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Day 6 – March 11, 2019

Another restful night.  I sleep with a fan blowing on me all the time to keep the mosquitos away and also keep me cooler.  After getting ready for the day, I went to the clinic where all of us gathered to have devotions and breakfast.  While we were just into the devotions the anesthesiologist and his wife and baby came and joined us.  They drove from Esmeraldes and will stay for the week.  

Our devotions focused on Psalm 86:1-13.  Upon reading this today I felt it was very appropriate for our situation here.  For one, Jane is not feeling well and has a cough.  And also the patients come because they are poor and needy and we have the opportunity to be the hands of Jesus and touch these people to bring them His healing power.  Take a moment and read this Psalm out loud and slowly.  

After breakfast we began our surgeries.  The anesthesia will be primarily spinal as this gives good coverage for pelvic surgery but also the patient can breath and even talk while undergoing surgery.  

Our first patient had a large fibroid of her uterus that because of its position caused pressure on the bladder making it very difficult for her to urinate without manually pushing on her abdomen to push the uterine mass out of the way so the bladder could function.  We did a hysterectomy and removed this large mass.  I am sure she will be thrilled to have normal bladder function again.  Had Jane not been her and this clinic not here, this woman would just have to live with this problem.  

Our second patient was a 21 year old with right pelvic pain.  The pain was somewhat disabling, especially at the time of her menstrual period.  An ultrasound showed what appeared to be a couple fibroids.  She had one child and wants to conceive again so we recommended removing the fibroids only.  When we were able to evaluate the situation after opening the abdomen, she only had one golf ball sized fibroid off the to right of the uterus.  This was what hurt when we examined her in the clinic.  This fibroid came out easily and it had some endometriosis combined with it.  That would explain her menstrually related pain.  We did not have to interfere with her uterus or tubes and ovaries so she should retain her fertility without any problem.  

After the second surgery we took a lunch break.  Lunch was good and refreshing.  Carmen included a bunch of Granadilla, a fruit that looks a little like a pear but has a thick rind.  You peel off some of the rind and inside are clusters of seeds and fluid.  The seeds and fluid are eaten and they are very sweet with a unique flavor.  These trips are not only for surgery but also for a new adventure for my taste buds. 



The third surgery was another hysterectomy for large fibroids.  That surgery went well.  Jane and I work so well together.  We know each other’s moves and we hardly have to talk about what the next step will be.  And we lose very little blood as we are meticulous on controlling bleeding as we go.  There is no blood bank so we take a lot of precautions to avoid any sudden bleeding.  

There is a family practitioner here seeing patients and he called us to see if we would see a patient who might need surgery.  So after we are finished with our day in the OR we will see this patient to determine if surgery is indicated.

After our long day in the OR Jane and I went to see the patient who Dr. Nelson saw.  She is 69 and has had 30 pregnancies!  Of those 30 she had several miscarriages and also lost 4 or 5 of her children not long after birth.  She has over 10 children that are alive.  She worked for 30 years as a concha, a clam digger.  This is hard work walking in shallow water near the mangrove islands digging with her fingers for clams.  The pay is not much at all.  I remember several years ago we did surgery on a woman who was a concha and she only made one dollar per day and worked from sun up to sun down every day.  We examined this patient and she does need some surgery so we are going to put her on Friday’s schedule.  

After a light dinner tonight I was able to get a good wifi signal upstairs by Jane’s apartment door.  I was able to FaceTime Phyllis and we enjoyed the opportunity to talk and see each other.  The technology certainly adds a new level to communication when we are separated by a long distance.  Even at night the temperature is still quite warm and the humidity high.  Just sitting is associated with lots of sweating.  I am ready to head to bed where I have a fan running all the time keeping me in a cooler breeze.

Father, today we were able to be Your hands as we gave surgical care to three people whom You love.  We felt Your hands around our hands as we did their surgeries and we felt Your guidance so we could do the surgeries with minimal difficulties and complications.  Thank You, Lord, for a good day in surgery.  Thank You, especially, for having confidence in us to be extensions of You to reach out and touch these people.  Tomorrow, Lord, we have three more major surgeries and again it will be a long day standing.  But, You will be there with us the whole time.  Thank You, Lord.  We worship You tonight.  Amen.

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