sounds of silence

just now, i am sitting in the midship's lounge during morning tea time. i can hear multiple conversations going on as well as the steaming of milk for a latte and in the background the ever-present sound of the generator. last weekend, however, a few friends and i were able to get away and experience some "silence".

we (sarah, miriam, amy, sam, ben and i) rode up kpalime (about a 3 hour trip from the ship) and checked into our hotel. the one i called with a french translator to book 2 rooms in...one 2 person room for the boys, one 4 person room for the girls. the manager had no idea we were coming (typical africa). the rooms were not big enough for 4 people so we split 3/3 instead with the boys graciously offering to take mattresses on the floor so the girls wouldn't have to. no sound of a generator here. just stillness. we got back into the van and met up with a group from the ship staying across the street and drove up to a waterfall. a rainstorm blew in while we were driving up and the wind was rushing through the trees. not really silence i guess but not 400 people trying to hold conversations at the same time. we hiked down the mountain to the waterfall in the rain and went swimming (cold!). when we arrived back to the hotel later it was to find that the power was out, more silence, and they were using tea lights in the corridor. thankfully, the water was running when we returned and we could shower (not so much the next morning). about halfway through our candle-lit time sitting at the dinner table, the power came back on. we played games until late and then crawled into our beds with only the sound of the fan to accompany our sleep. somewhere during the night, we lost this sound as the power went out again. the silence was then only disturbed in the morning by the hotel staff sweeping the walkways...and b/c of the previous silence, this was very loud indeed. after doing a sterile dressing change on sam's finger while sitting on the porch of the hotel, we wandered around the village's red, dusty roads exploring. we ate some fan ice (frozen milk/juice in plastic packets) sitting outside the fan ice building, spending an hour or so haggling over football (soccer) shirts in the market, passing a very ornate church building, and listening as a man tried to convince ben and i he would either "take us to a place where the fish would come to us" or "take us to a place and offer us as a sacrifice to the fish gods" and then finally piling back into the van to return home. even the van trip was one of those sounds of silence moments...good friends who've spent a good time together and can now just sit in each others' company with only a few words spoken here and there.

above photos...me under the waterfall, group shot in front of the waterfall, us in front of the fan ice building (minus ben) and our hotel courtyard

triumphal entry

my last post was asking you to pray for marius (and mom chantal)
marius had a rocky week. he went back to surgery the same night as his lip repair and received a trach b/c he was still having trouble with his lungs being clamped down made worse by getting blood clots in his breathing tube. by day one post-op, we had him off the breathing machine but then we had to wait on his little stressed body to recover in order to get the trach out. first attempt...failed miserably. second attempt a couple days later...ok but not great and we ended up putting it back in 12 hours later. third attempt...he did it!

today, we removed his central line and the tracheal flap suture and moved him from the ICU to the ward. mom chantal carried him down the hallway from ICU to A-ward and the moment we stepped out of ICU, a praise song spilled from her lips. she walked the entire way singing praise and then into A-ward where she knelt by his bed and lifted him up praising God in song and then prayer. (a translator told me she was praising God...this was one thing i didn't need interpretation of!) it was a beautiful moment and tears of joy were falling. =)

well done my little rockstar and more importantly, thank You Father for Your touch on him.

another day in paradise...well, maybe not so much

Today started out as a fairly easy shift. One pre-op, one six days out from surgery and one here a day too early for surgery so not even pre-op yet patient. Not a heavy load at all. Down in A-ward, my little rockstar, Marius, was going to surgery to have his bilateral cleft lip repaired. Marius, my rockstar because in his first week of the infant feeding program he never gained less than 100 grams of weight a day. Chantal, his mom, who taught a bunch of nurses how to dance one morning after church. Mid-morning, we got a call into D-ward/ICU that D-11 wasn’t going to be going to surgery today b/c their first case wasn’t doing well…wait a minute, their first case was Marius…what?!?!?

