Triplets!

When Mark came home at lunch time and told me he had triplets to deliver I couldn’t my excitement.  Quickly I looked through our stash of baby blankets, hats and newborn clothing to see what would work.  Not knowing if we had boys or girls I set aside three girl blankets and hats and three boy blankets and hats.  I knew this would not matter to the Ethiopians, but in my American mind they had to be the ‘right’ colors.  He went back to work and I waited for him to call.  I waited and waited and finally thought he had forgotten me.  I wanted so bad to videotape the delivery and see them born.  But finally the call came through at 5:00 that the spinal was in and I should come. I put on Mark’s blue scrubs, a surgical hat, grabbed the clothes and cameras and headed for the OR.

The room was bustling with excitement.  There were three midwives waiting to take care of the babies along with the normal surgical crew. Each baby had a towel and blanket along with its own bulb syringe waiting for them in the large bassinet.   I showed them the blankets and hats I had brought and we laughed about what colors we should use.  All of us had an opinion about the sexes.  Some thought two boys and a girl and others two girls and a boy.  No one ventured to think they would all be the same sex.  The only thing missing was the father.  He and the grandmothers were waiting outside surgery. Fathers are still not allowed in the operating room.

It took a while for the spinal to take but finally the surgeons were ready.  Mark had his first year resident, Dr. Ronald from Rwanda make the incision.  Many thoughts went through my mind.  No. 1…I’m glad I’m not queasy when I see blood. No. 2…in just seconds three new lives will enter this world…it was a humbling thought that I would witness their first breaths and 3…I was so proud of my husband who was allowing his student to do most of the case. It was only Mark’s second set of triplets to deliver. They reviewed the procedure once again, made sure all of the instruments were ready with the scrub tech, said a prayer, looked around one more time to make sure everyone was ready and the surgery began.  It seemed like a long time from the initial skin incision until the uterus was opened but in reality it didn’t take more than five minutes.  The first baby emerged quickly and took her first gasp for air and cried lustily.  The room erupted in excitement. It’s a girl!  Our head midwife, Bekalu immediately scooped her up in his arms and began to work on her.  Within in seconds baby two was delivered and again the room happily noted it was another girl!  The next midwife, Tigist took this baby in her arms and began to clean her and suction her out.  And then we waited.  I watched and videotaped as Dr. Ronald searched for baby three.  Mark put pressure on the abdomen and finally (it seemed like forever) baby three emerged in his own meconium stained sac.  It’s a boy everyone shouted.  He was so little but his arms flailed and his cry was hearty as our third midwife, Meskeram, scooped him up and placed him in the bassinet. Each baby was weighed in the OR and then we discussed which blankets and hats to wrap them up in. It was a magical moment for Soddo Christian Hospital.

The triplets. L-R No. 1 girl, No. 3 boy and No. 2 girl

Staff popped their heads in the OR wanting to see the babies and checking on the mom.  Finally the cleaned up babies were wheeled over to the mother who had, up to then, only heard their cries.  She already seemed weary as her tired smile took in her three new children.  The midwives wheeled the bassinet out of surgery and into the outdoor corridor where the father and his family stood waiting to see their babies.  I think he was a tad overwhelmed when he took in the magnitude of three little babies, however he smiled and the grandmothers standing next to him were ecstatic.  The babies were then quickly wheeled into our ICU ward.

Dad sees his babies for the first time

Two days later I went down to the hospital to see the babies, pray for them and give a gift to the mother.  I used the nice bag sewn by Kainey Church and packed it full of three outfits each for the babies donated by Muskegon area women.  They actually paid for us to bring two suitcases back with baby clothing. This family is very poor and it was a privilege to share your gifts from the USA with this very deserving family.  This time we did not have “naked twins” but fully clothed healthy triplets.

This is a video I made about our lives in Soddo.

Faith was such a helper

Mark enjoyed raking leaves with Grammy and Grandpa

Being back in the states with our grandkids from Johannesburg, S. Africa has been so much fun.  Raking leaves in chilly November was magical!

