Cured!

Dear Friends,

I am pleased to announce that after a long, and strenuous four month battle with scabies, I am now in remission. I say in remission because it is quite possible that it will show its ugly head once again with simple contact of an unknown carrier.

The treatment has been long and hard. It began by applying a cream no longer used in the United States because of the serious side effects. The cream was applied head to toe. About 10 minutes later, my body began to feel like thousands of needles were being pressed into my skin. This lasted about twenty minutes. Meanwhile, I could be found standing in front of a fan, taking really slow, deep breaths trying to think of anything other than my skin that was on fire. Then my sheets were changed for two consecutive nights.

Unwilling to go through that again, a doctor friend of mine brought me some Permethrin from the States. Permethrin is the preferred first line of scabies chemotherapy. It is a pesticide, but has minimal side effects if used correctly.

I spent about three weeks in remission last May, and was very content to not be taking benadryl to help me sleep through all the itching in the night. However, around the three week mark, a baby came into the hospital with scabies, unbeknown to me, and within a week, my arms were once again covered with the horrible sight of scabs and red bumps.

The next several weeks consisted of me using the Permethrin treatment about once every two weeks, without cure.

In July, I went back to the mission hospital for treatment, now with it metastasized to my legs. A new treatment regime was started called Ivermectin. I was to have two "rounds" of this pill-form treatment. To reduce the side effects of the allergy response and increased itching to the mite's cells being killed, I was put on a steroid taper for twelve days.

After the first round of treatment, the steroids did a good job of controlling the itching. However, a day after I began to taper them, I woke up in the morning with swollen lips and hives all over my body. I had an allergy to Ivermectin! This continued daily for about five days. I was taking benadryl every time I broke out in hives, which was about twice a day, and then fighting sleep the rest of the day. Finally, I was put on claritin and the symptoms subsided.

The new treatment regime was a fail, and I still had scabies. Back to the creams, that by this point I had developed a tolerance to, and were had become essentially ineffective.

I decided, that if I used the creams more frequently, it would surely get rid of these mites. Well, this did not help kill the scabies anymore than it had before. Instead, I started developing headaches, and feeling like I had less energy than normal. Too much pesticide was getting absorbed into my body, and it was toxic! On top of that, I had a mountain of sheets in my closet because I had to change them every time I did the treatment.

All other treatment plans exhausted, I turned to the one I had been avoiding even since I was first diagnosed--radiation. It was time to take a blow torch to the skin. It was the only way.

Ok--I didn't actually do that, but I think it did crossed my mind once or twice in moments of insanity from the itching:)

Instead of the blow torch, I chose a more mild form of localized treatment. Fingernail polish. After a month of applying fingernail polish on every new bump that showed up (and no, sometimes I did not have clear fingernail polish with me), I am now scabies free!

So, scabies isn't a life threatening condition by any means, but having it for four months, definitely helped me relate more to what these people go through everyday with untreated illnesses. Christ came to earth and lived like us so that He could help us. Why do I think I am above that?

I am moving into a nearby village where the electricity will probably go out daily and where it really isn't that safe compared to the nice guard protected hospital compound. I am really excited to be able to relate more to these beautiful people. Please keep me in your prayers!

The Vinedresser

John 15. "I am the true vine and my Father is the vinedresser"

A famous chapter in the Bible. It contains some of our Lord's final words before He was crucified.

I took a trip to Italy a year ago and, very appropriately, heard a sermon on this chapter. It really opened my eyes to God's dealings with us.

The branches of a grape vine receive all of it's life and nutrients from the vine itself. With a healthy vine the branches grow out long and full. There comes a point, though, where the branches get so long, that they no longer produce any fruit. You see, all of the nutrients from the vine must go into keeping the long branch alive, that it cannot support the growth of any grapes. The vinedresser then must come along and cut away at the branch. He knows exactly where the branch needs to be cut. If he cuts it too close to the vine, the branch will die all together. If he cuts it too far away, the branch will still not produce optimal fruit. So he cuts the branch. What happens next? Not only does the branch begin to produce fruit once again, but several new branches sprout out from the shortened branch! Eventually much more fruit is produced with the shortened branch than what was originally produced when that branch was first that length!