Marius didn’t do well in surgery. He came back to us on the vent and we spent the next 3 hours working on him to get him some sort of stabilized. My shift ended an hour into that 3 hours but there was no leaving Marius. When he finally was a bit better, I went to find Chantal and pray with her and talk with her about what was going on. One of the other nurses said “Natalie, I’m sorry you always seem to get the bad ones.” But really, THIS is (or at least used to be) my normal. I work in a PICU at home and having a child with respiratory distress is more normal than having one without it. It doesn’t mean it is easier for me or that it hurts my heart any less to see a child hurting, but this is my normal. And if my being there means someone else doesn’t have to watch a child hurt, then that is what I accept from my Father’s hand, relying on His strength. (ok, now that just sounds sanctimonious but no idea how to really say what I want)

Anyways, all this to say, please pray for Marius and his mom Chantal…pray for healing of his little body, the lungs fighting so hard for air, pray for peace to cover and fill mom, pray for wisdom and strength for those of us who care for them.

trusting in miracles

Before I ever got to work on Tuesday night, I knew I was in for a busy night. I had been called down earlier to help get Obre settled on CPAP (a way that we can provide a bit of pressure and oxygen to the lungs). Obre has a bilateral cleft lip and palate and earlier had aspirated (inhaled) some formula into his lungs and now had an aspiration pneumonia. So, I came to work knowing I would have him and that his very underweight body (he's 4 months old and weighs 3 kg or 6 1/2 lbs) would not help his healing from the pneumonia. I was prepared for busyness. I had no idea, though, what the night really had in store for me, for him.

I got report from the evening shift nurse and started off with my regular work. Safety equipment at bedside, check. Code sheet at bedside, no. Complete code sheet, check. Now on to Obre...full assessment, check. Even with the CPAP, Obre's body was still working fairly hard. The muscles around his ribcage were pulling in harder in order to try and help his breathing, his oxygen level was in the 90's but on 60% oxygen and he was requiring help in the form of CPAP. At 11pm, Obre's oxygen levels started falling and I was having to move his jaw forward every couple of minutes to keep his oxygen up. Then I tried going up on his oxygen thru the CPAP. Everything worked for a few seconds and then he would start drifting down on his sats again. So, let's adjust his mask. At this point, Jenny, the other ICU nurse starts helping and ends up stuck for the next while with me. After 20 minutes of adjustments here and there and Obre just not settling, we call down the anesthetist Fotius. More adjustments, more work, no improvement after 20 more minutes. At home, at this point, we would have intubated (put in a breathing tube and placed on a ventilator), no questions. But, with our limited resources and his very malnourished body, this was not a decision without risk to him. So, we called Dr. Gary, the surgeon to see what he thought. And thus ensued another 40 minutes of working with Obre's body working harder and harder. His retractions were now severe, his oxygen level averaging between 60-80, his heart rate in the 200's, his breathing rate in the 80s.

At 1220am, we decided to intubate. As Jenny and I drew up medications and gathered supplies, it got quiet over by the bed...we looked over to see Dr. Gary and Fotius were praying. Jenny and I came up as the prayer was finishing and Fotius moved the CPAP mask off to just beside Obre's face. And, his oxygen level went up and his heart rate came down and his breathing rate came down and his retractions came back to mild. And we just watched for a minute and Obre didn't need intubation...in fact, we didn't even put him back on CPAP, we put him on just a simple face mask (oxygen without pressure). This is 5 minutes after the decision to intubate! We are doing less than we were before! I couldn't, at that point, call it what it was but as the night progressed and I just watched my baby in awe move closer towards normal vitals signs and his work of breathing settle even more, my mind whispered (a bit in disbelief) while my heart shouted in praise....MIRACLE! Jenny and I kept saying we can't believe it. At one point, Obre's vital signs actually dropped into the normal range and I started hovering even more (all PALS trained nurses know a pediatric body at stress can go for a while but vital signs dropping may actually by an ominous sign). But no, Obre was just getting more and more settled.

The night ended with me giving report and Jenny and I continuing to say we couldn't believe it but now quite willing to call it what it was...a miracle.

I went home and was walking thru the night again in my head. When I thought about getting concerned when his vital signs dropped to normal, it was if the Holy Spirit nudged me and said, "you didn't trust Me to finish the miracle." And it is true, I didn't trust despite what I had seen. Dr. Gary and I talked about a bit the next night and he said if that was the case, "he didn't fully trust it either because he wasn't sure we hadn't done it later without calling him down again." He also talked about feeling the peace settle as they prayed.

This night, what I saw, it was nothing less than miraculous, amazing. I am thankful the Father healed Obre. I am even more thankful that He let me see it. It was beautiful.