Getting sick on a hospital compound has certain advantages.  I discovered them first hand last week.  Subtly an inner ear illness had been creeping up on me over several months like a cat crouching in the flowers slowly inching up on his victim before the final pounce.  My pounce came with a vengeance last Tuesday morning.  Feeling a bit shaky and dizzy while working on the computer Tuesday morning, I went into the living room and lay down on the sofa thinking I could work on the computer lying on my back.  That was a big mistake.  The room began to spin and my eyes started flickering and violent vomiting ensued.  My sweet house worker Demeketch grabbed a pan and held my head as the vomiting continued without ceasing.  Just when she thought she had time to empty the pan it would start again. I realized this was no stomach flu and told her to send someone to get Mark.  Within fifteen minutes I heard his comforting voice enter the room along with Dr. Ruth (our internist) and my friend Jackie Anderson.  They did the normal things like take my pulse and BP and scratch their heads.  What in the world could this be?  Ruth suspected it was something with the inner ear but hadn’t treated it before so she left to do some Internet research.  The vomiting continued…on and on and on. Any movement of my head brought on vomiting.  The sunlight hurt my eyes so they covered my face with a towel. Ruth wrote a prescription for some medication from the hospital pharmacy.  The meds she wanted were unavailable but there were substitutes that might work, she thought. Later I heard Amharic voices in the room but could not see where they were coming from. I felt, but could not see, the two OB nurses as they worked to start an IV in my arm and give me nausea medicine. Later Stephanie Hail checked on me and went to a city pharmacy and brought some different medicines. Mark had one surgery to complete so Jackie Anderson sat with me during that time.  I literally could not raise my head from the pillow, even to take a sip of water.  They talked about taking me to Addis Abba but there was no way I could make the long 6 hour drive.  Actually, in the states, I don’t think I could have even gotten to a hospital.  The vertigo was so intense and the vomiting so violent that movement was impossible. How fortunate for me that everything I needed could be carried down the hill from the hospital to my house and a makeshift hospital room set up in my living room.

My make-shift hospital room

The IVs with medication helped and the vomiting ceased in the late afternoon.  Mark talked to our kids on Skype and asked them to pray for me.  He also put on Sara’s prophetic piano music which was like a balm for my soul. I felt the Holy Spirit gentle my soul and I rested quietly on the sofa drifting in and out of sleep. Slowly the intense vertigo subsided in the evening to where Mark could carry/drag me to the bathroom like a recovering stroke victim. My balance was nonexistent. I remained another day in bed with no light and no movement but could take tiny sips of icy carbonated water called Ambo. Lucky for me it was a national holiday called Meskel so Mark did not have to go into the hospital. Dr. Paul Gray slipped in that morning and prayed for me.  Jackie came and prayed for me.  Our chief resident and his wife, our head midwife came and prayed for me.  I had Amharic prayers and English prayers. Both were equally beautiful to my ears. And then just as it came quickly, it left quickly.  I sat up in bed and thought, “My head feels clear.”  I put on my glasses and everything focused.  But my balance was still off and it took another four days before I could walk without holding on to someone or something.

So what did I have?  Between all the specialists on the compound and my own family doctor, Dr. Tom Watkins, back in Muskegon, they felt like it was an inner ear infection caused by a virus and labeled it labyrinthitis. I am still not 100%.  I tire very easily.  Last night I was in bed by 8:30.  And my balance is still off.  On Wednesday I played a game with my students which required moving from side to side. The dizziness came back quickly and I lost my balance. I love to exercise and I’ve had to give that up for a while until my balance returns. So my kickboxing DVDs will gather a little dust until my head feels normal.  In the meantime, I’m walking and doing some physical therapy exercises that are supposed to help the crystals in my ear realign. If this is something you or a loved one has gone through I would love to hear from you.  In the meantime, I am so grateful for my missionary friends here in Soddo and our Ethiopian hospital friends who came down to the house to check on me and pray for me.  I am so incredibly blessed!

