Last Blog from Honduras

Today is our last day here at Loma de Luz. We spent the morning with our little Miguel. He had not been washed since arriving here at the hospital and boy was he "ripe". So, we washed and scrubbed him up and then were able to fix his hair in his MOHAWK! He was so cute!

We spent some time taking pictures and saying goodbye. We just heard that his mommy is coming down with something and has a fever, so pray that she heals soon. She is going to get to take Miguel home in a couple of days and she will need all her strength. Remember, she has 3 other little ones that cant wait to see her!

MIGUEL ROCKIN HIS NEW DO!

We have some other highlights from the trip that we have not written about but have been very memorable. Spending time at the Church in Marguerita is always a blessing. This is the building that past trips has been a focus of our work groups. The kids are so fun and it is fun to see them year after year. They love our cameras and we always take lots of pictures of them.

This is a great story! A very pregnant woman, whose older kids come to the church, had not had any prenatal care. She was on her sixth pregnancy and thought she should of had her baby in August. Penny, as a gift, told her that John would give her an appointment for free and she could hear the babys heartbeat. The woman agreed and thanked Penny. The following day when Penny arrived to pick her up, she stated "Its too late. I think the baby is dead and I'm bleeding." Penny explained then that it was very important to go and see John so she loaded her up in the truck and brought her to Loma de Luz. When John did an ultrasound, he only saw one head but he definitely saw two spines! Off she then went to La Ceiba where, after waiting all day in a hallway, she had a c/s for twins. Two girls! We visited these two cute babies when they were about 6 days old. 5-1 and 5-12. We cant wait to see them next year as 1 year olds!!!

Well, as our trip winds down, we want to thank all of you who have been following these posts. We have felt your thoughts and prayers while we have been down here and we are ready to come back home to be present with you. Continue to pray for this place. There is much sorrow and struggle, but as much love and joy! What a great people. They deserve Hospital Loma de Luz and we are so glad we have been able to be a little part in it!

We leave in the morning to head to San Pedro Sula. Our flight is at 9:15 pm so we have the whole day to travel the 4 hours and make some stops along the way. We are driving a young nurse back to the airport too. She leaves for the states the following morning. She arrived the same day we did and was able to help us with our sick babies! Looking forward to spending the day with her!

All our love,

The Team

Good bye Baby Elder

Elder Yasir Rivas Ulloa

Aug 5-Sept 29, 2010

We sadly said goodbye to baby Elder today at 3:39 pm. He lost his battle for life on this earth but is now in heaven where he has no pain or sorrow. The picture above is of his sweet little mommy. Her name is Ludin Ondina Ulloa. He was her first baby and she is grieving deeply. He was doing so poorly today and plans were in the works for a transfer. The red in the IV tubing is Ambers blood. She was able to donate blood for elder because his counts were so low. His little body was not able to maintain good oxygen sats and we were trying to get him a little stable so we could transport him to La Cieba to a pediatric intensivist.
We are all very sad. We worked hard to help Elder and were hoping for another miracle. None was to come. With all of Elders chronic problems, in a country that has very little resources, God said "I have a better place for him" and took him home.

This picture we took early in the day today. His grandmother (aubuela) wanted us to take some pictures for the family so we will stop in La Ceiba on friday on our way to the airport. There is a photo shop there and we will print out all our pictures of Elder. We are glad we got this one because he was resting comfortably. So, our pray is now for Elders mom and family. Please pray with us.

The Team

Ninos

This is baby Elder. He is a 2 month old baby boy that was born approx. 4 weeks early via cesarean section. His mom says that the midwife was "manipulating my organs and made me bleed". So she had an emergency c/s. He was born with a congenital disorder that causes his body not to make thyroid hormones. If caught early, the prognosis is not too bad, lifelong maintenance doses of thyroid hormones. If not detected, this is the result. Elder is only 4 pounds. His head is very small and his brain hasnt been developing. He has large open fontanels (soft spots)and a large tongue. He also suffers lethargy and, what brought him to the hospital, constipation. When he showed up this kiddo was "full of it!" Unfortunately, we have not been successful in getting "it" out. Tonight he took a turn for the worse and developed a small arrhythmia and had an increase need for supplemental oxygen. We are praying hard for this little one. We are asking for another miracle. We just watched one with Miguel! Why cant we have another? We were able to get a name of a pediatric endocrinologist (thanks Greg!) so the pediatrician down here can consult and hopefully find the best way to care for this little guy. So, we will keep you all updated. Elders mom is a 16 year old girl that has been here by herself for the most part. Tonight she cried so hard it would have broke your heart. Pray for her too.

