How scary is it? Oh I'm glad you asked!

Well, as much of the free world knows by now (possibly due to all my whining??) , this has been a week of organizing the Scary Room and Clinic.   On the first day alone, we made 13 dump runs.  On day 2 there were at least 3 more dump runs and 3 truckloads of metal sold to the Metal Guy.   I couldn't be happier.   I think I sigh with joy as I watch the pickups depart for the dump with supplies from 1998.    We have found some treasures (I think?).   I found some clear garbage bags (win!) and bovies for the OR.  

We are also working on clearing out some "dumping grounds" in the clinic, such as the laundry, extra supply rooms, closets, etc.   I discovered a disgustingly filthy supply room outside that we gutted, cleared out, cleaned, and then I noted a sign on one of the closet doors "This is Jim's- keep it clean!  If you take something, put it back".   I'm sure it was referring to Jim Smith,  our "Founding Father" here at SRI.   How cool to find his note...and how awesome to have his "room" cleaned up and functional again!   And how nice to have SPACE in the clinic for patients, consult rooms, nurses and doctors instead of zones for non-functional equipment!  It feels almost like we are starting over in a new clinic and it's been neat to see the clinic staff working with our amazing SRI translators, eating lunch together, having devotions together in the afternoon with our staff pastor Enol, and playing fun games as well.

We'll have plenty more photos to follow...but here, for your viewing pleasure, some shots of the first two days.  

Our awesome translators working with the clinic staff in an assembly line to "empty out" the Scary Room.  For those who aren't "in the know"- the Scary Room is a medical supply room which has gotten WAY OUT OF CONTROL.  

YAY!  As you can see, we are really GETTING there.  Stay tuned for further Scary Room and Clinic Renovation updates!  

What does 68 surgeries look like?

So several weeks ago I went down in flames with the flu.   Of course it was HIDEOUS but the worst part was not being able to participate in one of my favorite surgical weeks, ENT (lots of tonsils!).  I was there for Monday morning before the plague struck me down...and I robbed lots of photos from the fabulous folks of Hickory NC, Fort Wayne, IN and my dear friend Cathy to demonstrate a bit of what a busy ENT week (PLUS a team going out to serve and treat barrios) may look like.  Thanks guys!  You did a great job!  68 surgeries in the clinic and HUNDREDS of folks served in 4 different neighborhoods (barrios, campos) by the mobile barrio team.   It's such an inspiration to see, even if it's either from a bed in the clinic (yup- I too received an IV in the clinic), via the photos and stories from the team, and best yet- the testimony of the folks who were served.  Amazing stuff!

So first of all, the teams arrive on Sunday mornings and bring in about one billion suitcases full of TREASURES and supplies!

They spend Sunday afternoon in orientation and then unpacking and setting up the ORS, Recovery rooms, Pre-op, etc...

 

The clinic is usually FULL of folks waiting either for consults or surgery.    There are consults before surgery to determine who is a candidate for surgery.    The OR crews are busy at work prepping the beds, getting supplies ready, checking the equipment, unpacking, etc.

The hallways are LINED with folks waiting!

Meanwhile, the barrio teams are unpacking their meds in the pharmacy and then REPACKING for the week in a big pharmacy box to dispurse medications.

Whichever day we hold consults (either a Friday before or a Monday morning)....there are HUNDREDS of folks waiting outside.  This is a pic of Nef and I giving instructions to the crowd in an attempt to be organized.

Our American nurses working with the Dominican nurses.....awesome teamwork!

And when surgery begins....ahhhh the sweet love and care that the nurses give to the patients.   I learn a LOT...and it's just so inspirational to see.  

Everybody gets a chance to listen and learn!  :)

We have a lot of fun with the amazing surgeons who come to serve here!  Here we are teasing Dr. Frank after a busy week of 68 surgeries!  

The amazing OR team....what a great job!   These guys do a TON of organizing and packing before they come.   We are so grateful.....as are the patients who have a much better quality of life after surgery.  THANKS HICKORY- FORT WAYNE- CATHY CASE...and everyone who came down and cared for the Dominicans...oh yeah- and cared for me too!  :)  

Birthdays and babies.....

So not only did I just have a birthday but today TODAY Baby Nicole is turning THREE!  How did that happen!

Life in the DR flies by...I can't believe that 3 years ago TODAY was one of the most stretching, exciting, emotional, crazy days of my time here (see Blog post BASTIDA for more details...).  