It was raining and I was muddy and exhausted. A few feet away my home beckoned to me but my mind was wandering.  I walked past the Grays house, thinking about Paul Gray in the hospital in Addis Abba and wondering what strange illness he had that would spike fevers to 103 for over seven days.  Was it malaria, typhoid or relapsing fever or some other unnamed dreaded disease?  Walking on I looked across to Dr’s. Ruth and Mogus’ house.   Just last week she noticed that her beloved nanny was losing weight.  Hepatitis B was the culprit. Only today, my gardener, Tilahun, had left work early with headache, nausea and fever.  Previously he had been diagnosed with malaria and typhoid.  Was it back again? And then earlier in the week Mark had come home from the hospital wiped out after doing an extremely difficult case on one of our nurses.  When he opened her up, it appeared that this young nurse was full of ovarian cancer.  It was seeded all throughout her abdomen with large tumors in the ovaries and fallopian tubes.  But on further inspection he discovered that this pseudo cancer was in fact a terrible case of peritoneal tuberculosis.  As I neared my house I noticed a wild dog lurking behind Dr. Ruth’s house.  Rabies is a huge problem here and currently our hospital fence has large holes big enough to allow this tall dog to wander among our houses unchecked.  So during this brief walk home in the pouring rain I did a quick reality check.  We are not invincible.  Daily we see illnesses that in the states would be confined to a quarantine ward in the hospital.  We interact with our patients, friends and strangers daily: hugging, praying, eating, laughing, riding in taxis, worshipping together and inviting them into our homes.  The nurse with TB had been in my home the previous Saturday for a Bible study.  I’m not complaining, I love this country and the people and know that I am called to be here in this place at this time.  It was just a brief reality check…that we are vulnerable to some particularly deadly diseases and we must be careful.

The birthday party for Lydia Gray was over and still there was no sign of Mark.  Lydia’s dad had also missed her 2^nd birthday party and came in just at the tail end to watch as she opened presents from her grandparents.  “Have you seen Mark?” I asked Paul.  “Yes,” he responded. “He’s still in the OR.  He has a bad baby.” With those words my heart sunk.  It is what Mark dreads the most.  Trained as an obstetrician in the states, he was always able to refer those cases to the pediatrician.  Now the responsibility fell on his shoulders and it was heavy.  I made a thermos of hot tea and grabbed some cookies and bread and headed for the OR.  It was already 5:30 and he had been there since 1.

The usually bustling OR was eerily quiet except for the persistent beep of the ventilator machine.  I found him sitting on a stool next to the sick baby.  He and his new resident from Rwanda were the only ones in the room.  The bed where the mother had had her emergency C-section was washed clean; the only sign remaining of the traumatic delivery was her sick baby lying on a table wrapped in green surgical drapes with an oxygen tube running down her mouth.  The baby was blue and lifeless. The steady beep of the ventilator told me that she wasn’t getting enough oxygen. Our OR ventilator machines are different than the ones in the states.  They are equipped with their own oxygen supply.  Mark patiently pumped the green leather bag giving the life sustaining oxygen to the baby. “She has a steady heartbeat, “ he said, “but she just can’t breathe on her own.”  “I can’t just let her die, she has a heartbeat.”  “I have to try.”  He took a sip of hot tea and offered some to Dr. Ron.  Ron declined but took the bread.  He hadn’t eaten all day.   The baby’s stats continued to drop as I stood over her and watched her chest rise and fall with the oxygen.  Later the on call night nurse anesthetist came in and reinserted her oxygen tube.    The baby’s stats began to rise dramatically.  50, 60, 70, 75, 80, 82, 85, 90.  She was getting 90 percent oxygen now and she began to pink up.  It was quite remarkable to see the dramatic change.  But she never moved a muscle, not even a slight finger flicker.  I laid my hands on her chest and prayed for her.  Mark left me to watch the machine and he went to find some nurses to cover the shifts.  He couldn’t move the baby to the ICU because the ventilator machine in the OR was the best one in the hospital.

One of our nurses watching the baby.

The nurses made a plan and we headed to the ICU to check on the mother.  The grandmother was hovering closely to her very sick daughter who had lost a lot of blood. Her case was all too familiar.  It was her first baby. She had been in labor in the countryside and pushing for two days. Mark asked the grandmother if she would like to see her new grandchild.  She smiled, bowed her head in acquiescence and followed him to the OR.  She was a tiny woman, dressed in a long flowing skirt with her head and shoulders draped in the traditional white Ethiopian shawl.  Even though she spoke no Amharic her body language needed no translator.  When she saw her little granddaughter, she lifted her hands in praise and worshiped.  As tears swelled in our eyes…did she really know how sick her granddaughter was…we hugged each other and cried, two grandmothers worlds apart culturally, but united in the love of a grandchild as only grandmothers can be.  I wish this story had a dramatic happy ending, but it doesn’t.  The baby died Monday morning.

