Tuesday, June 24, 2014

Vast beyond all measure

Normally I find writing in my blog about the experiences here therapeutic.  This time, though, my hands nearly shake as I try to put words to what happened at Kudjip last week.

On Thursday morning Levi woke up with a bit of a runny nose and wheezing.  He did this a couple times before we left the States, needing a visit to urgent cares and some nebulized medicines to calm him down.  I gave him a treatment but worried more later that morning when Esther asked me to bring my pulse oximeter (used to measure oxygen levels in the blood) home from work at lunch.

When I got home he wasn't doing too badly, but Dr Erin came to check on him as well.  I went back to work believing that his medicines would enable him to turn the corner.

After work, Levi looked drained, sitting alone on the couch watching a cartoon on the laptop while getting his medicine.  He could only speak in one-word answers to my questions so I called Erin again.  She recommended IV fluid to get him some energy since he was breathing so fast.  The next ten hours were probably the longest and scariest of my life.

Getting oxygen and IV medicines at the hospital

We got our fluids in the ER and planned to return home.  But I noticed Levi having more difficulty and had to give him breathing medicine every hour or so.  His heart rate hovering at 180 and his breathing labored and coming about 60-70 times per minute, I needed this illness to be managed by someone else.  Erin graciously came back to check on him.  Her level of concern told me that this was getting serious.

She brought Esther, Levi and I back to the hospital while our neighbors took care of Anna and Lucy.  When we got to Levi's hospital room, our field coordinators were there and so was our Anesthesia officer with pediatric intubation (breathing tube) supplies.  Levi was getting continuous nebulized medicines, oxygen, IV aminophylline and a dose of IV magnesium but still breathing about 80 times per minute, struggling to get enough air and wheezing so loudly you could hear each one of his labored breaths from across the room.  Erin got information about having him evacuated to Australia.

Would we actually need these for a breathing tube?

Esther needed to go home to take care of our girls, so I held Levi to keep him calm while he received drugs to keep his airways open.  I couldn't believe what was happening, but I felt the effects of dozens if not hundreds of people praying for us.  I also saw that Erin had no intentions of going anywhere - she stayed awake at his bedside all night, adjusting IV drip rates, giving nebulized treatments and praying at his bedside.  (Levi noticed this at one point and said, "wake up!" which made us both smile - partially out of relief to hear his voice)

About six hours later, in the early morning, Levi took an interest in Erin's iPad, and began playing a game on it.  I believe the pediatricians might make an exception on the idea of limiting computer and movie exposure in kids if such devices calm them down enough to keep them breathing.

From that point on, he showed gradual improvement.  We spaced out his breathing medicines to every hour, gave him additional oral medicine and took a chest Xray which showed pneumonia.  I was able to take the oxygen away and Esther showed up with some breakfast and to give me a break.

As he got better, we transitioned him back to the house to receive the rest of his IV medications but kept him on breathing treatments every two hours.

Trying it out at home

Just 72 hours after this ordeal, you would barely know that he was sick.  He's back to running, playing with Anna, talking excitedly but also to being a bit moody (from loss of sleep and steroids, I hope)

Was this kid sick?

One of our family members back home admitted the day after we left the hospital that their first reaction to hearing about his illness was "You get all three of those babies on a plane and back here now!"  In my heart, I confess I too knew that thought and felt the anxiety leading up to it.

Now Levi is on a host of medications to prevent flare ups of his condition.  They're not easy to get here.  There's also no guarantee that he won't have another episode like this one, or that it might even get worse.  How do I approach that knowledge?  I asked Bill via email if it made me a bad missionary that I was considering the wisdom of living somewhere without the advanced medical care he could potentially need.

I blogged in the past about the concept of following God's call even when circumstances or outcomes might be challenging for me.  Now I face that idea in a new light.  That night in the hospital with Levi shook everything I felt to be secure around me.  Does that change where I live - who I serve - how I see patients - my calling?

"The heavens and the earth will shake; but the Lord will be a shelter for His people."
-Joel 3:16

We've not felt compelled to change our plans for staying here.  Esther and I are both prayerfully considering these next weeks and months while seeing how Levi does.

