oranges and cabbage) and veggies separated in groups.  Best to tell them how much you want to spend and they load a bag of that item for you of your desired amount.  (You ignore the mice running through the barrels!)  But I was impressed with the selection and quality of produce they had. 





At market, chickens they sell whole ($16/chicken), beef and goat is butchered in the vendors tent and laid out on the table out front for you to choose from (no refrigeration and lots of flys).  Fish is sold whole, usually frozen or already cooked, also on tables displayed for you to pick from.  I am really looking forward to a nice steak when we get home!  Not much meat for me here!

As I said, highlight of shopping what the twix Suzanne bought me on the way out of town.

Went to bed early due to the termite invasion.  So nasty!  I can handle the ants and roaches and mice, but this getting a bit extreme!  Tonight we are bug spraying all the outside windows before dark with the super toxic African bug spray.  I hope it works so I don't have to tell the kids to sleep with their mouths closed!!! :)

Grace and I left for breakfast early today to take a run.  Grace is getting jealous that Grandma and I are both loosing a little weight and she is not.  So she came up with this great plan that she and I need to start running.  I say maybe not so many Puff-puffs!  No, I'll go along with it for now and see how it goes.  Didn't make it too far today.  Hiking has been ok, but I sure could tell the altitude difference when I was running.  Not quite the same as at home.  Also VERY bad roads and I do not want either of us breaking an ankle while here!

Today I have a large pile of laundry to do.  So why am I blogging you ask?!?!  Well that would be because we have no water.  Can you believe it? All the rain and NO WATER!  I was really motivated this morning after breakfast to get it done.  (Hand washing two small buckets will take me two hours)  So I'm a bit frustrated right now with west Africa and I am positive that I will never complain of laundry again when I get home.  I have so much respect for my ancestors and the people here who have to hand wash clothes everyday.  And PRAISES for a washer and dryer at home!

Oh well, we are enjoying a mild day outside.  Kids playing, not sure what mom is doing (probably still sweeping termite wings), daddy is bored and is walking around snapping photos.  I probably should try to motivate a hike or something unless the water has decided to come back on and it doesn't look like rain yet. 

Hope you all are enjoying our blog.  We look forward to sharing with you what we are doing.  I hope that it is not too boring!  Just kidding.  Still praying for all you friends in Joplin.  You are on my heart EVERYDAY! 

Angela, tell Wally and Bells that we miss them.  And again, thanks for taking care of them.  I don't know what I would do without your!  Love you! 

Hugs and Kisses to you all

-al

PS-Granny, The Red Velvet Cake turned out great!  It was a big hit!  Thnx
Sorry bout the small print, not sure how to fix it.  Will do better next time!



 



TGIF

Now that I've finally got some access I'm going to keep going with today's blog.

The food isn't bad, but they come up with the most random and crazy combinations of western food.  I was doing pretty good, until the garlic bread came out for breakfast yesterday and I couldn't take it anymore.  Also wishing I had fresh milk.  Freeze dried milk and cereal just isn't the same. 
Toby has finally started to crack, when I put the heat on him to try stuff last nite and today he did with an "awww right Dad...."  He agreed he liked the hand cut french fries and chicken after I convinced him it was just like African McD's.  Still can't get him to try banana french fries, (fried plantains) which are awesome with ketchup.  Finally had another food experience I've been needing to try.  FooFoo JamaJama.  It is a local favorite made of corn meal pudding/dumpling and JamaJama which is like spinach.  Got invited into the OR tech lounge to eat it today.  I was not offered a fork, so was also the first hands only meal, when I thought I needed a fork.




Birthday Dinner




Refined Toby, drinking morning Tea....


Amy went to  Bamanenda shopping with some of the other wives today.  Will be excited to see what she has to bring home.

As for me, did another spine trauma today.  T3-4 fracture/dislocation with cord injury. I think this will be the biggest impact we can make here is trying to improve spine trauma care.  I pretty much let Dr Nana do the whole case and he did very well.  He and I were both pleased.
He then walked me thru the osteotomy on the legs of that boy with rickets.  Crazy, crooked.


  

Before

 

After





Got home about 2pm, so I decided today was the day to conquer Mt. Mbingo, the big looming hill that is right behind the house.  Didn't look so big from down here.  Holy crap, that was steep, grass, mostly over Toby's head and I had to carry him down.  I can check that off my to-do list now.

 

Starting up Mt Mbingo




So Toby initially liked my idea of sharing his "silly bands" however, it was about now he started squealing for help.
Feeling a bit over-run......

  

Yes, It is the hill directly behind them we went up, straight up I think...





View of our House (red arrow)
View of Roxy/Grace waving at us (Yellow arrow), don't trust me blow it up big, they are in the photo.....




Hospital Valley





Amy made it back just in time for dinner, with lots of goodies from shopping.  She says it was too busy and stressful to try to shop that way.  They had to go to 3 big supermarket type places, because one doesn't care all the items.  They also went to a fruit/vegetable market and couple other mom/pop places.  She was thankfully able to secure some Coca-lite...its a good day.  Been pretty lean, bumming about one a week of Dr Sparks, who had the hook up in Bamenda.

