All in a Day's Work

So I've had some interesting adventures this past week that I thought you all might enjoy reading about. I am loving how doing something once or twice qualifies one as an expert, it was a bit disconcerting at first, but the experiences are great... and especially great stories to share :)


Breech Baby

I was kinda excited last Wednesday, as many of you saw from FB, to have delivered my first breech baby by myself... Emma was told by the ward staff there was a lady delivering breech. Usually JR would come for those sorts of deliveries because they are high risk and need to be prepared for C-section. But JR was busy in another specialized procedure... so guess who was sent in her place.

After a quick refresher on how to set up, Emma and I traipsed off to deliver this baby! I was super glad to have Emma there with me, especially when she started reading the text book on how to deliver breech babies ... oh the things that wouldn't happen at home!!! We were very careful to listen to our instructions and had the lady up in stirrups immediately... but the ward nurse reminded us it may be a bit of time yet and we probably wouldn't want to exhaust the lady just yet... Thankfully, we had just enough time to read through that portion of the text book about the different parts of the delivery when the mom communicated she felt like it was time to push....

yeah... did I mention I was excited before? Of course I was bathed once again in fluid. But the first part of the delivery went well. The body came out nicely, I didn't have to do too much.... everything was cool ... until I remembered that I couldn't remember how to get the arms out. PANIC .... there are only three minutes from the time the cord is out to the time the mouth comes out before the baby starts to go into distress. And the arms need to come out before the mouth can come. Yet again I was super glad that Emma was nearby and ran as soon as I said "I need JR". Just as she left the room tho I remembered how to pull the arms out over the baby's chest and was working on turning the baby to get the second arm out by the time JR came. Once the second arm was out, the head was the easy part that I remembered well what to do and definitely within our 3 minute time allotment we had delivered a beautiful baby girl :)

It was also especially exciting to be there when the nkaka came in to see her new granddaughter as the baby before had also been breech and was delivered in the village and didn't make it.

We discharged mom and baby girl Sunday morning and both were doing wonderful!


Weekend On Call

I learned how to do a lumbar puncture Friday (put a needle into the lower spine and draw out some spinal fluid). Unfortunately, the reason for this was a small baby about 7 mos was brought to us seizing. The baby seized for 40 minutes, which is a terribly long time, despite many doses of valium and a dose of phenobarb. But the hardest part was not fighting for the baby but watching the mom slowly give up hope. She brought the baby to us crying, and at first she was standing nearby watching everything. Maybe the nurses asked her to move back but not too long later she was sitting on a stool on the other side of the room looking completely hopeless. Even after we settled the baby and he was sleeping (drugged up on the valium) when I brought the mom over to sit with her baby she seemed completely detached.

It was special to go in the next day and be greeted with ecstatic smiles and thanks by mom holding her living baby. We're still not sure what caused the seizure... and we can only pray that there are no long term effects from the length of the seizure, but am very grateful to see both mom and baby doing well.


Saturday, I delivered my first 'normal' delivery. Up till now, all the deliveries have been high risk ones- twins, breech, prems. So it was cool to work with the ward nurses and deliver a healthy baby boy.

Saturday evening I received a call to come up to assess a referred patient who had dove into the Zambezi, hit his head and had a possible neck fracture. Rebekah, the ultra sonographer, and I went up and assessed the patient and did x-rays and then called Tanis and Dr. David to come take a look. It was determined that he had a c3 and c5 fracture and definite paralysis from the waist down, so into a neck collar and brought to the ICU for monitoring.

On ward rounds Sunday, Tanis decided that he was thrashing his head about way too much and he would benefit from skull traction. Especially as he was not listening when we explained he need to keep his neck still so as not to do any more damage.

So, after church Tanis and I with the help of Rebekah and then Emma returned to hospital to put our patient into head traction. What an involved process! The set up alone took about an hour and just when we thought we were ready to go we realized there was more to be sterilized which added another about 20 minutes to the whole process :S Considering the amount of time to set up, the actual procedure was relatively straightforward... oh, until we realized we needed pliers for the screws :) Tanis and Emma stayed with the patient, while I slipped out to Shawn n Rhonda's - the nearest house that would have the tools we needed ... again thinking... oh the things that would never happen back home :)

We set the traction up and settled the patient and then left. I received a call a few hours later. "Sister, the patient is gasping" I made it up there to see the patient was in fact cheyne stoking (irregular breathing pattern preceding death). It wasn't too much longer after that, that the patient did pass away. It is hard to try so hard to help only to watch a patient slip away and know there is nothing that can be done about it. But there were so many things against him- the location of the fracture, the crazy high fevers, a history of alcohol abuse and the signs of withdrawal. In one sense it is a blessing, he'll not be pinned to a chair or a bed all his life (he was only 34) but where is his soul now? Did he have a relationship with God? Did he know Christ as Saviour? Right now, only God knows, but how much more reason to share with people how much God loves them and that He wants them to come to Him and accept His Son as their Saviour!

When the Doctor is Away

This same night I was called up to hospital once again for a patient emergency. We had a lady with placenta previa who has been monitored in hospital for about a month. We've been hoping to get her baby as close to full term as possible before she delivered. Things were taken out of our hands when she started bleeding. So thankful to have Rebekah here as she came up and scanned our lady and determined that the bleeding was coming from where the placenta had begun to separate from the wall. Of course, the doctor was away for all this fun otherwise it would have been an emergency c section without question. After much discussion- all via txt (aren't we technologically advanced), and after an emergency call to the doctor, it was decided this lady needed immediate attention and required an emergency transfer to the nearest hospital with a doctor.

Since it was 730 at night, it was decided that it would be more efficient if Tanis and I went with the patient to Chavuma MH, 2 hrs away; Tanis driving and myself in the back of the truck with the patient. It was quite an experience! About 10 minutes in I realized the blood transfusion we had started wasn't transfusing any more, so for the next 1/2 hr on a very bumpy dirt road and in the dark I struggled to figure out what was wrong with the IV and how to get the transfusion working again. There was a valve inside that the cannula was resting against and after some repositioning it was working again but I had taken all the tape off the IV so for the remainder od the two hr trip I had to hold the IV in place while monitoring the transfusion and the patient.

We made it there in good time and the patient received her section, but we found out the next day that baby didn't make it. :( Its too bad, but she was only at 29 weeks and that's a struggle back home never mind here.


It was quite an interesting experience tho and a great learning opportunity. I am learning to be prepared for ANYTHING! All in a day's work!