Under Pressure September Email

She was our first patient of a very busy clinic day.  Her sister just suffered a stroke and she, the patient's guardian, was staying by her side day and night, sleeping on the hard hospital floor and cooking meals in the hospital's open areas. Her sister’s stroke was sudden, right after hearing about an unexpected death.  And like the majority of strokes in Malawi, were there isn't a single neurologist, outcomes were not looking good.  But today the caregiver was our patient.  Was it any surprise that her blood pressure was 220/110 - almost double the healthy level?  She had been so weighed down with responsibility and stress she didn't even think to take her medication. She was  dangerously close to having a stroke herself, and joining her sister in the hospital.  We agreed together that her family had more than its share of trauma this month.  I didn't want to stress her more by admitting her to the hospital on a drip of blood pressure medication (the usual protocol based solely on numbers). Instead, we gave her doses of her usual medication, prayed for her, her sister, and her family, and we asked her to try to rest and come back after a couple hours.  Four hours and 20 patients later, we saw her again.  she was looking brighter, younger.  Her blood pressure this time was 156/78, still slightly high, but nowhere near the stroke-inducing levels earlier that morning.  She had dropped nearly 100 blood pressure points!  We gave her several medications, sure, but some of those shouldn't have kicked in for 8 hours, and other shouldn't have reduced her pressure more than a couple points.  We prayed together again, this time praising God for His miraculous healing in such a short time.  It will be a while before her family heals from the trauma it's already suffered, but at least this woman can remain taking care of her family instead of filling another hospital bed.

Greg and I continue to settle in to our new place. We now have a gate and a fence which separates our dogs from local farm animals.  Greg is enjoying teaching Church History and Systematic Theology at NTCCA.  I worked for a few hectic weeks on the medical ward, and have now moved more towards outpatient care and teaching.  Nkhoma hospital is severely short staffed at this time, and we just ushered in our new medical director last week.  Praise God that the erosive esophagitis I developed from my medication to prevent malaria has resolved, and I am able to swallow without difficulty again.

This month, please pray for : - Staffing at Nkhoma hospital, and patient care in times of provider shortage - Continued peaceful resolution of election conflicts - For Greg's students to grown in knowledge of God and His calling on their lives

Thank you for your prayers, encouragement, and support,   -  Greg and Christina

Welcome to Africa

Today was a very “this is Africa” day. I woke up at 3:15, and 4:20. And 5:20. But then I got to take the dogs for a walk before work with Greg and saw the sun cresting Nkhoma mountain. I faceplanted (well, leg, hip, torso, forearm, basically everything-planted) on gravel as dog sprinted after a stray that got inside our fence. Turns out grass fences don’t keep dogs out or in very well. Next we discovered that our dogs could open our front door if it isn’t dead-bolted. So they bolted as Greg walked me to work, and he had to track them down asking locals and finally found them half a mile away. Our dogs are obsessed with goats at the moment, though they still love sprinting after chickens. I thought I would drop in to the hospital and meet a few people, show my face, then retreat home to settle, because it was only my second full day in town. Ten hours later, I learned a lot about our team and where I might be useful in the future. I am trying to be intentional about not taking on too much, which is good, because it’s only my second day here. Greg went into the city, that is, after finding out that our battery was dead and jumping it himself. He bought a new battery but ran into some cash flow issues since our international ATM expired while we were in the States and he had no idea about his domestic debit card pin, and didn’t have my debit card with him. All things worked out and he got home before dark, with bags of groceries which are nice because you can only eat peanut butter sandwiches 3 meals a day for so long. Like until you run out of bread or peanut butter. After I got home I had a brief crisis thinking that some friends from town were planning to come up, visit, and spend the night with us. Turns out that is happening night after next, which is good, because our rooms are filled with boxes and suitcases in various stages of unpack. Greg is being wonderful cooking dinner now (using our single-burner gas back-up stove, because even though we have power, we haven’t figured out how to hook up our multi-burner electric stove, rendering it rather useless.) Meanwhile, I am icing and elevating my ankle (turns out, walking 10,000 steps on a twisted ankle was not my brightest idea, and the compression bandage I rigged out of the elastic from my previously-favorite, now-irreparably-torn pair of capris just wasn’t cutting it. Well, all’s well that ends well, and I’m on my third cup of tea for the day, with all the promises of getting to bed early tonight. The stars are beautiful in this rural, mountain home, and I think the relaxed pace of life will suit us really well. Once we get around to actually settling into that pace.

Revival

Two patients in medical ward were in a coma – one old and one young. The old one was just rolled in a few minutes ago; she was in her 70’s and was already on palliative care for liver disease. The nurse said she had been in that state a long time and wasn’t going to make it. The young one, in her twenties, had been with us for three days – her family found her collapsed and unresponsive and she hadn’t improved since she arrived. She had a history of seizures, so we thought maybe she had an uncontrolled seizure so long that her brain could no longer function. I prayed for her healing, but also sent the chaplain to discuss with the family that no improvement in 3 days was not a good sign. After 2 weeks on the ward, without many resources and with some of the sickest patients I’d seen in my life, I sure had become quick to give up. I never would have thought that both patients would bounce back to full recoveries. Praise God that my nurses checked the sugar in the older patient – it was low, but not terribly low or coma-inducingly low. However, within an hour of giving her an injection of sugar, she was up and talking, bright and cheerful. When I came into the room to evaluate her, I couldn’t believe that she was the woman I had seen admitted before. She could have been that patient’s daughter – decades younger, vibrant and healthy. She still had pain, which the palliative care team treated, but they helped her leave the same day, to enjoy the time she had left with her family. It’s been a long time since I’d seen a terminal patient that full of life. And the younger patient, she woke up too, albiet slowly. Within 5 days of admission, she was sitting up and eating, and we were praising God for such a recovery. We found out later that she had been given increasingly high doses of seizure medications, the kind that build up in the blood and take three days just to be halfway cleared by the kidneys. She was essentially poisoned by the cumulative effects of her prescription medications, something we never guessed in all our time scratching our heads about her case. But God knew, even if we didn’t, and He brought healing even when my faith was slim about her outcomes. I didn’t do much for either of those patients, but they were to me a wake-up call. When I pray for healing, I need to believe God can heal. When I want to throw up my hands and give up on a patient’s chances, I need to remember these two who bounced back the same day, even when they were critically ill, even when we had so few resources to share with them. Praise God that life and death, healing and sickness, are not in my hands, but His.