I remember a couple years ago speaking with a friend about the incredible love a father has for their children.  Obviously, there are Biblical parallels to this concept.  That Christ would give up his own life to make things right for his children (us) resonates easily with me.  I would give my life in a heartbeat for my children.  But another amazing love is that God would give His son for us.  I find it harder to as readily say I would give one of my children's lives for others.  I don't know what that means yet.  But I do know that I can very slightly understand the great pain that God the Father must have felt as He saw His child suffering.  And I pray that I'll use that as motivation to continue to share His love with those brought under my care here.

How deep the father's love for us
How vast beyond all measure
That He would give His only son
To make a wretch His treasure

Saturday, June 7, 2014


On Sunday the 19th of May, one of the politicians in this country threw a great party.  His son graduated from high school and the entire family came to see him and celebrate.  Unfortunately, someone who shouldn't have been driving got behind the wheel and their bus "capsized" (Tok Pijin for rolled over) on the road near a bridge, killing three people at the scene and seriously wounding ten others.  Two subsequently died in the emergency room while I tended to them.  Others had various injuries and, after getting stabilized, stayed in the hospital.  One of them was Gibson.  I wrote about this accident in my last blog post

Gibson fell through the car as the vehicle rolled over and caught all of his weight on his right leg, dislocating his hip.  Equipment or another passenger fell onto his left leg causing a fracture of his left knee and a large collection of blood to build up in the joint, called hemarthrosis. 

I reduced Gibson's dislocation and discovered his knee fracture the following day, which had to be drained through a needle placed into his joint.  Gibson stayed in the hospital about two weeks while his hip remained in traction and we worked a cast around his fractured knee.

I thought Gibson was depressed, and with good reason.  He faced a long period of debility and lost some of his family members in the accident.  But when I told Gibson he could go home, he and his family members accepted my prayers and I saw his first smile in weeks.

Gibson happy to go home alive

We are currently in the middle of a measles epidemic in our area of Papua New Guinea and half my medical ward was confiscated for additional pediatric cases.  

Measles is vanishingly rare in the states, like tetanus, thanks to nearly universal immunization practices.  But in Papua New Guinea children less than five are coming in nearly every hour with high fevers, cough and rashes from this virus.  Measles itself only causes half the battle, it also results in pneumonias and, in several of our patients, seizures.  There is no medicine for Measles.  Children who can't breathe get oxygen, children who can't eat or drink get IV fluids, children who seize get valium and they all get prayers (and vitamin A).

I've tried to stay away from the serial postings on Facebook about immunizations.  But working in Papua New Guinea I must say I am VERY grateful that nearly all children are immunized against these diseases in the US.  Immunizations are extremely effective, extremely safe and save the lives of the smallest and most vulnerable patients.  Please give your children their immunizations.

We've had a relaxing weekend so far.  Saturday Levi and I worked on a project I've been trying to complete for a couple months now.  My best intentions were to give Esther her porch swing for her birthday (April 28th) but due to some power cuts I couldn't get my lumber cut fast enough.  Mother's day seemed the next best target (May 11th).  Unfortunately that day came and went without completion.  Yesterday Levi and I put the decking oil on the swing and as soon as it is dry we can hang it!

 Applying the deck oil

 Clean up

After finishing off the swing, our family joined the Thompsons, Petersons and Morses (a visiting doctor here) to drive our bus down to the reservoir for some play time.  The kids enjoyed splashing in the river and I took a dip in the reservoir and slid down the dam.  I love this addition to our station and hope to resume swimming on a regular basis if I can endure the cold mountain water.

Some shots of the reservoir

Public service announcement: when spending most of your day outside on the equator at 5,000 feet, wear a shirt.  I feel like a lobster.

These days have flown by.  In Papua New Guinea, January becomes June without any change in the weather.  Back home, I got very used to measuring time by seasons and weather but here it's all the same.  The main chronometer around here is Lucy.

 Lucy "enjoying" the reservoir

She is growing quickly, topping off U.S. growth curves and smiling and babling regularly.  Someone once told us that with children, the days are long but the years are short.  I'm finding this truer here now that our kids are the only way we can really see how much time is passing.  In fact, we are about 1/4th through our first term in PNG!

Please pray for our family's direction.  We don't want to make decisions about our next steps until after the first year has passed.  But we want to have discernment knowing whether God plans for us to return here or if there are other opportunities He has ahead for us.