I spent my birthday hiking in Hondo Valle, ascending mountains to get to a posted Dominican flag, eating lunch and breakfast in a Dominican "ecoturistico park", and laughing for hours in the truck while we bounced over horrid bumpy roads to arrive there.   We finished up with tacos in the Guesthouse for dinner and it was a fabulous fabulous exhausting exhilarating day.   Photos below- God is so good!  Grateful for another year of life, not just for me...but for the precious 3 year old who is named for me and brings me great joy (and lots of laughter!).  

Birthday crown....(Kari has mad crown-making skills!)

Seriously feeling loved with these notes on the wall.  

These guys know how to make a birthday girl feel special!

Laura made me a chocolate cake with peanut butter icing!  WOW- killer good!

The "ecoturistico" park where we hiked and ate breakfast and lunch.  Gorgeousness....

We have almost made it to the top of the mountain!

Dan and Kamanda on the way up!

Monchy carrying Braegan to the Bandera (the flag!) .....she was such a trooper and snoozed much of the way up!

The view from the peak...looking down over Hondo Valle.  

We made it to the top!  Beautifulness!

And now.....look at this beautiful face!  THREE YEARS OLD TODAY.  Can't wait to celebrate with cake and the whole nine yards........  Let the chaos begin.....

Unplugged

I have to laugh at many of the seemingly normal things that happen here that just wouldn’t fly in the States.

From the motorcycles stuffed with 7 people to the “no-call, no-shows” of hordes of folks that one was EXPECTING, I’m still trying to get used to the “norm” of San Juan.    Of COURSE it’s normal to have one’s keys up on the roof, with one stuck on the balcony trying with a mop handle to wrestle them down.  THAT happens when friends offer to put away your pasola and then toss your keys up to the balcony.  Oops.  And of course it’s NORMAL to wear parkas in 70 degree weather here because it’s COLD in the wintertime.   It’s NORMAL to eat boiled bananas and pumpkins with onions for dinner.  In fact, I love it.  Toss some eggs on top and I’m happy as a clam.

It’s NORMAL to show up for an appointment or a class (after traveling up to 2 hours) and have the doctor or professor  just “not be there”, even if it was scheduled.  Dominicans don’t flip out or become furious (although I would).  They just sigh and plan their next trip.    It’s NORMAL to bathe at least 2 times a day- only dirty folks shower once a day (oops!).   It’s normal to NEVER mix milk and juice, drinking them at the same time in two different glasses.   That would be gross, except that we put milk IN our juice when we are mixing it up in the blender and that is not only NORMAL, it’s how you SHOULD make juice (with vanilla, ice, plenty of sugar, and milk).  Huh?  Yup.  I can’t explain it but it’s normal here.

It’s normal to have your phone suddenly be dead in the middle of a conversation.  Clearly you or they have run out of minutes.   It’s also normal to hang up in the middle of conversation- signifying that you are CLEARLY running out of minutes and cannot continue to chat.    Its normal to have your phone ring once and then stop.  THAT means a Dominican is calling you who doesn’t have phone minutes and you need to call them back immediately.

It’s normal to state AMEN when someone says “Dios te Bendiga” (or God bless you).  In fact, it’s the only proper response and completely expected.    It’s normal to have toothpaste on any cut or pimple on your body.  Toothpaste cures everything.   It’s normal to drink tea remedys that taste HORRIFIC for any malady that you may have, from headaches to stomachaches to cough/colds.  I think they make it out of tree bark possibly and I have to hold my nose to get it down.

Ahhhhh the joys of learning culture and LAUGHING about new normals.   I’m thankful for Jesus, the same YESTERDAY, TODAY and TOMORROW.  :)

-

30 Hours of One of the Craziest Days

***Patient Names are not used in order to provide some sort of privacy

Tuesday night 8 pm.  Drank the bowel prep stuff for scheduled colonoscopy in the am.   Watered plants on balcony.  Wednesday early morning hours- up approximately every hour for bathroom fun.  Possibly will not sleep at all tonight.  5:50 am alarm goes off.  Up, shower, wash my hair for the FIRST TIME IN 5 days (total record!), grab laundry basket, change bathroom trash can.  6:07am.  On pasola somehow holding laundry basket driving to clinic in dark.

