Sustained and restored after cholecystitis

Psalm 41 says "Blessed is the one who has regard for the weak; the Lord delivers him in times of trouble." Indeed, "The Lord has protected me and preserved my life. The Lord has sustained me on my sickbed and restored me from my bed of illness. I said, O Lord have mercy on me; heal me..... "

It began abruptly just after 9pm on a Wednesday evening. Shortly thereafter I was unable to remain in bed due to the severity of pain. I paced and tried various positions; on my hands and knees, leaning over the table, sitting upright, to no avail. As doctors we are trained to ask, "Is there any position that makes it better or worse. Is there anything you do (eating, going to the bathroom etc) that brings it on or makes it better or worse." The answer to all of those questions was "no." The pain remained constant and severe, a band reaching from the middle just below the sternum to the far right side of my upper abdomen boring through into the back. After three hours I woke Jim up to examine me, not because he could do anything except perhaps be impressed.  I had Murphy's sign: as the patient takes a deep breath the liver is palpated and when the gallbladder is irritated there is an immediate cessation of breathing due to pain. I had been teaching this maneuver to 4th year medical students at the medical school just a few weeks earlier.  Jim agreed that it was most probably my gallbladder.  As I huffed and puffed, I prayed God would help me bear the pain and give relief. An hour later after vomiting several times the pain resolved within minutes (most likely after the stone passed into the intestines) and I was able to sleep. In the morning I proceeded to the get an ultrasound (+gallstones) and blood tests (my liver tests were 100 times the normal level). The clinical picture looked like a stone had been blocking the common bile duct. By the afternoon I developed a fever and started antibiotics. At that point I felt really exhausted and crummy. Friday morning Jim and I set out on a flight to South Africa. The ANTS taxi service took us directly to hospital where I was admitted and had repeat testing. Surgery was performed Saturday.  Less than 24 hours later I was discharged and we headed to the same B&B, The Crane's Nest, where Jim had recovered after colostomy two years previously.

Jim left Monday night to return to Zambia where Chris had fallen by the wayside with gastroenteritis. Then on Friday with my suitcase and backpack in hand ready to go directly to the airport I arrived at the surgeon's office only to be told the repeat blood tests were not all improving and some were worse. Jim felt the elevated tests were easily explained; the surgery, intraoperative dye study and the physiology of one test (alkaline phosphatase); delayed manufacture and release had all led to the increase. The surgeon insisted I remain. I returned to the Villas next to the US Embassy for easy access to the Internet and medical unit. Over the weekend I watched some of the winter Olympics (we don't have TV in Zambia so this was a treat).  Amazing what the human body can do.

On Monday the labs had all improved and it was agreed I would repeat them in Zambia in a month to be sure they were normal. I had the opportunity to share scripture with my surgeon who was troubled by a decision he needed to make. One of his patient's had end stage cancer and bowel obstruction. There was no further treatment or hope of prolonging her life. He was unsure as to whether to recommend a line be placed into a large central vein to give nutrition because this can sometimes result in discomfort and even infection and death. I asked him what the patient wanted and he said, "That's a good question." He didn't know. Doctors in South Africa do not always talk with their patients in the same way we do in the US. I went on to suggest that most people at the end of their life just want a little more time to be with family. We can always give hope and assure them we will be there for them. I told him that Psalm 139 has always been a comfort to me when it says, "Everyone of our days is already written in His book before there is even one." I cannot shorten or lengthen anyone's life. I am not God. I am grateful He is in control. Many times I can do very little for my patients except to be present at the end and that is enough." I sensed a deep loneliness in this man. He mentioned in a pained way that he did not have the same intimate relationship with many of his patients that an internist or a general practitioner might. People often did not even remember his name. As I left I thanked him and called him by name.

I thank God for all of you; my friends and family around the world who supported me in prayer, praying for my healing and for all the emails which were a daily encouragement and blessing!

Today I delivered food to the children in the prison. Last Friday I discovered a malnourished 9 month old with brittle reddish tinged hair, no family to bring food and a 3 year old from Congo, again no one to bring food. I was again reminded of Psalm 41 “Blessed is the one who has regard for the weak…”as well as the passage in my daily reading in Luke 14, ”When you give a luncheon, or a dinner …or a banquet invite the poor.” I don’t think God wants us to just read the words and study them. I think He’s serious about us doing them. So, today I delivered peanut butter, mango, potatoes, rice, Cheerios, avocado, biscuits and bananas.

This is my Life

The week I decide to blog about a typical week, ends up being the week I end up being medavaced to South Africa. If you asked Molly Crane who stayed with us a month last summer she would laugh and agree that yes that would be a typical week. Just when you thought you knew what you would be doing everything changes  (both car batteries die in one day and you aren't going anywhere). It reminds me of Jesus words about not worrying about tomorrow ,in fact don't even plan tomorrow but instead just be faithful with what God puts in front of you today. (Matthew 6:34, James 4:24)

Monday I drive to Mercy Ministries to drop off the $500 that Molly and her mother raised. I had called Dorothy, the Zambian woman in charge of the school for orphaned and vulnerable children and agreed with Edna her daughter on the date and time. When I arrive no one is there to accept the money. Edna has been admitted to the University Teaching Hospital, has had a c-section and delivered a healthy baby boy. Dorothy has taken a group of children to the ophthalmologist for eye exams. I depart taking the envelope with me.  I will text and make plans for a drop off next week.

