Monday, November 28, 2011
Thursday, November 24, 2011
Brit: "So...the pilgrims, from England, were thankful to the Indians that they didn't starve?"
Canadian: "Yeah, and then they gave the Indians smallpox blankets."
American: "They didn't know the blankets had smallpox on them!"
Brit: "England's such a small country, but it's interesting how we're involved in everything."
American: "We were trying to get away from you!"
I ate dinner with 3 nurses from the United Kingdom, and when we sat down to eat Jess looked at me, the lone American at the table, and said "is there something we're supposed to do? Do we have to sing a song or say something special before we can eat?"
I'd already started eating. Oops. "Um, well, sometimes my family all goes around the table and everyone says something they're thankful for." So we did that, and then I got back to my turkey and mashed potatoes. Yum!
I didn't get very far though before Larry, an older gentleman from somewhere in America, stood up and rang the bell. There's a bell in the middle of our dining room that people ring when they want to make an announcement during a meal. Usually it's an announcement for someone's birthday, and everyone in the dining room sings happy birthday. Today, Larry stood up and said something nice and nostalgic about it being Thanksgiving, and then added "and I'd like all the Americans to join me in singing God Bless America."
What followed was a half-hearted rendition of what sort of sounded like 'God Bless America,' but nobody really knew all the words, and everyone was off-key. Every time I tried to sing I just heard how off-key everyone was, and started laughing, which made me start coughing. I've had a cough for about 3 weeks now. Anyway...the Thanksgiving song fell rather flat, but the meal was lovely. I miss my mama's cornbread stuffing and sweet potato pudding, but dinner was still really good. And a few hours later we all gathered in the cafe and had delicious apple pie and ice cream! All in all, it was a nice Thanksgiving. I have so much to be thankful for right now, I can't even begin to list it all.
Wednesday, November 23, 2011
Monday, November 21, 2011
Thursday, November 17, 2011
When I first arrived in Sierra Leone and found out that I would be taking care of both adults AND children on the wards, I was nervous. My last experience in pediatrics was my limited clinical time in college, and I was (and still am, to some extent) very insecure about my abilities as a peds nurse. One of my first little patients way back in June was Aminata, a baby with a big tumor growing underneath her jaw. She was severely malnourished and developmentally delayed when she came to us, so she was put on the infant feeding program to get her healthy enough for surgery. I remember when we were taking care of her in June, Ami was very lethargic and didn't even have the energy to cry or kick her legs. Her arms and legs were much too skinny in proportion to the rest of her body, and her hair was thin and pale.
After staying in the hospital for awhile on tube feedings, she and her mother were sent to live at the Hope Center while she continued to fatten up before surgery. Over the next few months, Ami slowly gained weight and began acting more and more like the 2-year-old she is. Finally she was healthy enough to undergo surgery! All the nurses were so excited to see her back in the hospital, and she quickly became the Princess of D Ward. I remember one day I looked over and saw a group of our day volunteers gathered around Ami's bed, playing the guitar and singing to her. She had the biggest smile on her face, and was waving her arms at them while they sang.
In the operating room, the surgeons found that the tumor was much bigger than they'd anticipated. They had to do quite a bit of "digging" to get it all out, and as a result Aminata had a lot of swelling around her throat after the procedure. She came back to us intubated and breathing on a ventilator, and took up residence in the ICU. She had one-on-one care from nurses with pediatric ICU experience, and lots of visitors over the next few weeks. One evening as I was getting ready for my shift, I heard an announcement come on the overhead speakers: "Emergency medical team to the ICU!" My heart sank when I heard that; I knew we only had one patient in the ICU at the time. When I showed up in the ward for work, a crowd was gathered around Ami's bed. Despite being sedated, she had pulled her breathing tube out and there was too much swelling around her throat to put a new one in. As the doctors and emergency medical team were working, all the D Ward nurses waited nervously next door. At one point our team leader, Natalie, looked up at us and said "Are you guys ok? I think I'm more worried about you than Aminata!" Several of us were close to tears, worried about our little princess. Ami was rushed down the hall to the operating room to have a tracheostomy placed, and she came back to us on the ventilator again.