Well, now on to the fat and juicy baby! Miguel is doing so well. We are so happy to see his progress. Today he cried and got mad when his food didn't come fast enough or if he was uncomfortable, just like a healthy normal 20 day old baby! These pictures say 1000 words. We will remove his arterial line (the one in his head) tomorrow and give him a bath. I cant wait to fix his mohawk and take pictures! Oh how we love this baby. When we raise funds for this mission trip we do it with the knowledge that God has a plan for the money and we see where the need is greatest. Well, after making sure the hospital was reimbersed for his oxygen consumption (6 big tanks at 100 limperas (about 55 bucks) a piece, we turned our attention to his hospital bill. Hospital Loma de Luz is the only private hospital that doesn't charge patients prior to admission. Miguel would have simply died if that was how they cared for the community. His family is so poor that besides the clothes on their back and maybe one extra set, the only thing they own is a small dog (which fends for herself) and two chickens. The hospital does charge its patients for care but does it with the knowledge that some bills will be paid in other ways than with cash. They can do work around the hospital grounds to pay back a bill. Some provide some of their harvest to the hospital kitchen to feed other patients. It is a good system that allows the local people to be responsible for their care, yet allows them the kind of care they would never be able to afford otherwise. Miguels bill up to today, without oxygen charges, is $471.74. An amount they could never pay. Miguels family lives 6 hours away (all by foot) and could not work this bill off. Nor do we want him to sell his chickens to pay his bill. They will provide eggs for the family (food for Miguel). God did not spare his life to have him starve or be malnourished. So, thanks to all our great financial support, his bill will be paid in full. Thanks to all our great prayer support his life has been saved! What a blessing you all are. From the bottom of our hearts, we thank you. I wish you ALL could be down here to experience this time. We all miss our families and are looking forward to seeing them, but wouldn't trade this time for anything.

The Team

Baby Elder

Just a quick note. Please pray for baby Elder. He is the two month old baby with congenital hypothyroidism. He is 4 pounds and has gained no wait since birth. He has a long list of problems but right now he is struggling. He is having difficulty maintaining his Oxygen sats. More info later. I will post pics. Just PRAY!
The Team

Womens Clinic Pics

These are some pictures of the womans clinic in the Cayos Cochina. Beautiful locations, filthy building. Hey ladies...How would you like to have your next annual appointment here??!! By the way....NO stirups :0

The adventures of Ricardo

Richard has been very busy this week so far. We have updated you on so much, but this post is dedicated to Richard and his adventures. The biggest project that Richard has been working on is making steel covers or lids for vaults that contain water controls on the hospital grounds. The old vault covers were chunks of 4x6 beams

that spread about 6 across. They were really close to becoming "tank traps" because the termites have eaten 3/4 of the way through them! John had steel waiting when we arrived and Richard got straight to work. He welded a frame with some braces for strength and then covered the frame with a sheet of steel. A key hole then was cut with a torch for access. He has done many other things as well. He has spent time

with his amigos in the bodega(shop)helping out and specifically helped repair a plainer. In the hospital he has already fixed a toilet and an air conditioning unit. He came to Pennys rescue one night and fixed her flat tire (The roads here are so bad, flats are common). Lots of welding still to come. He is going to make some catch basin grates and whatever else comes up which we know will be lots! Please pray for Richards safety with all his projects!
The Team