Tuesday I lecture to 4th year medical students on Five Common Diseases in Children in Zambia; acute respiratory infection (pneumonia), malaria, diarrhea, HIV/AIDS, and malnutrition. I try an interactive style picking out a name on the list of over 100 students and calling on students to answer questions. Although not intended to be a humorous presentation one slide gets a laugh. It's a picture of a severely malnourished child. What I failed to notice before is the filthy ragged grey shirt worn by the mother with "Survivor" printed on it.

Most Tuesday mornings I attend an International Women's Bible study with a wonderfully prayerful group of ladies from all over the world; Zambia, Zimbabwe, South Africa, Ireland, Holland, New Zealand, Australia, Guatemala, Philippians, US, Ethiopia and England. A recent Beth Moore study on Daniel was a great encouragement to me as I under went three mammograms, an ultrasound and a breast aspiration during our month home in the US. I kept recalling the fiery furnaces of life where there are 3 possible endings. God either delivers us from the fire (we don't have to endure it, the spot on the CXR disappears, our faith is built up), or he delivers us through the fire (we have to have the radiation and chemo but we are cured and our faith is refined) or he delivers us by the fire and takes us into the arms of Jesus (the trial or suffering ends in death with no miraculous healing and our faith is perfected) As Jim and I often joke "What's the worst thing that could happen? and then what? and then what? "and eventually we end up in the arms of Jesus and remember that that is actually the best place to be.

Wednesday morning I paint with a multi-generational, multicultural art group at a local cafe. The owner of an art supply shop offers lessons and artists come for fellowship, encouragement and inspiration. In the  afternoon I experiment with a sack of guavas from a friend with a guava tree in her yard; the guava sorbet is refreshing, the guava and apple curry is inedible and the guava jelly well to be honest no one has actually tried it yet.

Thursday I head to the prison. I drop off the hot water kettle (thanks to Luke/Atticus Getz for his donation). The women are surprised. I assure them I have the commander's permission. I emphasize due to the filthy conditions and the recent outbreak of Shigella that all drinking water should be boiled. I say this as I stand by a pile of sacks reaching to the ceiling filled with dried foul smelling kapenta fish. I try not to stare at the flies creeping into the holes in the sacks. I pretend they are not there as if the situation is not that bad. I sit down and take out my bag and begin to listen to the stories in French, Swahili, Bemba, Nyanja and English. There are rashes, bug bites, headaches, back aches, watery eyes, stomach pain, heavy periods, vomiting, coughs, weight loss, racing hearts, anxiety, too much thinking, fear and depression. I pray with everyone. Many weep. I assure them there is a God who sees. The God who made them and formed them in their mother's womb has not forgotten them. If they were the only person in the world God would have still sent his Son Jesus to die for them. They are precious in His sight. They are not forgotten. Some women are refugees, some have been trafficked, some are drug addicts, thieves, even murderers. A few of the women guards stop by for medical advise and prayer. I am following His great commission in Mark 16:18 to place my hands on sick people so that they will get well." I am trying to do what Jesus did "preaching good news to the poor, proclaiming freedom for the prisoner, releasing the oppressed" Luke 4:18 and I am trying to be a sheep watching for the Son of Man,  the King who reminds us that when we serve others we are serving Him. "I was sick and you looked after me, I was in prison and you came to visit me." Matthew 25:31-46.

Friday I am back at the medical school pretending to be a patient waiting to receive "Bad News" from one of the 4th year medical students. My child has died. I am devastated. I weep tears.  I have a positive HIV test. They are nervous. I am in denial, I am angry and going to kill my husband, I refuse to get my result, I cry, I rage... you get the picture. Then we sit and discuss the interaction. Did they make sure they had the right patient, did they look me in the face, were they empathetic, did they make rash promises for a long life or a cure....or that surely God would give me another child.

Saturday I walk Terra with Jim at 6am. Nose to the ground she discovers an owl pellet and looking up we can see an owl roosting in a palm tree. Good dog! Back at home she jumps in the pool and lies down on the step submerging herself and gulping water. She shakes water all over us, leaps on the lounge chair and then onto the metal table. She towers above us standing upright.  Bad dog! "Down" I tell her. She lays down on the table and curls into a ball. I realize we need a new word, "Off."

Sunday we worship. The sermon focuses on the beatitudes; blessed are those who spiritually mourn over their lost and sinful condition, for they will be comforted by God's forgiveness and grace. I plant flower seeds in old plastic yogurt containers and harvest onions and avocados. Jim sleeps in the afternoon. Chris plays frisbee with friends and then attends the Baptist Fellowship where the topic of discussion is euthanasia. We talk about the lie of unmanageable pain over dinner.