“Pickles and ice cream, please.” I have been waiting to actually hear a pregnant woman ask for this combo, but I may be waiting for many years. While we are on the topic of pickles, I thought I would tell you about some.
Sick patient. Check. Surgeon. Check. Gowns. Check. Laryngoscope. Check. Light to laryngoscope… not functioning. Laryngoscope: appears to be a mid evil torture device, but is used to see the back of the throat to make sure you put the breathing tube , for surgery, into the lungs and NOT the stomach. Not a big deal to have a light bulb go out, unless it is the only one in the hospital. Next step, checking all the broken laryngoscopes for a functioning bulb. We found some bulbs that worked, but they didn’t screw into to light socket. They were all either too big or too small. Solution: pull a MacGyver. Since we didn’t have any duct tape we used surgical tape. The light bulb then screwed in perfectly. We taped it into place on the outside for extra support so she wouldn’t ingest the bulb and got started on the case.
There are many things here that are solved via a MacGyver move, but many things cannot be taken care of with duct tape, a safety pen and a piece of gum.
Another problem is not being able to appropriately monitor a baby during labor. It was not uncommon to lose a baby during labor. Let me just clarify that most of the babies that die come in dead, but we also lose them in labor. In the last month, we have had three babies, three beautiful, healthy babies, saved because of being able to monitor them during labor. When I first arrived at Otona hospital the only way to monitor the babies was using a pinard. You put one end on your ear and the other on the mother’s belly. Then, some dopplers were donated and an electronic fetal monitor (this means you can watch the babies heart rate over a period of time, not just listen with your ear, but see it). When I left the hospital I brought the fetal monitor with me to the Christian Hospital, so now they don’t have one.
Back to the good news.
Two survivors, were a mom and her little girl that we had to deliver at 30 weeks because her mother was very sick. We had induced mom because she was so sick and the treatment/cure is delivery. The baby was doing great and then suddenly everything changed. We were able to get the mom to the operating room in a short time and out came a little girl weighing in at three pounds. She has been an amazing fighter. She on medications to remind her to breath, she has had some problems maintaining her temperature, she developed an infection, is on medications to prevent seizures… BUT I think she is going to make it. She is now 2 weeks old and up to 3.4 pounds.
If you are not medical, you may not want to read this paragraph. It isn’t gross it is just explaining the medical condition of the mother. The mother had developed severe preeclampsia at about 27 weeks and we had been watching her for over two weeks when she went into HELLP syndrome. When I opened the mothers abdomen for the c-section I was met by a massive hemoperitoneum. Blood was just pouring out. I couldn’t clear it fast enough to even see the lower uterine segment. Finally, I just swiped the uterus with the sponge and cut where my memory told me I should. I was asking for blood for the mom and all I could think was we are going to lose her. I was scared the mother had gone into DIC, had a uterine rupture or had a liver rupture. I got the baby out and we suctioned out the blood. The uterus was completely intact, except for my incision. I closed the uterus as fast as I could. The incision and uterus weren’t bleeding that much, so I figured she wasn’t in DIC. I had done a pfannenstiel incision, so I couldn’t see the liver. I felt around the abdomen softly. The bleeding, where ever it had come from had stopped, so I closed her up in order to get her out of the OR. From my reading, I think she had a liver rupture or tear in Glison’s capsule. I will never know because I didn’t look. Scary. Then and now. Mortality for a liver rupture with the best of care is up to 60%. Somehow her body took care of whatever the issue was. It may have been the prayers that were going up. It may have just been God’s hands, I know it wasn’t mine.
Another baby was showing signs of distress and the midwives were able to do a vacuum delivery to expedite the babies birth. Healthy little boy. Dr. Mark was also able to do an emergency c-section to save another, now, healthy baby.
Sophie Ness, Dr Mark and I have been doing weekly classes with the nurses and midwives on how to monitor the babies while the mom is in labor and looking for signs of distress. Most of the work for this class was done by Sophie. She made books explaining the patterns, found strips to review and made tests. We just finished the coarse this week. The difference in the 2-3 months of class has been huge! We are now getting calls that aren’t just the baby is stressed, but accurate descriptions that help us know if we need to run or can walk to the hospital. It has been so encouraging to see this!!!
Otona Hospital still does not have electronic fetal monitors. They do more deliveries and are taking care of the poorer and sicker patients. A lot, not all, but a lot of our really sick, scary patients have been transferred to us from Otona. The doctor there has asked if I have a fetal monitor they can use. We are always using the ones we have at the Christian hospital, but I would love to be able to give them two monitors. I found a monitor that has good reviews and looks like a perfect fit. One monitor is only $1400 plus shipping.
I went ahead and bought two on faith. I do NOT have the money in my personal savings accounts to pay for these, but you all have been faithful in giving, so I know the money will come in. Thank you for all that you do!!! To help look at the right of the blog. There is a link to donate or an address if you prefer to send in a check.