6:10 am.  Arrival to clinic,  drop off laundry and head out to see patients.   Hmmmm colostomy guy is still on oxygen but the gallbladder and thryoid ladies are stable and should be able to go home.  Give instructions to sweet lil Dominican nurses to move colostomy guy to private room and head to preop to make up the beds and review charts for day.  6:30 Back to clinic, can’t eat breakfast- laundry started.  Listen to end of devotions, make my announcements for the group (“it’s UNPACK Thursday!”.) and talk to doc about pending colonoscopy- I’d like to be first.  Game on.  7:05ish  Take my bactrim for the weird infection thing on my leg that is clearing up nicely.  7:10 Out to clinic.   Cora puts IV in my arm, ahhhhhh IV fluid feels so good.  I was so dehydrated.  250cc bolus.  7:30 Back to Guesthouse, flip laundry to dryer, open up Room 14 to grab some paperwork for the day and pocket some pain meds just in case I need it for my colonoscopy.

7:35 Out to clinic, push the nurses to get the colostomy patient moved before the incoming patient arrive.  Begin calling the first 3 patients of the day.  Cute 9 year old circumcision is first.  He’s scared.  But we hang- he’ll be alright.  No IV for him.  Ahhhhh dear 71 year old hernia comes next.  Hugs/kisses/saludos.  Just excited to be here.  He can’t wait for surgery.   Walking through the hallway, I am stopped at least 10 times for greetings and questions.    Noted Gunshot-wound-to-the-foot guy who was here last night in the hallway.   Review plan of care with him and and orthopedic surgeon.   He will have his labs drawn, I will call cardiology and try to get him cleared for surgery.   In a bit, I get a message from Dr. Canario- he’s on it.  His wife will come in to clear the patient- we are good.   Back to Pre-op now Nef-The-Mighty Translator is here.  Great- he can run pre-op and call the patients.   Quick review of charts to be sure everything is there.  We are good in the hood.   Small concern that 14 year old hernia has not shown up yet.   Nef phones him- they don’t have the money for surgery.  “No worries- come on in- we’ll work something out”.   He’s on his way.

7:50 Bathroom enema fun.  Yay.

7:55 In gastro room for my scope.   Love these peeps- they are awesome.   So blessed to have the greatest docs in the world come down here.

8:25  Goal achieved- this wasn’t bad.   I’m off to Guesthouse to scarf down some food.  I haven’t eaten any solid food since Monday night and it’s Thursday morning. Two pieces of salami and a small pancake.  Huge cup of coffee with milk.  Checking in with Kari- laughing about my scope.  Coffee=Heaven.  8:35 Back to clinic.   Check on Gunshot Wound- he’s got his labs drawn and waiting for cardiology.  Good stuff.  Hey, 14 year old hernia made it but oops- he ate some yucca this morning.  No worries- we’re good!  Quick conference with Dr. Valdez about family situation- Valdez handles everything.  Yippeee- he’s off for his labs and will find me when they are drawn.  Good stuff.  Check in on colostomy guy.  He’s good, in his room with his family there.   AndryOmar, super nurse, has an oxygen tank in the room cuz he’s good like that and this guy can’t quite keep his oxygen levels up well.     General surgeon at bedside, changes dressing, has pulled NG tube.  We’re moving on up!  Good times.    Two post op ladies are up, bathed, ready to go.  Discharged.

Patients come out of the OR.  I bounce between OR and Pre-op and Post-op and Canario and Valdez and the consultation rooms.    Look for some supplies for the OR, pray with the Gunshot wound guy in pre-op.  Talk to his sister about how hard this is.  Oh, here comes the 14 year old with a big fat grin.  He got his labs drawn and he’s psyched for surgery today.   I park him in a bed and hand him an IPOD so he can listen to some sweet music while he waits for a few hours for his surgery.   Ah, there’s a 19 year old with a necrotic finger who needs to have surgery to debride it/possibly amputate.   He’s devastated at the thought of losing some of his finger.  Consult room.  Prayer.   Call in his Dad to discuss plan of care as well.    They are sober, thinking, hurting.   We pray.   They agree to the surgery.   I send him off to the lab and run to Valdez’s room to work out a plan of care.    I bring lunch to Canario and we grin over the huge pumpkin that someone brought us to eat that Margo cooked up for the group.   It’s at least 20 pounds.  Check in on Colostomy guy.  He really doesn’t keep his sats up well, needs to walk, needs to get out of bed.   General surgeon at bedside.   Lungs don’t sound the greatest.    We talk to the family.   They agree to help him walk around his room.

Necrotic finger guy has his labs drawn and I park him in a bed.     Oh- here comes hernia guy that I called last week to come on in for a consult after he was seen in one of our barrio clinics.  He doesn’t understand the system.  I explain how to meet with Canario or Valdez to be prepared well for surgery next week.   He’s excited.   He’ll do whatever they ask of him.  

