Posts Tagged With: Jesus

Miracle at Tenwek!

Hello all!  Scott again.  I wanted to share a story from the medical ward. 

The patient I want to share about is a patient whom I will call Harrison.  Harrison is a delightful young man in his early 30s who came to us with considerable shortness of breath and hypoxia (low blood oxygen saturations).  After taking a history, performing a physical exam, reviewing his chest xray, and having his sputum evaluated in the lab, we diagnosed him with tuberculosis and started treating him for this.  Incidentally, his labwork revealed severe kidney failure.  The kidney has many jobs, including getting rid of potassium and maintaining an optimal pH (acid-base status) in the body.  Since his kidneys were failing, he had a profound elevation in his potassium, and was severely acidotic.  The cause of his kidney failure was quite unclear, and our investigation did not reveal a cause.  Unfortunately, despite our initial treatment approach, his kidney function had worsened the next day, and his potassium level and pH had reached dangerous levels.  At this point, seemingly the only available option was dialysis.  However, in Kenya, dialysis is only offered in two cities, and is extremely expensive, with few able to afford it.  I explained to him that without dialysis, I was worried his heart would develop an arrhythmia and he would likely not survive (this is what commonly occurs when potassium reaches his level), and his ECG was already showing abnormalities from his potassium. 

We next had a family meeting with his wife, brothers, sisters, and parents.  He and his family are primarily farmers, and were already in hard times financially as much of their maize (corn) crop had been wiped out by a fungus.  They determined that if they sold a few of their cows, they would be able to raise enough money for at least three dialysis sessions with hope for eventual improvement in his kidney function.  I hated to put his family in financial hardship, but he was so young, and I was really hopeful that dialysis would possibly be merely temporary if his kidney function improved.  I called the referral hospital in Eldoret, a city a few hours away to arrange the transfer, but they said it would be several hours before they would be able to accept him.

Next, I updated the family on the situation and told them it would be a few hours before he would be able to be transferred.  By this time, I had developed a nice rapport with the patient and his family and we discussed various other life issues, which was made easier by their excellent proficiency in English.  He and his family were people of tremendous faith in the Lord, and they were trusting God for a miraculous healing, and trusted that his will would be done.  Before I left, they asked me if I would be willing to pray for him.  Here at Tenwek, we commonly pray with our patients, but it struck me that despite knowing he was very ill, I had not taken the time to pray for this patient.  I proceeded to pray, and I must say, while praying something came over me.  It was as if words were coming out with such ease, and with more confidence than I had ever prayed.  I knew from a medical standpoint, based on everything I have ever learned and experienced, that urgent dialysis was needed.  Yet, for some reason, I thought God was revealing his glory through this patient.  After praying, I left and prayed again by myself for God to intervene for this patient.  I sensed he was moving, so I grabbed a needle, and lab tube, and went back into the patients room to re-draw blood to recheck his kidney function (even though we had just checked four hours earlier).  I brought the tube to the lab, and just waited in the lab for the results to return.  In my head I knew it was silly to expect his kidney function to suddenly improve without any intervention, but yet I held onto that glimmer of faith, that maybe, somehow, God was actually really going to intervene.

Anyways, 30 minutes later, the technician had finished running the sample.  He handed me the printout of his labs.  My eyes went right to his creatinine, which the lab we used to measure kidney function…the higher the creatinine, the worse the kidney function.   His creatinine had dropped by more than half, meaning his kidney function had more than doubled!  Additionally, his potassium levels had considerably dropped,and his acidosis was much better!!   I honestly could not believe what I was seeing with my eyes!  This sort of thing does not just happen.  With essentially little to no treatment, over those past four hours, his kidney function suddenly and rapidly improved.  There was no medical explanation for what I was witnessing, and only God could be behind what was happening.  I was so excited to tell the patient the results, however, on the way back to his room, I honestly was overcome with emotion.  I will admit that I found a bathroom, locked the door, and just broke down after experience the glory of God revealed in this way!  Finally, I gained my composure, and delivered some of the best news I have ever been able to share with a patient.  There was so much joy in that room, and we all gave thanks to God for what he had done. We cancelled the transfer to Eldoret as he no longer required dialysis.   I eventually left the room, did several fist pumps and was able to proceed with the rest of the day.  I will never ever forget those moments, and my faith continues to expand in new ways.  The Tenwek motto indeed was true…We treat, but Jesus heals!  I am happy to say that over the next 48 hours, his kidney function completely normalized, his potassium levels are normal, as is his pH.  Also, he was weaned off oxygen and is completing his TB treatment.  He returned yesterday for his 10 day followup from discharge, and continues to do amazingly well with absolutely no symptoms.  Praise God!!

As I left the hospital that day, a motorcycle taxi (called a boda boda) crossed the road right in front of me.  Many of the boda bodas will have a message of some sort on the rear of the bike.  This particular bike had on its bumper, “Jeremiah 33:3.”  When I got home, I read this verse which reads, “Call to me and I will answer you and show you great and unsearchable things you do not know.”  This was such a fitting verse to end the day, and I am sure it was God’s way of reminding me to continue to call out to Him, and he will continue to reveal himself to me in new ways!

Thanks again for reading and sharing with me in celebrating another Miracle at Tenwek!  I have another incredible story from just today of a really amazing recovery in one of our patients, but I will save it for another time. God Bless!

 

Scott

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Myself and Dennis, a Kenyan intern, rounding on the medical ward.