It was a long, slow process, but eventually the swelling went down enough for Ami to start breathing on her own and come off the ventilator. Her trach site healed up, but she had a pretty nasty respiratory infection after that. Several more weeks on antibiotics and tube feedings had her slowly but surely feeling better. She's been going back and forth between the Hope Center and the hospital since getting her feeding tube out, and is brighter-eyed and happier than ever these days. It's really amazing to see the change in her, since having taken care of her back in June. She's definitely fattened up since then, loves to play with the nurses, and smiles all the time. Her hair is healthy, and her legs are strong enough for her to start learning how to walk!
Despite the improvements, Aminata's tumor may return, and her chest infection never quite went away. And the ship is leaving in December. Leaving Ami before she's completely healed is something we're all struggling with. It's hard to leave before the problem is fixed. It's hard to go home to a country where I have immediate access to whatever healthcare I need, when the people I leave behind don't have enough medicine or doctors or food or clean water. All of Ami's memories are here on the ship; what's she going to think when all of a sudden, we're gone? Her home is probably not a very clean environment; what if her infection gets worse? One of my coworkers reminded me the other day: God brought Aminata to us. He was with her all along, and He'll still be with her when we leave.
Saturday, November 12, 2011
We have the cutest little cleft lip baby named Alpha on D ward right now. Since he was born with a cleft lip, he never learned how to suck, so he has to be fed formula with a spoon or syringe. The other day he was crying and screaming for food, and by the time Jess got the formula mixed up and sat down to feed him, he was quite a pathetic little mess. He was hungry so he was trying to eat, but not used to breathing differently yet after the surgery, so he kept choking. On top of that he was mad so he was crying and kicking, and he may have had a dose of lactulose, which was making things get rather squishy in that diaper of his. Poor little Alpha was just an angry, spluttering, burping, farting, hungry mess. In between the gasps and coughs, Jess managed to squirt enough formula in his mouth to satisfy him, and in the end he was content and fell asleep.
Yesterday I went down the hall to fetch something from the kitchen, and heard quite the commotion down by A ward. A few of the nurses and plastics kids were having a bowling tournament in the hallway with a plastic toy bowling ball, using empty pediasure bottles for bowling pins. They looked like they were having a blast.
During some down time when I had nothing to do yesterday evening, I just sat down on a stool and Kadiatu, my wild woman, came and crawled up on my lap. She started nodding off so I carried her to bed. Her dad called me back as I was walking away and said "she needs nappy!" I hadn't realized that she was sitting in my lap for 20 minutes without a diaper on. Glad I didn't find that out the hard way.
Taking care of kids, I've had lots of medicine spit back out into my face. My little 13-month-old patient Esther was quite a surprise yesterday when she saw me coming with a syringe full of her antibiotics. She sat up, crawled over to me, and sweetly tilted her head up with her mouth open. I squirted the medicine in, and she just swallowed it without a fuss! What a nice treat for me - no metronidazole splattered across my scrubs or anything. :)
We have a little girl named Sia who has Burkitt's lymphoma, a nasty cancer causing huge facial tumors. Usually we would have cared for her through the Burkitt's program we have on the ship, but since it's the end of the outreach, the Burkitt's program is shut down and we aren't able to finish her chemotherapy treatments. Instead, we're sending Sia and her mother and little sister to a hospital in Guinea to complete the chemo. Mercy Ships is paying for the medical care, but there was a bit of an issue finding the money to pay for their transportation and lodging, and the patient life team was working to find donations. The other day our team leader Natalie came running into the ward with some great news - she had been talking to one of the patient life people upstairs in the cafe, about how much money they would need to take care of Sia and her family for the next few months in Guinea. A lady in the cafe came over and said "excuse me - I don't mean to be eavesdropping - but are you talking about a child? I have some money set aside from one of my donors that's meant to go to help a child, and I've been wondering how I could find a child to help." The money the woman had set aside was just the right amount to help Sia. Isn't God amazing?!
At the end of my shift last night I grabbed my water bottle, and Kadiatu immediately started waving goodbye to me. She's figured out that when the nurses pick up their water bottles, they're leaving for the day. So cute!