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2/09/07 (Friday)

Up by 6:00 because of the traffic noise outside.  Some truck went by backfiring all the time making it sound like someone was shooting guns right outside my window.  Maybe that was what was going on, who knows?  At any rate I was able to get up and get a quick shower.  The temperature last evening as we were turning in was 84 with 85% humidity.  That was about 10 PM.  This morning the temperature is 71 and humidity at 84%.  Our clinic room is not air conditioned and poorly ventilated.  It usually gets very warm and stuffy in there, especially as we are in there all day.  I brought the thermometer and humidistat here for Jane so she can monitor the temperature and humidity in her operating room.  The humidity must be low in there because condensation gathers on everything and then can drip into the wound.  Also the wet walls are breeding grounds for bacteria.   

Lord, this is a new day and the sun is shining bright and full.  It looks like it will be a hot day today.  I pray for the patients we will see today and for the right amount of wisdom to make the right decisions on their management.  Give Jane and me the endurance to make it through the day.  If it is hot outside, it will be much more uncomfortable inside, especially in that closed up exam room.  Keep us from being distracted from Your love and Your grace as we work through the day.  Thank You, Lord, for this privilege to reach out in Your name to serve others.  I ask You to bless this day for it is You who receives all the glory!  Amen 

It is about noon and we have worked through 10 patients.  There were 20 scheduled appointments and Jane had told her team that we did not want to see any more.  Shortly after the first patient, Jane asked how many were scheduled and Angelita said 35!  She said people came from a distance and she didn’t want to turn any away.  Jane was not happy that our schedule was so full.  I wondered about the number we had for us to see because the waiting area was quite full this morning when I went to the clinic building.  Jane gave instructions to reschedule 10 so we are not still seeing patients by bedtime tonight.  The room has reached 87 degrees with 91% humidity.  It is fairly uncomfortable, needless to say.  About 1 PM the humidistat registered HH and then Err.  Temperature was 87.  I have a feeling the humidity exceeded the upper limit on the humidistat.  It is really warm and sticky in that room. After lunch we came back to the room and the temperature climbed to 88 and the humidity was at 88.  Then over the next hour the humidity climbed up steadily.  It reached 95% and then shortly after that the reading switched to HH, which I suspect means “High Humidity.”  Then a little while later it switched to Err.  I suspect HH stood for 96% or higher and Err was even higher than that.  When Jane looked at it she commented that it should start raining in our room very soon.  All afternoon the temperature stayed at 88 and the humidity stayed in the Err zone which was probably 97% or higher.  Needless to say that room was very uncomfortable.  Yet, the people just kept coming in.  We finally finished about 6 PM having seen 27 patients.  Our surgery schedule is lighter so far with only 15 patients scheduled.  We have a full day tomorrow seeing another 20 plus patients in the hot, sticky, sweaty room. 

I did call Phyl today with the satellite phone and got a great connection standing on the porch of the house where we sleep and eat.  The signal must come in at an angle because the phone picked it up right away.  I purposely walked under the roof of the porch and the signal was still strong.  I was able to spend 3 minutes talking with Phyl.    We had an opportunity to use the colposcope today on one lady.  Jane was thrilled to be able to see the area of question so clearly and precisely.  I hope to teach her more about using this instrument for it will be a great asset for her as she works with ladies with abnormal pap smears.   We saw one lady today that will be a difficult patient for Jane to follow.  She is desperate to conceive and has what appears to be polycystic ovary syndrome.  This problem is a complex interaction of hormones at the ovarian level and requires some careful monitoring and management if any success is to be achieved.  I tried to explain it to Jane and get her to a level of understanding on how to carry this over the next several months.  The patient may not even be able to afford the medication.  At any rate, it is very difficult trying to explain a complex endocrine problem to a person of another language who has no understanding of how the ovaries work and why she is having the symptoms she is experiencing and why she isn’t getting pregnant.  These patients are hard to manage when they speak English and have some level of understanding.  This will be a difficult patient for Jane to follow.  She did tell me to keep my email on so she can connect with me over the next several months to ask questions and seek more guidance. We saw another lady today who appears to have ovarian cancer.  It could be an early stage tumor but will be a tough case for us.  I am so glad Greg Sutton is coming on Sunday.  He will be able to do this surgery much more easily than we could.   After finishing up we are back at the house and now are getting our dinner around.  Damarys went out and obtained pork chops to cook.  I keep wanting to go outside and light the grill but I have to remember the grill is home and I am here in Ecuador.  There is no such thing as a grill here.  At any rate, they should be good and we will also have corn on the cob as well.    Father, thank You for a good day.  We were able to help several women and have others scheduled for surgery that should manage their problems and make their lives much better.  Life is so hard here and then to have a chronic illness on top of that hardship makes living even more stressful and painful.  Thank You for allowing me to walk with You to San Lorenzo to spend a couple weeks here sharing Your love with these people.  I give You all the praise!!!  Amen.

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