Mark doing an ultrasound on a patient in the outpatient clinic. He does his ultrasounds in a small clinic just inside the maternity ward. This patient came in with her brother,who translated, and her husband. She has five children and Mark discovered a possible tumor in her uterus. Her husband was consulted and he and his wife opted for a hysterectomy because they did not want anymore children.

The final result of the surgery. One large uterine fibroid on the right and one large ovarian dermoid cyst on the left.

A few weeks ago I followed Mark around to take some pictures and see what his life is really like at the hospital.  He was super busy on this day, running between the outpatient clinic and juggling the surgery schedule.  The following are a few pictures of my morning spent with Mark.  Even as he was doing this ultrasound his cell phone was ringing telling him to come to surgery.  His patience under stress always impresses me…he has been this way ever since I have known him.  He just calmly asked the surgical crew to wait for him and he would be there in a few minutes and then proceeded to do the ultrasound and interview the patient and listen to her husband and her brother as he translated the discussion from Wolaittina into Amharina and then into English.  As he left the examining room, the hallway was lined with patients waiting to consult with him.  He walked to surgery, where the patient was already anesthetized with a spinal anesthetic and within five minutes began operating.  Amazingly, I watched from the sidelines and didn’t get queezy at all.  The same cannot be said for my daughter Sara, who became quite light headed and elected to leave the surgery after about 10 minutes.

Events have a way of bringing out energy that we never knew we were capable of.  When we learned that the COSECSA organization was coming to Soddo Christian Hospital to do an inspection with the anticipation of credentialing our hospital for our resident’s surgical certification, we pulled out all stops.   In pulling out the stops I must give most of the credit to our cleaners, repairmen and gardeners. They worked exceptionally hard.   COSECSA is the acronym for College of Surgeons of East, Central and Southern Africa.  By credentialing our residents, it would allow them to practice medicine in any African country where COSECSA was the credentialing body. This was huge.

There is nothing like a goal to get one motivated.  One month before the physicians were due to arrive; the hospital began to spruce up.  Bafa, our painter, painted all the trim of the hospital a rich dark brown.  Philemon, our head repairman, took out the old IV tubing that was used for fencing and replaced it with new silver chains.  As Mark did a C-section one night, he could hear the repairman hanging a new door in surgery.  Later he returned to OB and the painters were painting the hallway at 10:00 at night! We have a new outpatient registration building that was recently completed, but it still needed a little tweaking.  It got tweaked.  The lights on the front gate of the hospital had never been put in place…they magically appeared just before COSECSA arrived.  My part was the grounds.  We have been tirelessly working on condensing the hospital gardens into manageable sections, instead of the large overgrown areas that we once had.  We have bought and planted thousands of red and green tiny landscaping plants and painstakingly laid them out in various designs along the long hospital walkways.

Mogus planting rows of red and green plants

But the one thing we have not been able to tackle is the grass.  We have acres of grass at the hospital that just doesn’t get cut.  Without a lawnmower, our grass is cut blade by blade with a sickle.  I can design and plant gardens, but if the grass is long and shaggy, the hospital will always look unkempt.  Three days before COSECSA was due to arrive, we brought in all the missionary home gardeners, all of our extra repairmen and the three hospital gardeners to cut the grass.  In the pouring rain we weeded the gardens on the main drive into the hospital, planted more flowers and cut all of the grass on the main thoroughfare into the hospital.

The after effects of working in the mud and rain.

Dego, our head gardener with the new lawn mower

A power mower would have cut this grass in two hours.  It took our hand laborers three days, but it looked lovely.The representatives from COSECSA were impressed with our hospital and gave us a favorable review.  We hope that we will receive a five year certification.  So much credit goes to our awesome hospital staff.  On Thursday of last week we threw them a popcorn and pop party to say thank you.

Some of the gardeners enjoying their drinks

Becka Gray and I popped mounds and mounds of popcorn and set up a table on the hospital grounds where we served all of the workers. It was a fun time saying thank you and… showing off our new push lawnmower!

Sara, my daughter and Rosie (short term administration helper) at the popcorn table.