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6-23-2014 (Monday)

6:00 am.  I awoke from a good night’s sleep inside the mosquito net and a fan running for ventilation and white noise.  It was still hot and I was sweaty most of the night.  Our day today involves 4 big surgeries.  That will keep us on our feet most of the day meaning that my ankles will likely be hanging over my shoes by the end of the day.

Lord, thank You for a good rest last night.  I feel refreshed and energized.  I pray, Father, for the patients who are recovering from surgery.  I pray for their healing and keeping free from infection and other complications.  Thank You for protecting them.  Lord, I pray for their spiritual health as well.  Yesterday, two of the patients placed their faith in You for the first time in their lives.  We were able to observe spiritual rebirth, Father, and I am so thankful to be able to see You do this.  Lord, I ask for Your blessing on us today.  I pray for stamina and clarity of mind so we can make the right decisions.  Thank You for inviting me to walk with You here.  Thank You, Lord.  Amen.

7:00 am.  We met for devotions and breakfast.  Carmen made empanadas and they were hot and delicious.  Our devotions centered around John 8 where Jesus was questiong the religious authorities for not believing in Him even though they felt they were following God better than anyone else.  His main conflicts were with those who put religion above having a relationship with God.  The made their religion, their rules and regulations, their idol instead of worshipping the only true God.  We see the same thing today.  A couple days ago we were discussing the churches in the area and Jane was talking about a couple churches that have so many rules and if you don’t adhere to these man-made rules, the accusation comes that you cannot be a Christian.  She said one couple came to her church because they went to another church and the lady was wearing slacks.  That church refused to allow her to come in because she couldn’t be a Christian and wear slacks.  Instead of opening their doors in Christian love, the shut them out because they didn’t live up to the rules.

Devotions before breakfast.

Devotions before breakfast.

Empenadas ready to be fried.  These are really good hot.

Empenadas ready to be fried. These are really good hot.

Carmen fixing our breakfast this morning

Carmen fixing our breakfast this morning

Our first surgery was a laparoscopic cholecystectomy.  The patient, D.M., had been having pain and had gall stones on x-ray.  Jordan came in the operating room with me and watched the procedure.  He was able to stand back and watch all the work on the TV monitor.  The surgery went well with no problems.  Thank You, Father, for covering D.M. with Your healing power.  Thank You for protecting her and enabling us to accomplish this surgery for her.  Thank You for Your unfailing love.

Jordan and Angelita

Jordan and Angelita

Our second surgery was for large uterine fibroids.  The patient, E.C., had large fibroids and heavy bleeding associated with these resulting in a chronic anemia.  She had a hemoglobin of 9 in spite of iron therapy.  This surgery was a challenge in that the uterus was quite large and irregular in shape.  The vessels to the uterus were large requiring extra care to control them so we didn’t have extra bleeding.  We were able to do this procedure with minimal blood loss.  Father, once again You provide so much for the patient and us.  You ask us to step forward and participate while You fill in all that is needed to take this patient through a risky surgery safely and efficiently.  Thank You, Father, for how You cover us with Your grace and continually allow us to participate in Your work.  Thank You, Lord.  Amen.

