These past few weeks have been pretty interesting.  The surgeries are coming close to the end with the last surgery being on June 1 because we want to give the last surgical patients several weeks to recover and heal before the ship takes off to its next destination.  Time is flying by and I'm trying to really appreciate and soak up everything here, but at the same time its hard not to anticipate coming home a little over a month from now and seeing friends and family whom I haven't seen in nearly four months.  I really am going to miss the Togolese especially all the kids and babies so it will be bitter sweet.

60 minutes has been here all week because they're going to show a short segment on Mercy Ships in October.  Its kinda funny how they do hours and hours of footage and have been here for several weeks, while they only plan on showing less than 20 minutes on Mercy Ships during the episode.  There's definitely a ton of work that goes into their show.  The host of 60 minutes came today to interview my charge nurse Ali who has been volunteering with Mercy Ships for several years, Dr. Gary, and Don Stevens the founder of Mercy Ships who also flew in for the interview.  They've been following several patient's stories so it will be interesting seeing which patient they choose to aire.  They're extremely intrigued by the whole blood donation process because when we give blood it usually goes directly to the patient within five minutes instead of waiting in a fridge so they were really hoping to catch some footage.  One of the filmmakers was shocked when he saw Esther's before picture and couldn't believe she was the same person. 

Esther still has a long way to go though.  They've been downsizing her trach all week and were finally able to officially remove it yesterday.  She can now talk although her voice is quiet and it takes quite a bit of energy whenever she says anything although she has been making tremendous progress.  When she went back to the OR last week to get her whiteheads pack(gauze packing with antibiotics) removed, Dr. Gary decided to do another flap on her to make her "prettier".  He also decided to give her more of a nose since he had extra tissue to work with.  She looks absolutely amazing although the finished product won't really being complete until at least 6 months from now.  She has quite a bit of extra skin which isn't taken off initially because over a period of six months the skin contracts back to the way it used to as it does after someone has a baby or loses weight.  If it is removed too soon it would cause major problems and could make her skin way too tight.  It will also take time for the skin to change back to its original color that had been changed from the stretching over many years.  The next time Mercy Ships comes back to Togo or a country close to Togo she will qualify for an ICBG(iliac crest bone graft).  This is when part of the hip bone is taken and placed over the titanium metal plate that replaced her mandible from the mandibulectomy.  Bone miraculously fuses to titanium which then adheres to the tissue on her chin.  This is necessary because over time the titanium rubbing on chin tissue causes friction and can actually come through the chin and become visible.  If this procedure is done initially the hip bone transplant would likely fail because the previous tumor would prevent the site from being sterile.  Therefore, she has to wait at least 6 months to get this procedure as well as then get any extra skin also removed.

As far as patients having any real complications I believe we have been really blessed this field service.  However, one patient sadly did pass away last month named Chantal who was only 25.  Towards the end of her life she had been placed on hospice because of a chronic disease that had taken over her body and everything we were doing just wasn't working.  It was quite difficult for some of the nurses who had grown quite close to her.  She came from a family that was really involved in voodoo and had a daughter who was only 4 years old.  I was told though that she had accepted Christ just two weeks before she passed away so even though her physical body wasn't healed perhaps she spent the last few weeks of her life on the ship for a bigger purpose.

A complication did start to develop with a patient named Esther, a different Esther.  This Esther had a cyst drained above her left eye.  She had been a patient of Mercy Ships in 2010 so she was chosen to receive this simple procedure.  I arrived on shift and was quickly told by my one of my roommates that there was a patient in PACU who had been unresponsive for over 5 hours and the doctors didn't know why.  They had completed multiple tests including a head CT and had pretty much ruled everything out.  I looked down on my assignment sheet and then realized that she was going to become my ICU patient.  I started getting a little nervous especially because no one really knew the reason on why she wasn't responding to any stimuli.  During each handover all the nurses and day workers gather around in prayer for our patients or anything else we want to pray about and we also discuss any announcements or things we need to work on with charting ect..  I usually avoid praying out loud in front of large groups of people, but every blue moon I get a really strong feeling to pray for certain things with other people.  This time it was for Esther whom I was about to have as my unresponsive patient.  A couple other nurses also prayed for Esther.  Then literally about five or ten minutes later one of the PACU nurses comes in and reports to us that Esther has just woken up without explanation and is fine now and the doctors can't explain it and are baffled.  We then half seriously and half jokingly told the PACU nurse well we did just pray for her.  One of the doctors then came up with a syndrome that I've never heard of that basically is caused by a reaction to one of the muscle relaxants she received during the procedure called central anti-cholinergic syndrome.  They then brought her over to me about 15 minutes after that and my whole shift I didn't have any issues with her.   I happened to see her joyfully leaving the ship yesterday to go home and we waved to each other as she was leaving the ships entrance.  Perhaps it was just a coincidence that right after we all prayed for her she came out of it, or maybe God really did answer our desperate prayers that she would be healed.  Either way though I'm happy that God healed her and she was able to go home without any complications.

Mother's Day Suprise!

Thank You Lindsey!
Around the world Hugs and Kisses,
Love You,
Mom

VVF Dress ceremony

B ward has been taken over by all the VVF(vesicovaginal fistula) women this last month.  I work on D ward with the maxfax patients so I haven't had the opportunity to work with them.  However, I was able to witness one of their dress ceromonies which they have one to two times a week.  It was incredible.  They all looked gorgeous with beautiful brand new dresses and hats with matching jewlry and earings and even some makeup.  They have dress ceremonies whenever a group of them are deemed "dry" meaning the surgery worked and they are cured.  The women are also given the opportunity to recieve a mirror, soap, and a Bible in their language.  The women all shared their testimonies many of which included years of praying that they would recieve a cure.  Many of these women have been shunned by society, left by their old husbands, and sometimes their own family.  It was quite a site to see all these women smiling and dancing.

Esther

There is a girl from Nigeria, sixteen years old, who we have been expecting and were told was coming last week.  She is one of the few patients who we know will go to the ICU straight from surgery because she would likely need a tracheostomy due to the tumors occluding her airway.  All the nurses were asked to start praying for her last week and we were told her name is Esther.  She is a special case because she will be getting both a mandibulectomy and a maxillectomy because her facial tumors have been growing in both places.  They started when she was 3 months old and now she is sixteen.
Yesterday my roomate and I went outside on the dock and stopped by the admissions tent while we were waiting for one of the jeeps to arrive so we could visit the Hope Center.  We started talking to some of the patients and then my roomate immediately put two and two together and noticed Esther.  She immediately said Esther, your name is Esther right!? She told her we have been waiting for you and praying for your surgery and are so glad you're here.  Esther smiled and gave us both hugs.  Since she's from Nigeria she could speak English which was very very nice.  We talked to her for awhile and found out she has a very large family with six siblings.  She was wearing a very pretty dress and flower flip flops with a colorful scarf around her face.  She said she couldn't wait to go inside the ship and we assured her it shouldn't be too much longer. They just had to clear out the other patients and clean her bed.  Later on in the night my bunkmate and I peaked in the wards to say a quick hello and wish her well for her surgery.
So right now she is still in the OR getting worked on by Dr. Gary who just had his 60th birthday a couple days ago.  I was told that the mandibulectomy went well and now they're working on the maxillectomy which is more complex.  She's been in everyones prayers all day and I can't wait to see her after surgery and talk with her in English.  I work four nightshifts starting this weekend and hopefully will get to have her as my patient.