IV started on the 14 year old.  He’s a trooper- “it didn’t hurt”.   Grin.

Lunch.  Fabulous cooked mashed pumpkin with Margo’s beef gravy.  Molasses cookies that Kari made about 5 minutes ago still warm in the middle.  This might be the greatest food I’ve ever eaten.

I check in on the post ops, write down some vitals,  change out a monitor, look for my portable pulse ox for the colostomy guy,  talk to family members waiting.   Wait, here’s another patient sent from Caceres, a 13 year old circircusion.    The docs are still in surgery or eating.   I park him in a bed and review the labs.     They are thrilled to make the surgery schedule cut.   Necrotic finger guy is really quiet.   We promise again to try as hard as we can to leave as much finger as we can.    I’m wishing wishing wishing for him but not feeling so great about the possibility of it.    Gunshot wound guy is nervous and has lots of questions.  We talk a lot about the surgery.    His son comes in and would like to hear everything from the beginning.

Surgeons come in and check out the 13 year old.  We can do his surgery!  yay.  Consents,  gown,  and an IV.  He’s also a trooper.   Big grin.

14 year old hernia kid’s  time for surgery has come.   I tell him I’m coming to surgery with him and we grin and take the IPOD with us.     He’s quiet as a mouse on the OR table while we get him settled.    His eyes stay with me until he’s out like a light.    I take the IPOD out to the 13 year old and he lights up like a Christmas tree.

Post op- sweet 9 year old circ is outta there.  He’s not quite as happy as he was when he arrived this morning but he’s prepared to leave and his doting family members walk him out to their waiting car.    The other two dear little old hernia men are both in post op hanging out and hanging on.   Today was definitely the hernia special.

I head into the office to type up a surgical report for the week.   I give Livida a copy and the surgical team a copy as well.   Check a few emails.  Sigh.  Lots to return.  I’ll write them later.

Back to clinic.  Colostomy guy is doing better, up, sitting in a chair.   I touch base with Valdez about a follow up care plan for the Gunshot Wound guy.   We’re good.

I hang in post op with Nef for a while checking out the recoveries.   14 year old is serious and quiet but says he’s not in pain, he just “feels weird”.   He takes the IPOD again and puts it up against his cheek to listen to the music.   His Grandma makes me cry as she hugs me and says “this was our only chance….thank you- thank you-thank you!”.   I wipe my eyes and head back to OR 2 to see how the 13 year old circ is going.  All good in the hood.

Post op remains chill.   Everyone comes out of anesthesia well.   The dentists need their instruments run in the autoclave.  I put them in and start the autoclave.  Lily and AndryOmar are buzzing around helping everyone.   14 year old leaves with a big hug and they promise to come back and visit.   Gunshot Wound guy keeps thanking us over and over and over again.   13 year old circ has tears.  I head off to find anesthesia for more pain meds and we fix that all up.

Lily and AndryOmar are good to go so we bail on Post op.  2 quick meetings with Dan and some of the translators.   Nice- nice.  Dan and I head out at 5:55 for the Guesthouse.   I catch up with Laura, Jeff, Kamanda, Kari and Dan in the kitchen while dinner is being prepared.   Ahhh asopao- my favorite dinner.   Soup with rice and chicken- delish!  Total feast.   Dinner, catching up with the crew.   Take my second Bactrim- leg looks even better.

6:40- off to apartment to shower, etc.  Oops- don’t forget the laundry.   It’s finished.   Again, squashed laundry basket on the pasola is a joke.  But I can pull it off.   Back at apartment, water plants again.  Put laundry away.   Shower.   Check emails.  Start this blog.   7:20 Head over to CCED to support Student Sponsorship Meeting.   Wow- lots of folks.   Really cool.  But there are plenty of translators and I can skate outta here.     8:15 I skate with Monch.  We head over to his mom’s house to visit.   9:40 Head back to apartment,, hang out and relax while he plans for his journey to the capital.   I doze off.  11:00 Drive M home on the pasola.  It’s COLD.  11:15 Home again.   Check in with Laura and catch up on the last couple days and what’s been going on with this current group.

12:58 Finish this blog.  Lay thinking of how good God is.   The patients feel great- they felt loved.  They were prayed for.  The Americans worked so well with the Dominicans.   I personally was loved on and prayed for.  The surgeons seem pleased with their surgeries.    Dr. Canario and Dr. Valdez seem pleased as well.  This team has done amazing things but I’ve SEEN even more amazing things that God is working out- bringing folks in and showing them Who He Is.   Showing ME more Who He Is.   And now sleepytime.   PEACE BE WITH YOU- May the God of our crazy days remind you more and more that He alone controls your every minute.    