The vinedresser is skilled in his work. Before if I had visited a vineyard and seen a vinedresser cutting back all the branches, I would question why he was destroying his beautiful vineyard. I would think him a very poor vinedresser. But such is not the case at all. In the "destruction" or cutting away that he performs, he is simply making his vineyard worth more value.

So, the connection? God is our vinedresser. He is skilled in His dealings with us and those who cross our paths. He knows what cutting away he needs to do in each one of our lives, because he knows his vineyard well. He sees our hearts, while others just see our outward appearances. And so he cuts away at the areas that have grown wild and interfere with our effectiveness. For a moment, the cutting away seems to be destructive to the branch, but with time, as new branches begin to grown, the faithfulness of our loving God is proven again.

Don't question the cutting away that God does in your own life. Embrace it with confidence knowing that His plans are for good and not for evil. And at the same time, don't question the work that God is doing in the lives of those around you. In seeking to trust God with your own life, learn to trust Him and His dealings with everyone else as well.

Recuerdito

Meet my man Anderson (Pronounced with a Spanish accent:). One of my cutest patients ever, who didn't talked to my once the entire time that he was in the hospital. No matter how nice I was to him or how much I tried to play with him, he would just give me a blank stare. Yes, a bit disheartening. :( Anyway, he's still cute, even with his blank stare.

This picture is of him when he first arrived to the hospital. His face and belly were extremely swollen. This picture shows how he could barely open his eyes because of how edematous they were. He had something called Nephrotic Syndrome. It's an illness caused by damage to the kidneys, and for this reason he was completely swollen.

Usually this syndrome is treated with a very strong diuretic, Lasix, to take off the fluid, and a blood product, called Albumin, to replace the protein that the damaged kidneys are excreting in the urine. Well, considering the fact that our only blood bank is a list of names of missionaries and their blood types for them to come give blood on the spot when necessary; we definitely did not have Albumin. Despite our limited resources, we decided to start treatment with just Lasix. The first couple of days showed no change in Anderson's swelling, but about three days after being admitted, it started to go down! He was discharged within a week and a half after being admitted to the hospital.

Just another reminder that God is powerful. He is the one that holds the world, the universe, your life, together. Without Him nothing exists. He is in charge 100% of the time. He decides when the sun rises and when it sets. It's funny how we live in nature every day and we see His greatness right before us, and yet we still forget. We forget that it is only through Him that we move and live and have our being. I think that we tend to forget how helpless we really are without Him until He puts us in situations where we are inadequately equipped or not prepared to handle. It forces us to fix our gaze back on Him, and to remember how great and mighty He truly is. We are not confined to our human resources and expertise, but to His; and "He gives to all men freely and without reproach" James 1:5. I have seen so many cases in the hospital where God takes the little that we have in resources, causes it to suffice. He is so great.

Good News!

I just was informed by Penny that the patient we took into La Ceiba because of iron overdose survived! He made it through the most critical time (first 48 hours) and he was actually discharged from the hospital yesterday. Praise God!!

Whatever you do, don't call an ambulance!

Yesterday night I was taking care of our precious Orlin, the baby who I wrote of in my last entry. He seems to be doing a bit better, but continues to have recurrent lung infections. He has been out of the hospital for a week now. Praise God for that!

When I was just about to leave from watching Orlin, I got a call on the radio from one of the nurses in the hospital. A two year old boy, Anyel, had gotten into his mother's iron pills and had swallowed thirty tablets: a lethal dose. He had suffered convulsions in his home, which prompted the mother to bring the child to our hospital about 5 hours after he had ingested the tablets. At that point it was too late to try to induce any vomiting of sorts. Our hospital did not have the medicine needed to excrete the iron from the body, so I was being called to help transport him via ambulance to a large public hospital in La Ceiba.