Cayos Cochinos

So, we returned from the Cayos yesterday at about 2pm but I will start from the beginning. We left Thursday about 10am from the beach close to the hospital. A boat came and picked us up and took us across to the Islands, about a 30 min. trip (8 miles). We arrived at the home of Lori and Hoss and loaded our personal stuff into their casita (small guest house). Lori and Hoss live full time on the island. They are retired and built a beautiful home overlooking the ocean. We were in paradise! Then we took our medical supplies and headed by boat for the clinic in the next cove over. The clinic was basically a concrete building at the edge of the beach. We opened it up and then spent an hour or so cleaning it up. Eventually, a few patients arrived and we spent some time doing pap smears and treating minor ailments. We closed up about 4 when we were sure we would have no other patients that day. These people are really poor and there health care is minimal. We arrived by boat back at the casita of Lori and Hoss and had a little time for R and R. The three of us actually were able to do some snorkeling using some equiptment our hosts had. the reefs are so beautiful and life is abundant under water! It was really fun and I feel blessed we had some time to just have fun! The next morning we were back at the clinic but all our patients were on the mainland because of the arriving tropical storm Matthew. So, we closed up the clinic at about 10 am and waited for our ride back to the mainland until about 12. When he arrived he had a load of supplies for one of the other islands. Its name is Chachuwatu and is the size of a soccerfield. The island is wall to wall huts and one "tourist type" restaurant. We were able to see the island on the way back because the supplies were for the restaurant. It was really tiny but beautiful. So.... as the storm started rolling in, we were on our way back to higher ground. It began to rain on the boatride and we were all soaked but if we would of left an hour later, it would have been much worse. So, the Lord continues to care for us. Now, as we land at the beach, Penny is picking us up and says "we have to go to the hospital, Baby Miguel is going to pass away.". This is such a change from when we left. We were aware that he had been re-intubated. But, thought he was doing ok. We arrived at the hospital wet from our boat trip and went strait in to see him. He was once again in his mothers arms with just mask oxygen and he was doing fine. Good pulse, good oxygen sats, rooting around acting like he wanted to eat! So after about a half hour of watching him fuss his mom lifted her shirt and put him to breast!!!! At that point we just held the oxygen tube to his face and let him nurse. It was beautiful. This is a baby who is dying??!! What a roller coaster! So, we put him on a nasal canula for his oxygen, turned it way down and watched him act like a normal 16 day old. Still, a miracle. Now it is Saturday. We just returned home from the hospital and I am happy to report he is still stable. He is just starting to get feverish and his respirations are increasing, but we got an order for some tylenol and that should help. He is still such a sick little baby, but he continues to amaze us. Thank you all for all your prayers! Keep praying. Gods not done yet! Richard continues to be Mr. Fixit and is repairing everything in site! God is blessing our time down here this year with miracles and adventures!!!
The Team

PICS

Well, I have figured out how to get photos on the blog, now I still have to figure out how to put on a caption. So, These are pictures of Miguel Angel in reverse order. The first pic is of him when we were expecting him to die. He was placed in his parents arms and lived! the next is when he was intubated and the last of him was how he looked when we first started taking care of him. The very last pic is a picture of some of the local children that came to the church when Penny had music practice. They all come to hang out and play on saturday afternoons. Somedays they have up to 30 local kids!! They are beautiful.

Off to the Pig Islands

Well we are happy to be writing you in the morning after sleeping in the night instead of the day! Baby Miguel continues to be a miracle! He was doing very well in the night. We had a 3 hour shift. Because his care in less intensive, some of the missionarys are "signing up" for shifts. He is LOVED! Rosa, his mother, has been pumping to provide him with breastmilk which is the best medicine ever! He is tolerating feeds and continues to have No blood in his tummy.
This morning we are setting off on an adventure. We are traveling by boat to the Cayos Cachinos, The pig islands. They are 6 miles off shore and we can see them from John and Pennys house. We are traveling there to operate a clinic for women. We will be doing what we consider to be annual care, for them its for the first or second time. Also, we will be conducting prenatal exams for all the islands pregnant women. Richard will be his typical Jack of all trades and probably fix everything on the islands!!!! Well, update and pics when we get back!
The Team

MIRACLE! (please read previous post first)