Another, Grace settling into African life story.  Just before dinner, she asks for 50 Francs (11 cents).  She and a neighbor go to the hospital canteen and come back with Puff-puff.  A guava juice sweet bread/roll she is chomping on.  He also took her across the road to the market, where he showed her the candy/gum stand.  She's starting to feel pretty settled.....

After dinner, had to walk thru hospital because it was raining, and ran into my scoliosis patient coming back from her post-op xrays.  She was good and xrays looked great!!!  Roxy hadn't been in the children's ward, so we dropped by and shared the love.  We then dropped by the orthopaedic/accident ward where the girl was and was a circus there.  Had the tables turned on us, and one of the husbands of the patients was filming us on his phone.  It's crazy when your an attraction, just cause your white....

Post-operative x-rays from girl with scoliosis

Home for treats from that Mom brought with her.  Kinder...somethings for the kids, which are egg shaped, half toy and half candy goodness.  They were pretty excited.  Cold Castle brew, for the adults. 



Then the flying termites hit.  Has happened a couple of times, usually at night, when it starts to rain hard, is dark and the lights are on.  Kinda like may-flies.  But somehow are getting into the house, and sorta freak you out, cause there are lots of them. 

So everyone, pretty much shut of all the lights and just went to bed at 8:00pm, rather than fight the flying termites.  I'm on the neighbors porch (to get Internet signal)  still fighting the flying beasts.

For the record...blogging with bad Internet is a lot of work...

Nite,

BI







36 is starting out way better than 35 ended!!!

Sorry, the internt was bad yesterday from heavy,heavy rain, so this is mostly yesterdays and todays post.



To all the birthday well-wishers, thank you.  It has been a good, B-day and its only 3:30pm. Started with a call at 3:30 this am from my old friend, Henry Heimsoth, who called to check on me/family and see if I wanted to play in the Cole Camp charity golf event.  Was surprised to find I was across the ocean and unavailable for golf, but glad the family is safe.

So when we were coming to Africa, I told my wife she could basically be anything she wanted here.  Hygienist, dentist, oral surgeon, endodontist, orthodontist.  The credentials aren't checked, only the willingness to try to perform the task, and a modicum of skill.  Well, after our new friends, the insurance agent and his pediatrician wife arrived and now after three days he is a full-fledged hospital chaplain she sees my point.  Over dinner we discussed that maybe she and Grace should come into the OR and see what I do, especially since it was going to be a big open scoliosis case.  So Amy suited up in the OR garb this morning and took "snaps", photos of the operation. Grace may come to next weeks case, yet to be determined. Pretty sure Amy could have scrubbed in and put in screws if she had wanted, but I was just impressed she didn't pass out or throw up.  It was a pretty big, somewhat gruesome affair.  But, it went awesome.  For as little hardware as we used to try to conserve and treat as many patients as possible.  I'm ecstatic about the results.  We used only 4 screws on top/4 screws on bottom, two rods, cross connector and some wire.  About a third of what we would use in the states and she has a very satisfactory correction.  Now we pray she heals her fusion.  Lucky the power didn't go out until I was ready to close. Very first stitch... no lights, had to close by camping head light.

And again I say, you see stuff you only see in books.  Not once, not twice, three times already today.  First is a boy who came for walking difficulty.  The picture below is of his feet. He is not turning them in, they are that turned in or more.  Ricketts so severe, his toes turn backward!!!

Second pics are of a three week old baby, born with no radius bones in either arm.  Never seen it before, but then the mom says well, his brother has it to and show me his brother with the same abnormality.

Last pic is of the Monsoon/ hail storm that occurred during the surgery to knock out the power and lasted most of the afternoon.  It was good though, clinic was light so I got out by about 3 pm and came home to an interesting lunch to heat up.  A spaghetti noodle/egg omelet, with peppers...was very tasty, heard from Roxy it was awesome warm.  Was very good cold.

So we've started using the term "African Up" to tell kids to "suck it up" and be tough.  Apparently its started working.  Made lemonade today in a water bottle out of one of the little packets of lemonade.  Set the packet down on counter, and in true African style, Joey came along and grabbed packet, tore it the rest of the way and licked the inside of the packet for any remaing grains of sugar. Later, we asked Grace to use the phone, and she was a little perplexed by it.  How does it dial?  Rotary phones aer still in use in Mbingo, and now my daughter can say she's used one. 





Amy then suprised me with a special dinner for my birthday at the hostel.  She had them get Chicken, which at $16 dollars a bird, American, we haven't had there yet, was very tasty treat.  As good as a steak dinner.  She then somehow figured out how to get the ingredients for red velvet cake and a choclate sheet cake.  Had all the ex-Patriots over to the house to celebrate, was a very pleasant birthday.

Birthday Boy...BI

Unanswered Prayers!