There went December...

I'm not exactly sure how it happened, but apparently while the United States was ushering in an insane season of cold and snow, time was speeding by under the Dominican sun in San Juan.   

We did have two weeks off in December but I don't know/remember exactly how I spent them?    There were some sweet visiting times, trips to El Cercado and Las Matas, photos at the school in the capital, lunching at the CCED Christmas party,  visits to the upcoming barrio sites to prepare and clarify road stability,  hanging out with Laura's mom as she visited San Juan, fun baseball games as the San Juan softball finals were going on, and lots of time spent with our friends here in San Juan.    And now begins the craziness of Winter Season for Solid Rock (and me!) as our Winter teams begin to arrive.    This is the busiest time for me, since the majority of the teams are Medical/Surgical.   

The Scary Room has been left to its own devices until Spring or a well-meaning team of 12,000 arrives to assist in the carnage.  ;)   I made it through 3 boxes before I threw in the towel.   But the clinic is looking great!    I'm looking forward to having a Pharmacy student (YAY for Miss Liz) arrive for 3 weeks at the end of this month to help keep the pharmacy "stable" during Winter Teams.  

One of my favorite things that recently has been going down is being able to visit our barrio sites several days before the team heads out to hold their Mobile Clinics.  Monchy (bus driver), Hector (our Education Coordinator), and myself (along with Community Leaders and others occasionally) have been visiting the sites to clarify road safety and ensure promotion in the areas.   It's been fun to build new relationships and know where and how we are going to set up the clinics when we arrive.    I've loved watching Monchy and Hector encourage the locals and talk about Solid Rock and our ministry before we actually start working in a region.    

This past week I was out in the barrios with the VIMM team (Volunteers in Medical Missions) and was able to connect with the folks we had coordinated with earlier and reinforce relationships with the Community Leaders, pastors, etc.    Thursday was especially fun as we were in Hondo Valle (over 2 hours away, WAYYYY up in the mountains near the Haitian border).   We saw over 265 patients but the coolest part was working with a local nurse who had set up the (CRAZY!) scene, partnering with Socios in Salud (Partners in Health.....who were doing free HIV tests and counseling at the same site) and then running into one of the boys from Pueblo Nuevo who I haven't seen for a year or so.    It was a 12 hour day but SATISFYING.    I love watching our staff, our translators interact with the patients with such patience and love and I feel so blessed to be working with such honorable and FUN folks.   We sometimes make them sing in the bus on the way home and the groups LOVE watching them shine.    When I think back to my first visits to San Juan 6-7 years ago......and where I am today- I am awed at how God moves in our lives.  And oh- so - grateful.  

And now- back to the clinic and pharmacy to finish up the prep for tomorrow and next week.  Blessings to all!  

The beautiful 3 Ojos (3 eyes) caves in the capital with Laura and her mother!  

Seems like a tropical paradise..and it's in the middle of busy Santo Domingo!

Braegan Mae is the Center of all attention and love here in San Juan.  WE LOVE HER! (and so does everyone else!)

The fiercely competitive San Juan Softball Finals!  

Yay for my guy!  He's the best....

Laura and I at the Signed Baseball Players game in San Juan..

The Little guys watching the Big Guys.  Always a highlight...

San Juan's own Jean Carlos Segura (shortstop for the Brewers)  playing in the local baseball game with  other signed players, incluing some 16 year olds.  Seriously these guys are humble, approachable, and just COOL!

Superstar Baby Nicole visiting our apartment......she'll be THREE YEARS OLD in March!  Wow!

Delicious dinner for Noche Buena (Christmas Eve)

The scouting trip to Hondo Valle with Gloria (the local superstar nurse), Monchy (bus driver) and Adia (his lovely wife).   There is an amazing Ecological park there that I would LOVE to return to...apparently you can climb the mountains in 2 hours and see as far south as Neiba.   Stunning area!  

the next year of my life....

I think I know what I'll be doing for the next year of my life (and maybe even forever....)  So you guys remember this, right?   My proud photos?  Of the Scary Room?

Remember how deliriously happy I was?  That the Scary Room was scary no more.  That nearly all of our storage stuff had its very own little place to live.   Ahhhhhhhhh those were the days.

Here's the Scary Room now....well, I mean, if you can get in the door.  

HA!  I.  Just.  Have.  No.   Words.  

( But, um.... Happy holidays to all!  :) )