Our third patient, M.R., is 28 and has a large mass in her lower abdomen.  She was told she has a large myoma and she wants to conceive and wanted the myoma removed to help her conceive.  Sometime these large fibroid tumors will get in the way and create problems conceiving or even carrying a pregnancy.  Initially she thought she was pregnant as she has not had a menstrual period for 7 months.  However, when the mass in her abdomen remained the same size she then sought an ultrasound.  This was performed in March and she was told she was not pregnant and the mass was a large myoma.  The recommendation was to have it removed.  She came to see Jane for that surgery.  Our exam pre-op showed a very mobile mass in the lower abdomen that felt like it even moved independent of the uterus.  I was wondering if the mass was attached to the uterus by a stalk as sometime fibroids will do.  Under spinal anesthesia we made an incision and entered the abdomen to expose this myoma.  I found a uterus that was large, smooth and very soft.  I asked Jane if this lady could be pregnant.  She said her history said no and she was told by the one who did the ultrasound that she was not pregnant but had a large myoma.  We then stopped and collected some urine and did a urine pregnancy test.  The test was inconclusive but appeared positive.  We did a second one with the same results.  Jane looked at the tests and they had expired in 2012.  So we drew some blood and sent it to the lab for a serum pregnancy test.  This returned positive.  A third urine pregnancy test then was positive.  We then talked with the patient and told her she was pregnant, which she said she was told she was not.  At this point we closed the incision and did not do anything to the uterus.  After the skin was closed Dahlia used a small doppler ultrasound that is to find pulses in arteries and tried to listen for fetal heart tones.  She picked up fetal heart tones easily, confirming the presence of a pregnancy.  Our plan now is to repeat an ultrasound tomorrow to determine the age of the pregnancy.  I am so glad we did not move forward and invade the uterus thinking we were removing a myoma.  We feel bad that we took this lady through a surgery that was not needed.  But we feel good that we didn’t proceed and destroy a developing pregnancy.  Thank You, Lord, for filling me with suspicion when we found the uterus to be large and soft.  You brought to our attention the fact that a small baby was forming inside this uterus, being knit in the mother’s womb by You.  You kept us from destroying this developing baby.  Lord, thank You for guiding us and protecting the patient and the unborn child.  Amen.

We stopped for lunch.  Carmen had made ceviche, a cold soup of baked fish, onions, tomatoes, green peppers, lemon juice, cilantro.  It is delicious and a favorite of mine.  Damarys said she made this special for me because they love me!  Wow!  I guess it is true, the way to a man’s heart is through his stomach.  That’s how I met Phyllis…she made me homemade cinnamon rolls.

Our fourth surgery involved M.B, age 37, who is in for an abdominal hysterectomy.  Her problem was heavy bleeding that did not respond well to hormone management.  The bleeding resulted in a significant anemia.  Recent iron therapy has improved her blood count to 11, safe enough to go ahead with surgery.  Jane and I, along with the Lord’s help, performed a total abdominal hysterectomy.  The uterus was involved with several myomas which most likely were the cause of her bleeding.  The surgery went very well with no problems.  Jordan came in and watched this procedure.  His comment at the end of the surgery, “It seems like a lot of work just to take out one organ.”

Father, it is such a joy and privilege to call You Father.  You make Yourself so close and personal to each one of us.  What a privilege to know You and walk with You!  Thank You for guiding us through this surgery.  I pray for M.B. for a safe recovery and quick healing.  Thank You for covering her with Your healing power.  Lord, You are so gracious to us and help us in so many ways.  I again looked at the picture by Nathan Greene and was reminded and reassured of Your presence at our sides and even wrapped around us as we worked serving You.  Thank You, Lord.  Amen.

At dinner we enjoyed trying to teach English to our Ecuadorian friends and they were trying to teach us Spanish.  Of course, we had available a dictionary to help us with words.  Our day is over and soon we will be going to bed.  Howard and Jordan have finished the tile work and grout and will likely be starting on putting up some of the wall tile in the bodega first floor.  The floor looks great!  This has been a huge help for Jane and the clinic.

Father, this has been a good day serving You.  Thank You for making it possible for us to accomplish so much in Your name.  You continue to bless us beyond measure.  Thank You, Lord.  I pray for our patients.  I pray for the team that works here at the clinic, Angelita, Carmen, Maria Luisa, Gonzalo.  I pray for Jane and Damarys.  Lord, thank You for these wonderful people.  I pray for Dahlia our anesthesiologist.  Please bless her.  And Lord, I pray for Jordan and Howard as they are putting in a lot of work and sweat with the tile installation.  Thank You for allowing them to come here to serve You.  Lord, I pray for all of us for a good night’s rest.  Thank You, Lord.  Amen.





1. Nancy Prins - June 26, 2014

What a blessing for MR that you were hesitant. This child will be special indeed.

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