 

 

 

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A day at the hospital

Scott here.  Well, what an interesting, amazing, and crazy first few days at Tenwek.  First, if interested, the typical work day for me looks like the following:

7:30-8:30: Round on patients in the Intensive Care Unit

8:30 -9:30: Morning report.  Typically someone will give a presentation on a variety of medical issues.

9:30-10:30: Interns round on the rest of the patients.  We help manage the most acutely ill.

10:30-11:00: CHAI TIME!  This is a fun tradition here.  At 10:30 am every day, the hospital essentially stops and everyone breaks for chai which provides a nice break from the busy schedule.  The internal medicine team meets in a small room with the attendings, interns and med. students.  One of the interns typically opens in prayer and then we discuss any deaths from the previous day, as well as any important issues.

11:00-1:30:  We round on all of the patients on the male and female medical wards, usually 40-45 patients. Sometimes the wards are extra crowded requiring patients to share beds or even sleep on the floor.

1:30-2:30:  Lunch

2:30-end of the day: There are a variety of things going on in the afternoon.  I help the interns with procedures or issues, intermittently check on our ICU patients to adjust meds, ventilator settings etc., see patients in clinic or in Casualty (the ER here is called casualty).

Standing in front of the Casualty (ER) entrance.

If not on call, the day typically ends around 5:30-6:30, however, call nights are different.  At Tenwek, I am considered a consultant, which is the equivalent to an attending physician in the U.S.  Basically, that means I have a team of Kenyan interns and medical students who are admitting patients, placing orders, managing issues, and presenting the patients to myself and the other consultants.  Currently, we have three other consultants including two long term staff, and a visiting physician from Canada, however, our numbers will dwindle to two including myself within a few weeks, which will greatly increase the work load.

My first day was a whirlwind, with a high number of acutely sick patients.  Although the cost of medical care here is very minimal (a hospital admission may cost only 20-30 dollars per day),  this is still a significant chunk of their income, so they often present late in their illness as they try to avoid coming to the hospital.

We see a large variety of diseases here, some are similar to the U.S., but the most common diseases here, are  rare in America.  Thus far, I have seen a large number of cases of tuberculosis, several people with meningitis, and an extremely high number of patients with AIDS/HIV (probably >50% of patients) and complications from this disease.  We also have a high rate of esophageal cancer, rheumatic heart disease, and lymphoma among other various diseases.

Mural painted just outside the entrance to the men’s and women’s medical wards.

My first night, I was on call.  It was quite busy until about midnight.  I had several interesting admissions, most of which we were able to stabilize and they are all doing well.  One patient had a large pleural effusion (fluid around the lung) which was causing significant respiratory distress.  With pleural effusions, the initial treatment consists of performing a thoracentesis which is a procedure done to drain the fluid by inserting a needle/drain into the lung cavity to remove the fluid and allow the lung to properly function.  In the U.S., we have a kit that allows for fast and relatively easy removal by aspirating 100 mL at a time.  Here, however, the largest syringe we had available was only 10 mL.  She had more than 1000 mL of fluid around her lungs, so I had to draw out 10 mL of fluid at a time, and do this 100 times in order to remove enough fluid!  It took forever, but she was a good sport and was definitely feeling better afterwards.

Most other admissions that night, we were able to stabilize and improve.  Unfortunately, one of the patients that was admitted a few days prior, passed away.  I was actually walking by the medical wards, and a nurse grabbed me to inform me a patient was not breathing.  On arrival, he was not breathing and did not have a pulse.  With his family there, we had to inform them that he had died.  He was only 41, and likely died from complications of kidney failure, as there is no dialysis available here, and it is only available in a few cities in the country.  After informing the family and offering my condolences, I was amazed at their peace about his death.  This patient had been suffering for some time according to his family.  He was an active believer in Christ, and although his mortal body failed him here, his family knows that where he is going is so much grander than here.  He is going to be with the Lord, where there will be only joy and singing.  I called the chaplain, and we prayed together in English as well as their native Kipsigis tongue as this man went to be with God.

When I made it back to the guesthouse that night, I reflected on this patient.  Although I wished we could have somehow healed him, I rejoice in the fact that he knew Christ and is now in Heaven.  That night, I read Isaiah chapter 35 which really spoke to my heart about the reassurance we have in Christ, and the  joy of the redeemed that awaits this patient, as well as all who believe.   What an amazing visual picture of what awaits us!!

Isaiah 35 (starting at v. 5)

5 Then will the eyes of the blind be opened
and the ears of the deaf unstopped.
Then will the lame leap like a deer,
and the mute tongue shout for joy.
Water will gush forth in the wilderness
and streams in the desert.
The burning sand will become a pool,
the thirsty ground bubbling springs.
In the haunts where jackals once lay,
grass and reeds and papyrus will grow.

And a highway will be there;
it will be called the Way of Holiness;
it will be for those who walk on that Way.
The unclean will not journey on it;
wicked fools will not go about on it.
No lion will be there,
nor any ravenous beast;
they will not be found there.
But only the redeemed will walk there,
10     and those the Lord has rescued will return.
They will enter Zion with singing;
everlasting joy will crown their heads.
Gladness and joy will overtake them,
and sorrow and sighing will flee away.

Well, I think that is enough for today.  Sorry about the length of this post, I will aim for a shorter entry next time!  Whitney and I are off to a pig and goat roast now put on by the surgical residents.  We were invited after Whitney proctored their end of the year exam yesterday…should be interesting.

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