There are 5 stages that a person goes through when they have overdosed on iron. In the first, the patient will usually experience gastrointestinal symptoms and convulsions. It is common for the patient to be bleeding in his stomach and intestines, which causes death in a significant percent of victims. The next phase, is deceptive in that most symptoms subside, and the patient appears stable. Within hours, however, the patient enters the third stage where low blood sugar, cardiac problems, shock, and coma often occur. This usually happens within 6-8 hours after ingestion. Most patients do not make it through this stage. If they do, they enter the fourth stage which is when the patient presents liver failure from the damage that the iron has done as the liver tries to filter out the toxins in the blood. Lastly, if the patient makes it through all of that, he must then deal with the residual gastric problems, which sometimes warrant surgery.

When we began transport, our patient was in the deceptive Stage 2. He was still vomiting and stooling blood, but he was at least alert and oriented. Knowing that he could begin to present cardiac symptoms at any point, and possibly go into coma or shock, I was extremely nervous about the hour ride ahead of us. I had no idea that by the end of the trip, I was going to be fearing for not only this baby's life, but also the lives or all of us in the vehicle.

The first half of the trip was on dirt roads. We sped along and cut corners as we went. Apparently the driver was determined to not allow anything to slow him down: not heavy rains, not terribly fogged windows, not even losing control of the vehicle on the slippery mud roads. I maintained my hand on the Anyel's pulse, and my eyes on the road, as my attention quickly became divided from that of the life of Anyel to also the lives of all of us in the vehicle. Penny, the nurse accompanying me refused to look at the road at all. It was so scary!

FINALLY, the rain subsided and we reached paved road. I breathed a sigh of relief, not realizing that these better conditions only meant more risky driving. We sped along, not stopping for anything or anyone: not even a semi-truck. Nope, we didn't budge one bit as we drove in the oncoming lane of traffic, and the semi came fast approaching. Thankfully the truck decided to drive into the ditch rather than smash into us at the last second. I can't count how many other times we pulled directly into oncoming traffic. I knew it could be the end for everyone in this...ambulance?

But we made! Alive! Anyel was hard to awaken and barely responsive when we arrived. Thank fully the hospital was expecting him and he was seen immediately. We found out that the medication that he desperately needed is no where to be found in the entire country. So we left, feeling a bit disheartened.

The following day, this past friday, he was visited by some of our staff. The doctors explained that his iron levels are about double where they should be, but they are lower than what requires drastic intervention. Anyel was not alert or responding much when they visited.

Please pray for him, as he is still in a very critical state. I will be posting more updates as I get them.

El Amor

So I am sitting in the pediatric room of the hospital right now, helping take care of one the children from the Children's Center, which is an extension of our hospital's ministry. His name is Orlin. A ten month old whose little life has experienced more complications and trials than most of us will experience in a lifetime. He has had to fight for his life from the day he was born, it seems. He came to the Children's Center about 3 months, weighing only 13 pounds. He had suffered abuse before coming to us, and acquired a skull fracture as well. On top of the neglect that he had received in his home life, he has cerebral palsy and other developmental delays.

In his first month at the Children's Center, Iain and Liz (the couple that started and runs the Children's Center) worked hard to get him up to a healthy weight. However he continually developed pneumonia. About 2 months ago he was admitted to our hospital because he had developed aspiration pneumonia, and was very critical for about a week. He ended up getting a gastric tube put in to help him with his nutrition, since every time he ate, he was breathing in some of the formula into his lungs, causing the pneumonia. He was in the hospital for several weeks after the surgery healing and slowly increasing the feeds, as he tolerated them. He stayed in the hospital until last Saturday. He was discharged because the hospital's only feeding pump broke, so all the feeds had to be done manually, which could be done at home. Only one minor problem: he gets formula every 90 minutes, and it has to go in over 20-25 minutes. On top of that he gets medications throughout the day, and breathing treatments every 4 hours. Talk about busy!

