Photo journalism at its best!

When I don't know what to write I think that maybe photos can cover it up for me.    It's been a great couple months;  winding down the medical/surgical season until July and ushering in the construction, youth group, and vacation Bible school groups.   Our pharmacy is as tight as I can get it.  Scary Room is under control.   Next surgical team is September.   I guess that  I'm gonna head to my passport country soon and visit my peoples for a while.    Blessings to all!

We all love Braegan so very much.  But this is one of my favorite pix of her OF ALL TIME.  She is shoving broccoli in her mouth at the speed of light, sitting on a huge bag of coffee, right between the Monch and I.  Just good times all around.  Our lives at Solid Rock are so very very much brighter with Braegan running around and saying funny things in Spanish/English/Braeganish.  :)  

To be honest, I'm not even sure what this dear little guy's name really is . We all call him Gordo ("chubby", "fatty"- it's a compliment here, really).   Although this photo doesn't show it, he is the jolliest of jollies in the barrio.   

We have found some beautiful sites while taking "lunch walks" from our mobile clinics.  This is a beautiful river near Cabeza de Toro with a sweet swimming hole.

Seriously!  You won't believe it but this guy is a twin!  He and his brother were equally squalling, snotting and crying nearly the entire day that we spent with them in Elias Pina at a mobile clinic.  They clung to their 6 year old brother very tightly and wailed whenever we even APPROACHED them.  But wow- how precious!

I have repeatedly mentioned that the DR has over 30 different kinds of mangos, right?  Only 30 billion times.   Never gets old.  And look how beautiful.  

I work with the greatest fellas.  And we have great times in the barrios.  3 of these brothers are some of my oldest friends in the DR..... way back from the Pueblo Nuevo days.   How cool that we get to connect and work together now!   God is so good!

A room with a view.  If you want to know more about this place...check out my blog from about a year ago called Casa Abandonado.   I still wander through these roofless walls wondering how I can live here one day.

They just don't get any cuter (or rowdier!) than the kids in Bastida.  Baby Nicole's brothers are included in this pic!  We held a WONDERFUL mobile clinic in Bastida and were able to see my beautiful baby, her family and many others in this place that I love!   

One foot in front of the other

Update on my running:  the two-a-days with Monchi didn't really work out.   My knees, sassy mouth, ankles and attitude really couldn't hack it.   But the one-a-days with me, myself, and I- those are still going onward.    I'm not good at it.   I don't exactly enjoy it.  But I feel better about myself....and I feel the tendrils of anxiety that tighten around my neck slipping away when I'm out huffing away, feet pounding on the gravel or rocks or sidewalk or wherever I am.   Just trying to keep it one foot in front of the other.

It helps that I live in possibly the most gorgeous place ever.   I don't look around a whole lot, because I'm trying to watch my feet and the road and make sure I don't fall on my face.   The streets here aren't exactly friendly to runners, and although the track is nice-  I loathe circling the same scene again and again and again with about 200 Dominicans staring at me wondering why I run so slowly.  :)   But when I do put my head up and check out what is around me..... I'm reminded that it's part of why I'm out here plodding away, sucking in air and pushing myself.  It's beautiful.  It clears my head.   It shows me again how stunning God's creation here in San Juan IS and how blessed I am to see it.   Below are a few of the scenes that I get to experience, when I'm not tripping over myself.

This is my screen saver right now.  I just. cannot. believe. I. live. here.  Look at those mountains. 

Outside the Guesthouse and clinic at 730 pm.  

Ahhhh the statue at Comemoros or San Tome.   Exactly one mile from my abode.  And three times around the park is another mile.  Baseball field across the street.  Outskirts of San Juan on the way to Las Matas or El Cercado.   I like it here.  

The road I'm on.   It's been rocky lately, both physically and emotionally.  I've been anxious- I've been stressed- I've been tired.   We've had off from teams the last 3 weeks and only this week have I felt the tension seeping out of me.   I'm working on trying to do the things that bring me JOY.  Watching baseball with Monch,  playing dominos, visiting friends,  reading books,  checking out movies, seeking and talking with Jesus, puttering with my balcony plants.     Putting one foot in front of the other.  Simple stuff.    Just like running.  One foot in front of the other.   Walking when I need to.   Plodding most of the time.  Waiting for that feeling that I can RUN now.  And sometimes I can.   Sometimes I can even go farther than I thought I could.    The feeling of exhilaration in THOSE moments  is enough to keep me going even when I'm exhausted....knowing it will come.  And that is just like life.  I KNOW the times of exhilaration are coming.    I know there is a finish line and I'm in my race and sometimes plodding, sometimes walking and sometimes FLYING.    

2Tim 4:7

I have fought the good fight, I have finished the race, I have kept the faith.

Acts 20:24

However, I consider my life worth nothing to me; my only aim is to finish the race and complete the task the Lord Jesus has given me--the task of testifying to the good news of God's grace.
1 Corinthians 9:24
Do you not know that in a race all the runners run, but only one gets the prize? Run in such a way as to get the prize.
1 Corinthians 9:25
Everyone who competes in the games goes into strict training. They do it to get a crown that will not last, but we do it to get a crown that will last forever.
1 Corinthians 9:26
Therefore I do not run like someone running aimlessly; I do not fight like a boxer beating the air.

Scripture says we are to "run with patience (endurance, persistence) the race set before us, looking unto Jesus the Author and Finisher of our faith ... For consider Him that endured ... lest ye be wearied and faint in your minds." (Heb 12:1-3)      I'm wearied.  I'm faint in my mind.  But I want to continue with endurance and persistence the race set before me.   Maybe plodding.  Sometimes flying along.   But looking to Jesus to walk or run alongside me.    One foot in front of the other.    

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.