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Back to a New Normal

I was about to leave the hospital on a Saturday afternoon after doing surgery for an ectopic pregnancy, when I received a call from Lori. There was a certain urgency that I immediately noticed in her voice, and it reminded me of the phone call she had made to me back in December when a grassfire was coming close to our house. Instead of a fire this time, though, our house was flooding! The ironic thing is that we were still in the dry season. It was not flooding because of a heavy rainstorm…it was flooding because our toilet had broken. Back in the US, we are used to toilets that are all one piece. Here, many toilets are two-pieces, the tank that holds the water and the toilet bowl, connected by a curved piece of PVC pipe. Our younger daughter is still working on potty-training, and she had just finished going to the toilet and was flushing the toilet when everything happened. The toilet tank fell off the wall and broke the water inflow pipe in the process. What made matters worse was that we did not have an indoor emergency stop valve to the toilet, and we did not know where the outside stop valve was for our house. When I arrived home from the hospital a few minutes after Lori had called, I could hear a waterfall flowing inside. Our whole bathroom and parts of our hallway and master bedroom were flooded already. Lori had fortunately been able to redirect the flow of water so that it shot across the bathroom into the bathtub, so as to decrease the amount of flooding in the house. She was also working frantically to soak up the water with clothes, towels, and a mop, to keep it from spreading to other parts of the house. I then made a careful search around the outside of the house (along with one of our neighbors, Francis, who is the hospital volunteer coordinator), and we eventually found the stop-valve and were able to mostly turn off the water to the house. The plumber then came and cut out our bad pipe, put in an indoor water stop-valve to the toilet, and installed a new toilet tank for us. We were very grateful for the quick response and help by both Francis and the plumber.
After arriving back in Nalerigu at the beginning of April, we have been busy with many things around the house, trying to get back to a new normal. I say a “new” normal for several reasons: we are starting to homeschool Rebekah, preparing for a new baby in the late summer,

taking Mampruli lessons, Tim taking a specific day off from work every week, etc…all things that we did not do or think about during our previous times in Ghana. Since we now plan on staying here for several more years, there have been a handful of projects that we have undertaken or are in the process of doing. I painted the room that we will eventually make into our nursery for the new baby; we learned that the old floor tiles in a couple of our rooms contained asbestos, and we are eager to have them replaced (reinforced by damage from the flooding); I cleaned out several trash bags full of leaves, dirt, and squirrel/lizard poop from our attic (that was weighing down the ceiling tiles and frequently finding its way into the rooms below); Lori is experimenting with a wicking garden (using local resources); and we had our hallway painted by someone else (because of lots of peeling paint).
We are also excited to announce that we have been accepted to MedSend. For those of you who don’t know about this organization, they help medical missionaries pay their monthly loan payments while serving on the mission field. It was definitely an answer to prayer, as medical school loans can be quite daunting to think about in the face of a missionary salary. As always though, God is faithful in how He provides. If not through MedSend, we trust that He would have provided for us by some other means. However, we are grateful for the ministry of MedSend and how God has used them to bless us in this area.

I started back to work at the hospital during the last week of April, and I have already had several new experiences and discoveries. The hospital, Baptist Medical Centre, has morning devotions every day at 7AM for the hospital staff (and whatever other patients may be sitting in the waiting room at the time). I did not know about these devotions until a little over a year after first arriving in Ghana in 2014. By that time, however, I was utterly exhausted from the workload and was finding it hard to even get up there by 7:30 or 8AM for rounds. I only went to a handful of the morning devotions from June 2015 until Dec 2016. I decided to make it a point this time around to make the hospital devotions a priority in my weekly routine. It is an encouraging time to sing some songs, listen to a sermon, and interact with some hospital workers in a slightly different context than usual. I learned a little later that these devotions used to be required of all hospital staff in the years before we came to Ghana, but now it seems to be optional (as there are usually only about 10-20 workers present each day). Being a regular attender of these devotions has also opened the door for me to give some of the sermons. One of the hospital pastors asked me a couple weeks ago if I would be willing to lead the morning devotions, preferably once per week. I am not naturally a public speaker, so I was a little hesitant. However, as I described in our last blog post, God did give us several opportunities to speak in front of groups during our last trip to the US. I believe that He was growing and preparing me for this opportunity. I have lead two morning devotions so far, focusing on the topic of worship, and I have thoroughly enjoyed preparing for and giving the sermons. Please pray that there would be a revival among the workers of the hospital to represent Christ well in how they live their lives, both inside and outside the hospital, and how they treat patients in the hospital.

