Day 4 – January 10, 2025
Since we saw almost all the patients we would put on the surgery schedule for next week, our Friday was a slower day in the clinic. This morning Jane saw some post-op patients who came in for a four-week check and a couple people who came in for consultation regarding some imaging studies follow-up. One of these patients, a young woman, had a previous ultrasound that showed a complex cyst on one ovary.
She was an example of the overuse of the diagnosis, polycystic ovaries, by the radiologists. It seems if anyone has a few follicle cysts in the ovary, a very common finding in any female younger than menopause age, the radiologist will tell them they have polycystic ovaries. According to Jane’s experience, some patients have come in with that diagnosis and a recommendation of a hysterectomy and removal of both ovaries. Jane and I talked about true polycystic ovarian disease and how it is not that common. It is more of a hormonal imbalance problem that results in excess androgen (male hormones) production. The patients will stop menses or will revert from regular cycles to very irregular patterns. Because of the excess androgens, some masculinization occurs with development of hair growth on face and more prone to acne as some of the common changes.
Certainly, a vast majority of the people coming to Jane with that label given to them are not dealing with true polycystic ovarian disease. Their problem, so to speak, is they have several follicle cysts in the ovaries. The follicles are small cystic structures that produce the egg cells needed for reproduction. The ovaries will contain several of these in various stages of maturation. It seems the ultrasound findings aren’t read with the context of the situation in mind and thus an extreme overuse of a diagnosis that only produces worry and fear among young women.
On the patient we saw today, she brought in a recent CT scan and Jane had received a recent ultrasound report and films to review. These studies showed the complex cysts had regressed dramatically and what she had remaining in the ovaries appeared normal. Jane explained to her that she did not need surgery and only reassured her and will follow up with her in a few months. The likelihood is the first studies were obtained prior to ovulation and the complex cysts happened to be seen after ovulation when the follicle that produced the egg that cycle now undergoes changes that will add complexity to the cyst as it now produces progesterone for the second half of the cycle. The context of her situation became very meaningful in deciding the management. In this patient’s situation, she was assured this was normal and nothing to worry about. She is 20 years old and does not need any surgical intervention.
We finished the morning schedule and then had a leisurely lunch with the staff. Jane has one patient who needs gyn surgery but needed to see a cardiologist first. She had an appointment with a new cardiologist in town for this morning and so far there have been no reports back. We were planning to see her this afternoon but by 2:30 she hadn’t appeared. If Jane hears from her today, she will urge her to come in so we can decide about her surgery. Otherwise, we are finished for the day.
Piedad is cooking for us and her creations are really delicious. This morning we had llapingachos, a ball of mashed potato that contains cheese inside and then cooked. They are usually fried, but she prepared them in an air fryer. They were really good. Lunch we had roast beef sandwiches and for dinner she fixed chicken wings, mashed potatoes and a salad that was more like slaw but bathed with fresh lime juice. It was absolutely delicious. Her 15 year old daughter ate with us.
As I think about how we encounter so many different people who are experiencing some form of suffering, from disease, from emotional upheaval, from loss of property and even loved ones, whatever may be the source of their malady, I wonder how many are experiencing the love of God in those situations. Is their suffering distracting them from even acknowledging the Lord and His healing power? Are they familiar with Him at all? Does the suffering cause them to search more for Him? Or to blame Him for the pain? I just wonder.
Then I come to a man in the Old Testament who is one who suffered intensely. Take a moment and turn to the book of Job and read the first two chapters. There we see Job, an innocent man who loved and worshipped God regularly. He was known for his devotion to Him. But then Satan challenges God over Job’s loyalty and claims he can cause Job to disavow Him. God allows Satan to afflict Job but not to take his life. We read how Job suffered extreme loss, his family, his wealth, his livelihood, and even his health. It is hard to imagine the pain he experienced, emotional pain to the extreme, physical pain also to the extreme. At the end of chapter 1 after Job received multiple reports of disaster occurring to his family, his livestock, his world, so to speak, we read:, “Then Job got up and tore his robe and shaved his head [in mourning for the children], and he fell to the ground and worshiped [God].” (1:20 Amplified Version).
Note his response: He fell to the ground and worshiped. Would worship be the first thought on your mind is you experienced a disaster in your life? I saw an article on the news today about a family and neighbors who lost their homes in the wild fires racing through parts of Los Angeles gathering together around the smoldering ruins and sang hymns and worshiped God. Imagine. What would worship at a moment like that do to you?
Look at chapter 2, verse 10. Job’s wife had just told him to curse God and die. Job responded, “But he said to her, ‘You speak as one of the [spiritually] foolish women speaks [ignorant and oblivious to God’s will]. Shall we indeed accept [only] good from God and not [also] accept adversity and disaster?’ In [spite of] all this Job did not sin with [words from] his lips.” (Amplified Version). Job maintained his attitude of worship. That controlled his response to whatever life brought to him.
I would think that turning to God in times like these would give me a peace that wouldn’t be there otherwise. It would fill me with a conviction that all is well in spite of the loss. It would turn me to what my relationship with my Lord and Savior really means to me. That personal, intimate, growing relationship with God is the most important possession we have. Do we realize how important that is to each of us? It is something we can never lose. It is the only thing we can take with us when we pass from this life to the next. Any disaster we may encounter cannot affect that relationship. Do we realize that and value it? Does that realization cause us to do as Job did and fall to the ground and worship God?
Tonight Jane took us on a pictorial tour of the clinic since its beginning in 1997 in a building downtown to what is here today. I started coming to work with her in 2004. The comparison of pictures from then to now was amazing and a trip down memory lane. It is a clear demonstration of how the Lord blesses the work that is done in His name to serve people and bring them into relationship with Him. I just want to spend time tonight just worshiping God. It is because of Him that this work, this ministry exists in San Lorenzo. The people whose lives have been changed by the work here are living testimonies of His great love and healing power.
As I recall my previous trips to Ecuador and the many people I have helped Jesus bring healing to them, I can only worship Him for allowing me the opportunity to be His representative here in Ecuador. If we have a relationship with Christ and walk with Him every day, we are given the privilege of shining His light of love and peace to our world around us. I see that here in Ecuador and wherever I am in the States. We all have the privilege of being Jesus to those we meet. When people look at us, at you, at me, do they see Jesus? I pray they do. I pray we can all react as Job did — worship God first as that gives us the right perspective to view everything else.
Medical Missions 