So as Amy said, yesterday sucked...had a patient miserable with neck and arm pain.  Planned to do neck surgery, but only problem was no x-ray capability in operating room, so I had to do my best clinical guess at which one was the right level.  Prayed and prayed to be at the right level...post-op x-rays showed that I was not at the right level.  Felt very bad..worried and fretted about it all day/night.  Thought of 20 different ways to try to remedy the situation overnight, as did the local orthopaedic surgeon.  But, alas apparently my prayers for operating on the right level were heard, as she has no pain and her arm feels better. I guess what thought needed to be the right level was not the level that needed to be done to take her pain away, I hope.

Fixed a 7 year old child with a broken pelvis this morning and went good, hadn't done one of those since residency.  The variety of surgery is amazing.  You do see things that you've only ever seen in books here.  It is not just a cliche', crazy stuff. 

Getting better at my Pigeon English, which is the local tongue. Here are a couple that caught my attention.

He be a choke.  (he needs a shot)
You use da sticks to dohn be go house.  ( get up on crutches and go home)
Wok fa strait nah pa.  (stand up and walk straight old man you are better)

Just a few, but interesting as you start to follow along. Da hot  (where is the pain) is a big one.  Where is da hot??

A few pics to follow.  Big scoliosis tomorrow, hope it goes well.

How I found Toby sleeping this morning.

Took a cyst off of a wrist yesterday, found a rooster talon as I was removing it.
Story goes, local witch Dr tried to "heal it" with traditional medicine.
Stuck it with a rooster talon and it got lost..

Later,  BI

Please pray for Brian and his patients today.  He had a really bad day yesterday,  including a wrong level when he tried to fix a neck (operating blind, no xray in OR and he missed) and the baby with fasciotomy took a turn for the worse.  He can fill in on details.  I really would like for him to have a great productive day today.  So please pray!

Back From Lunch

Ok let's see, yesterday...
After the children's ward we got stuck in the rain (imagine that!) and had to hang out at the hospital for a little while.  Here are some other pictures of the hospital campus.  You can see all the people that just hang around and "live" there.

Hospital registration is in building ahead.  There are racks for lugage for the patients and families.  It is always full.

Washing and drying clothes outside the wards on the lawn and bushes.

Waiting outside all day, everyday.

Here are some pictures of the work going on, nonmedical that is.

They have been building this since we got here, by hand with all hand tools.  It is crazy to watch.

Shoe shop on campus.  Lots of shoes.

Dr. B with Paul and Helen

B and Dr. Nana

Ortho ward nurses

I snuck into the OR and got Brian between cases.  They told me that they do not want him to leave.  He has to stay!  I said maybe settle for returning next year.  Apparently, he really impressed them with his skills yesterday (Monday, lots of weekend trauma) when they had to rod a femur.  Their standard proceedure here is to open the entire length of leg and place rod, he taught them how to do it through a small hole.  When he was done, they did not believe him that he had it in the right place.  They wiggled the leg and saw that it was all connected and functioning.  Small wound, smaller chance for infection, great lesson taught!  I know why they need him here. 

The kids have been getting a little restless and after Grace and I returned home, she and Joe got in trouble.  Grounded to their rooms for the rest of the day.  Nice and quiet for us, they had to be creative in what they could do to entertain each other.  Before we went to dinner, Brian stuck his head in to find them playing Ninja with some pull ups they found in the closet.  They sure are getting the Africa creativity down!

Ninja Joe!

Asha!!

"Asha", the word  the Cameroonians use regularly around here.  So much so that we have picked it up in our own speech.  I have noticed it used when greeting others, when one is hurt or needs help, as an end to a conversation, nearly always at some point in every conversation.  Since it is so generally used, I google searched the meaning to find out the exact meaning.  It is a word that expresses empathy and loosely means "I feel sorry for your life".  It struck me funny (not haha funny!!) and again can feel the sadness grow from the pit of my stomach for the people here whose lives are about survival.  WE HAVE NO IDEA!!  And I do not have words to articulate how normal a life this is for them.  How is it normal that the girl with the OPEN tibia fracture waited three weeks to come in?  How is it normal the it monsoons nearly every day, and yet with all that water available they have to carry buckets of water to their houses because there is no indoor plumbing?  How is it normal that they cut the whole yard of grass with a machete hunched over in the heat?  How is it normal that Grace's little friend Hannah after standing and waiting all day at the hospital for test to be done, found out that she has malaria?  Do I just say, "Asha", smile  and walk on?  Asha!!

After some encouraging words from my gal pals, Grace and I decided that no, we need to do more.  So yesterday we went  to the pediatric ward at the hospital.  We handed out some balls that we had brought the said "Smile, Jesus loves you!" and silly bands.  The kids loved them.  As Grace handed them out, I hugged the moms, gave some words of encouragement, and shared some love.  Even though some of them did not understand us, I think they liked to see faces other than the docs and nurses.  Next time we are taking bubbles, that should be a real hit!  Here are some of our pics.
 

Oh, time for luch.  I'll finish my story later!
Salute!