What have we been up to?

Many of you following along with us know that we are heading back to East Africa in June. This has been a season of in-between for us, with featuring stages like: recovering from being evacuated, getting into a routine, waiting to have a baby, having said baby, then preparing to return. Now we are in the throes of planning to see people one-last-time (so much grief!) and packing (slightly easier when you’ve launched a family over the ocean once, by God’s grace!). I thought I’d share a little bit of what our time here has looked like…

1. Henry. We had that baby. Gosh he is the sweetest thing. Here, I’ll show you:IMG_8558

For real…

 

2. Family and Friends. We were so grateful and blessed to be welcomed back into the fold with our family and friends, who let us back in, or came and visited from far away (sometimes multiple times). We were home for Thanksgiving, Christmas, Easter, and a wedding. Obviously, this is the best thing about being home. We have the best people in our life and I am so grateful for them.

 

3. Work and School. Matthew had the opportunity to complete 9 credits at St. Mary’s Seminary Ecumenical Institute and really enjoyed it. He also worked as part-time faculty at his old residency at Franklin Square, doing some clinic, inpatient, nursery, and OB. It was a good mix for him. I completed a couple of bible credits through BSF this year studying the Gospel of John, and 3 credits towards my BSN.

 

4. Books. SO MANY BOOKS.

Many people have asked about what we’re doing for Naomi’s school this year and the answer is, mostly, a lot of reading. This is how I have felt about being near public libraries again.

The gift of a safe delivery

As Dinya, the clinical officer, prayed, I quickly pushed the ketamine into the patient’s IV. I watched her carefully; she was struggling to relax.  After thirty seconds or so her face began to relax. Dinya began pinching folds of skin on her abdomen, while I watched her body language for tension, to ensure she was numb enough to begin the c-section.

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Five months in, it was my first time running anesthesia for a c-section independently. Since we’ve moved here, I have been working at the hospital on Thursdays. Matthew stays home with the kids and I am grateful for a husband that’s willing to jobshare a bit so I can be part of the action. It is true, though, that coming in only once a week has made for a slow onramp to feeling anywhere close to confident. Anesthesia in particular feels like something a nurse should have, oh, at least an additional Master’s degree in.

My preceptor, Kitty, poked her head into the OR. “You ok?” she asked. But I was; I was feeling like I could anticipate solving several problems independently before I’d call her for backup. It had helped that we’d been together with some difficult cases. “All right. Let me know if you need me.”

I turned back to the patient, and I watched the monitor as her oxygen level promptly dropped from 100… to 96… to 92… to 87. Right. I propped her jaw forward to open her airway further. Nothing. Time for oxygen. I watched her oxygen saturation rise again, and offered a quick prayer of thanks.

It was clear even a few minutes in that she was metabolizing the ketamine quickly. She began to grimace a little, to sing a little. I watched her carefully and prayed; sometimes ketamine just makes you talk. It can also cause uterine tension and make baby a little slow to start breathing. I really didn’t want to have to give her any more if I didn’t have to.

The blood pressure machine was broken, so I assigned a midwife student to take the patient’s blood pressure every few minutes manually for me. I also decided she needed a little more ketamine, explaining to the visiting doula who was shadowing why I was hesitant to do so.

A few minutes after that, Lo and Dinya pulled a 3-kg baby out. The cord was wrapped around the baby’s neck three times. “Right,” Lo said matter-of-factly in her Irish accent,. “this one definitely wasn’t coming out normally.”

In America, having a c-section can be a mark of shame for a woman. My first child was delivered via cesarean; when the doctor announced that, at the eleventh hour, Naomi had flipped into breech position, and with my water already broken, a c-section was our only option, quiet tears rolled down my face. I remember talking a friend through feelings of disappointment that she wasn’t able to deliver her baby vaginally, receiving positive e-mails from a VBAC (vaginal birth after cesarean) support group listing tips for talking to your doctor, reading in a childbirth book about ways to delay c-sections, and trying to drum up as many suggestions as possible for convincing your doctor to give you more time to do it yourself, as it were. To be fair, there are reasons why c-sections are not preferable to vaginal births. I pursued a VBAC with our second child, and was glad for the easier recovery. But as the baby’s cries rang in the air, indicating health and liveliness, I was reminded, again, that having a c-section available to me, done by competent health care professionals was, and is a gift.