 

To expound on the last patient: She had presented with two weeks of abdominal pain and then began vomiting profusely the night before she came to the hospital. Her abdomen was mild to moderately tender, mostly in the upper part, and she had a little bit of blood in her vomit. She then began having difficulty breathing and became less responsive. I used an ultrasound to look at her abdomen and saw that her stomach was massively dilated with a thick substance, and her bladder was also enlarged. I ordered that an NGT (nasogastric tube- tube that goes from the nose to the stomach, used to either evacuate the contents of the stomach or to feed a patient) and a urinary catheter be placed. The contents in the NGT bag were dark brown, and it was at this time that the family admitted to using local medicines/herbs that were that color in order to try and treat her abdominal pain. The color reminded me of a local fruit, the Akee fruit, that we have here in West Africa, (and that I had just read about online a few days prior) that, if not prepared properly, can cause severe hypoglycemia (low blood sugar). I asked the nurses to check the blood sugar, and the reading was >33.3 mmol/L (or >600mg/dL for those of you in the US- which is extremely high). I did not believe it, so I asked them to check it again…and it read the same number. She had diabetic ketoacidosis (DKA) (she had no previous history of diabetes), so we started treating her with IV fluids, IV insulin (best we could here with limited blood glucose strips and no infusion pumps to regulate an IV insulin infusion), serial urinalysis to check for ketones, and prayer. Her DKA resolved a few days later and she was feeling well for a few days. However, in the last several days, she has started showing signs of several cranial nerve palsies (possibly due to cerebral edema, which is a common complication when treating DKA in children) and has continued to spike high fevers, despite having been treated for malaria and with multiple antibiotics. She may have tuberculosis, as it can present in this way sometimes. It is the weekend now, so we cannot start TB meds until Monday.  This morning she became suddenly worse with hypoglycemia and breathing difficulties again, requiring oxygen. Please pray for healing for this girl and comfort and perseverance for her two caretakers (the father and grandmother). Also, please pray that Christ would be glorified, whatever the final outcome.Lastly, since we are medical missionaries, I think that it is necessary that I talk about some of the interesting cases in the hospital and how God has worked in different patients’ lives. Some interesting cases I have seen so far include:  herpes zoster (or shingles) on the face; polycystic kidneys; a horseshoe pelvic kidney; two women with ovarian masses (one with bilateral ovarian teratomas- masses on both ovaries; another with a unilateral massive tumor- mass on one ovary, found to have metastases (or spreading of cancer) all over the inside of her abdomen); a pregnant woman with a teratoma (ovarian tumor); a pregnant woman with a large jaw abscess from a tooth infection; a young boy with leukemia; a young girl with an acute subdural hematoma (I thought she had a brain tumor based on physical exam findings and no history of trauma, so I transferred her to a bigger hospital for a CT scan of the head and to see the neurosurgeon; it turns out that she had a brain bleed, they operated on her, and she is supposedly doing better—praise the Lord!); a baby with suspected tracheo-esophageal fistula (transferred down to Kumasi with a charity program we have at our hospital à baby WAS diagnosed with a TE fistula and reportedly underwent surgery – again, thank you Lord!); lady with a ruptured ectopic pregnancy; lady with a molar pregnancy; and a young girl who presented for first time with diabetic ketoacidosis (a severe complication of diabetes).

**Please see our personal blog for photos: Cahillsinghana.blogspot.com

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