Iain and Liz have some of the biggest hearts I have ever seen. They take care of 18 children who have either been abandoned, maltreated, or have special needs. But they don't simply take care of these children, they love them. Love is sacrificial, and that is what they are for these children. In the 7 months that I have been I have seen them sacrifice sleep, comfort, time with family and so much more to make a way for these children.

Today Orlin is back in the hospital because he started to develop pneumonia again. He is doing better now. I am the lucky one that gets to watch this cute little fellow, while Iain and Liz take a much needed break for a few days.

Please keep Orlin, Iain and Liz, and the whole Children's Center in your prayers.

Clinic in the Caribbean

This past weekend I had the pleasure of going to a small group of islands called the Cayos Cuchinos. There are about 13 small islands and are visible from where I live. I believe only 4 of the islands are actually big enough to be inhabited, as none of them are even a mile long. It takes an hour boat ride to reach them. The islands have no medical care available to them other than about 3 months out of the year when a nurse from the States comes down to hold clinic and once every six weeks when one of the doctors from the hospital comes over for a few days. For any other emergencies they have to travel via boat all the way to Loma de Luz. If it's stormy or the water is rough, it takes even longer than an hour to get to the hospital.

We did a small clinic this weekend. People from the different islands boated over throughout the day. It was really nice, actually. In between patients coming and going we would go snorkling:)

View from Clinic

Most of the patients we saw came for refills of medications, or to get their blood pressure or blood sugar checked. We had a couple kids come in with bad weight loss, probably from parasites and amoebas.

Sunday morning we lead a Sunday school class on one of the islands. The kids were so cute! We taught them about Joshua and the battle of Jericho. By the end of the lesson we had all of them marching around "the city of Jericho", made out of chairs stacked on each other. It was a lot of craziness...but fun!

Honduran Cold

So something pretty interesting about Hondurans is that they are scared to death of the cold. Literally.

Currently Honduras is in the middle of rainy season, which is our equivalent of "winter". Between the months of November and February it rains several times a week and the temperature fluctuates between 65 and 90 degrees. Instead of snowy roads to worry about, we get roads with mud ruts a foot and a half deep. There are no ice patches, just rivers that wash out bridges and flood roads making it impossible to get to town (where we buy our food).

Honduran's responses to the cold:

Instead of saying "bad weather", Hondurans say "bad time". At the beginning of rainy season, one of the Hondurans nurses pulled me aside, and gave me a 20 minute lecture about how these "bad times" were coming, and how important it was for me to stock up on food incase the roads became impassable. I felt like the end of the world was around the corner, or we were about to have another Y2K experience, with all this talk of bad times.

So that's the picture of our "winters" down here. Pretty mild other than the rain factor. So when the temperature drops to a horrid 65 degrees outside, the Hondurans come into the hospital wearing hats and coats as if it were 30 degrees out. They will actually work inside with hats on if it is "cold" enough. When I am walking around in short sleeves thinking it's a lovely day, they are talking about how "icy" the weather is.

Most people come in with their ears stuffed with cotton so that the cold cannot enter their bodies.

I visited a friend the other day and took off my shoes upon entering her tile floored home. It was probably in the 60's outside. Over the next thirty minutes, I got asked about 5 times whether or not I wanted shoes to wear on the tiled floors. Despite me saying that I was perfectly comfortable, it worried my friend's mom so much, that she got up and found a pair of her shoes for me to wear.

One evening one of my patients asked for some hot tea, because his stomach was cold. I asked him how that was possible, and he said that he had a cold drink and now his stomach hurt because it was cold.

The list goes on.

I just find it so neat to discover cultural differences. I am sure that, in America, we do things that are weird to other cultures....like not put cotton balls in our ears to keep out the cold:)