It was a gift that multiple competent doctors were ready at that hour of the morning when we went into the OR for Naomi’s delivery. It was a gift when Dave, the scrub tech, walked into the OR and cussed audibly because I was sitting on the table getting my spinal block put in. It was a gift when Rose, labor and delivery warhorse that she is, kept a close eye on my heartrate when it dropped into the 40s after surgery. And my anesthesiologist, Tom, was definitely a gift, as he explained to me what was going on behind the curtain– despite the fact that I had been in c-sections as baby nurse before, being the patient was a little scary for me. He walked me through it with a caring manner and kept me pain-free.

I took the bucket containing the placenta and blood out to the pit behind the incinerator. Emerging from the OR into the sunshine was a breath of fresh air. I made a mental note to bleach my shoes the next day. What a gift.

 

 

Slice of life: chicken edition

Robirda is our chicken. We have been working on adding to our flock, so far to no avail. No matter. She has enough sass for a whole brood of hens. (Sassy seems to be the only type of woman we keep around the Loftus homestead…)

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Robirda has one flaw, and that is that she likes to hang out at the hospital all day. One Thursday when I was working she casually sauntered onto the peds ward. The patients got a good laugh at me chasing her as she ducked under beds. Someone did help me catch her, and I took her home and kept her penned up for a few days. It didn’t really stick, though. The next day that I worked she was hanging out at the patient waiting area. I  joked to Anna, the nurse I was working with in antenatal clinic that I like to take my pets to work with me. She laughed and said, “Me too”– her dog had been sleeping in front of the clinic all morning!

On yet another day, Matthew carried Robirda home, looking a little harried. The health department had just arrived for an inspection. I don’t think they would have been very happy to see Robirda hanging out with the lab technicians…

Robirda likes to roam the whole hospital. Multiple people have told me they are ready to take her home and eat her. I hope not– she just started laying little eggs with bright yellow yolks (the other eggs you can get in town have very pale yolks, suggestive of low nutrition).

But maybe she does have something else in her future. Short term nurse Lydia has had several heart-to-hearts with Robirda in the administrative office at the hospital, which led her to text me one day about “prayerfully considering Robirda to CO (clinical officer) school.” Well. Medical education is certainly a passion for us. We’re not ruling it out.

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Robirda and her benefactor enjoying a nice swing.

How to be a nurse

Each week I get to work one day at the hospital while Matthew is home with the kids. I feel like I am taking a crash course in nursing all over again, this time in a low resource setting where the language, culture, and names of medicines are different– and the acuity tends to be much higher. When we first got here it had been ten months since my last shift, as I stopped working before Leo was born. I’m slowly figuring out how things work (no weeklong orientation or orientation protocols here, though the preceptors are pretty great), and how I can be helpful. Every day can look different, depending on who walks into the hospital. One of my first mornings I worked, I shadowed Kitty, a fellow missionary nurse. In between keeping meds stocked, making sure staff has shown up and clinic gets started, dressings for major wounds get changed, the morning looked like this:

  • Starting with prayers with fellow missionary nurses
  • Joining in with staff devotions
  • Listen in on the first half of staff education hour, glad for the opportunity to refresh on the pathophysiology of pre-eclampsia20160114_100602
  • Begin CPAP for a 29 week baby just born (footling breech) who is retracting deeply. CPAP is set up using neonatal oxygen tubing that’s split– one end gets tied off and the other goes 6 cm into water to provide adequate pressure for respiratory support
  • Greet a guard whose baby was born on Christmas and ask how baby Immanuel and his mom are doing in Arabic. (I realized after I walked away that I asked how MY baby was doing, not HIS… grateful he understood what I meant!)20160114_114747
  • Assist with setting up a c-section, helping the doctor start a spinal, getting set up for anesthesia using ketamine when the spinal didn’t take, setting up to receive the baby, running anesthesia for said c-section (went well, phew!). Get patient cleaned up, transferred to the antepartum unit (which doubles as postpartum).20160114_125247
  • Head to the office to catch up with Kitty, getting intercepted by the x-ray tech, Morris, who is drying an abdominal xray for said 29-weeker to check the UVC (an IV that goes into the umbilical cord) placement. Get asked opinion on whether or not it was advanced too far, into the heart. Observe that wow, it does look like the line goes up into the chest and then curves, then
  • Snap back to my senses and remind myself that though I just played the part of a nurse anesthetist, I am DEFINITELY not a radiologist, and say, “Hmm, what did Dr. Perry think?”
  • Go to lunch. That was only the first half of the day!

Slice of Life: Burning the Yard Edition

I am learning lots about how to live in South Sudan. How to cook on a small iron cookstove, how to be a surgery nurse in an operating room with flies in it, the words to all of the ingredients I need at the market… the list is endless. But this week I learned how to set my yard on fire.

teak leaf dec 2015

Our corner of South Sudan is covered in beautiful teak leaves. The trees provide beautiful wood, nice shade, and soundproofing. But during hot season, the enormous leaves dry out and fall. The sound they make when they land on the tin roof and screeech their way off before making a slight crashing sound on the ground was actually mildly alarming before we realized what it was.

The side yard of the house we’re staying in has a sizeable grove of teak trees. The leaves keep on piling up. People have been seeing more snakes than usual (so I’m told– I haven’t seen one yet, which I’m fine with), and burning them takes away their place to hide.  So our girl-neighbors came over and sweetly asked if they could help me out by setting fire to the leaf piles. So we got to work.

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Sweeping

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Small girl setting things on fire. Nothing to see here.

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Gratuitous baby who amused himself on the porch far away from burning leaves

A peek around

We are here, and settling into life as much as we can. We dearly miss our friends and family. But it is beautiful here, and the work is good. We have started learning language, and I got to shadow around one day at the hospital so far, and got to see a baby born at 31 weeks continuing to grow and mature two weeks later in the hospital. I saw a safe delivery of a healthy baby– and a student nurse who gave him his vitamin K shots under the watching eyes of an experienced nurse. I know that culture shock will set in eventually, I know that we will get tired and discouraged sooner than we’d like. But we are trusting in the truth pf Psalm 118:1– that the Lord is good, that following Him is always best.

More later, but here are some pictures–IMG_5413

Home sweet home for now, as ours is being built…

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… with a surprise tomato plant creeping up the back of the house!

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Leo LOVES sitting on the front porch.

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Naomi in charge of pushing. Who’s surprised?

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Inside, lizards (geckos?) are welcome– they can eat the bugs!

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The running scenery’s not bad.

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A safe delivery of a healthy baby– the reason we are here.

-Maggie

October Fundraiser 10/11/15 at Jubilee Arts!

We’re getting really close to our goal of raising all the support we need to get to South Sudan, but we’re not quite there yet! As of this writing, we’re at 75% of our monthly goal.

Thus, we’re having a fundraiser on Sunday, October 11th at 1947 Pennsylvania Avenue (the Harris-Marcus Center, AKA Jubilee Arts) at 6:30PM-8:00PM. 

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We’ve decided to do a coffeehouse format so our talented friends can share a song, poem, dramatic reading, or other talent. Interspersed with the sharing will be more detailed information and pictures of where we’re going. There is no obligation to give; you can just come to learn more or hang out. We will have stations set up if you’re so led (or you can always give here if you can’t come or you’d rather not wait!)

We hope you can come! Email me (our last name dot matthew at gmail dot com) if you’d like to participate.