Miguel and God decided he NO longer would like a breathing tube and he pulled it out with a quick jerk of his head. So.....we prepared. His heart rate went down to 60 and his oxygen level down to 50s-60s. This was the end. Sandy was present and we had all just had a long talk about what to "do". There are so many issues down here. He was not doing well. We found blood in his stomach and stool. He was not improving. Then you have to think about the family. They walked 6 hours from the mountains to get him help. They left their 3 other children at their home in the care of their pastor. If he dies, he must be burried in 24 hours. They would have to walk home with a dead baby, possibly in the middle of the night or maybe he heals but has subsequent disabilities from his low oxygen levels durring his illness. Lots of things to consider when choosing what to do. So, we called his pediatrician to come. We sent Penny to locate the Miguels dad. Sandy ventalated him with a bag and mask to try to keep him alive until the father arrived and we could speak to the parents together. We all cried and began saying our goodbyes to our sweet Angel. Then, the miracle. With the baby in dads arms supported only with an oxygen mask....He kept his pulse and oxygen levels up at normal. We were waiting for him to fall into the arms of his Loving Creator, whom he belongs to anyway....but he kept breathing..his oxygen level stayed up...his cheeks stayed pink and we all stood in amazement. MIRACLE - in front of our own eyes! Now, as I write this (actually I wrote this at 8ish this am), Miguel Angel is in the arms of his mother (something that has not happened for 6 days) and in the hands of his heavenly Father (something he has enjoyed since his life began). We wait. Will this miracle last another hour, day or lifetime? is he still here so his momma can hug and kiss him and say goodbye in a beautiful calm way? is he here because the Lord has big plans for him? we do not know nor do we pretend we have the answers. It is just a miraculous reminder the God is in control, not us. We get to participate in his story however. It is sometimes sad, sometimes happy, always miraculous.
God Bless you all
The Team

quick update. It is 930 pm and Amber and Lori are heading down for a short shift with Miguel. Yes, he is still with us. Doing well at this hour. Still cant tell you what Gods plan is with him, but we are along for the ride! Thank you for your prayers.

What a couple of days....we mean NIGHTS!

Recap of night #2 with Miguel Angel:
Our 12 hours with Miguel started at about 5 pm on the 21st. He had been intubated (a tube into his lungs) and he was being manually ventilated (someone sqeezing a ambu bag to give him air). So began our night of "bagging". The plan was to take turns through the night bagging. We planned to take 2 hour shifts (Amber and Lori) so that we would beable to get some more rest. We had only slept for 5 hours since our first night shift, so at 11 ish, the "non bagger" would sleep and then be awakened to switch. This was very difficult on the bagger. Knowing that if you fall asleep, the baby will not get air is a good motivator though. Still, it was hard but well worth it. We also didnt know if we would be relieved for day shift so some sleep was impairative. The night was lon but thankfully we got some day relief at about 7am. A honduran nurse (equiv. to an RN) was available to come in extra and be Miguels 1:1 care provider. After instructions in spanish (not very good:)) She understood and we were able to leave knowing he was in good hands. Dr. Sharron the pediatrician would be around and Sandy the nurse anesth. also. When we arrived back to the house, Richard was getting ready for work...Oh yeah, did we tell you Richard is working??!! More on that later!:) Well, apparently we were tired because we slept for 7 1/2 hours! Woke up at 430 pm feeling well rested. Thank you Lord!
Now, on to night #3 with Miguel:
We started our shift a 7 pm. Sandy was here and our report was that the baby was stable. No fever durring the day. He was requiring less oxygen but fighting the ventalation (good...but requires more taping and ajusting) We would like him to rest as much as possible until we extubate him, but he is a fighter and we love that about him. So the night went like this: We bagged him. Both Amber and Lori stayed up (again...well rested!) and we prayed. At about 2 am, his IV stopped working. Dr. Sharron came down after we attempted several times to get a new IV in and she tried too. Unsuccessful, so the question was...Do we place a central line? Our answer was yes. The real answer was maybe. Will the baby tolerate a proceedure like that. Will it change anything? Also, we found blood in the babys tummy. Not a good sign. So, baby Miguel got a hair cut for Iv access in his scalp. He has the coolest mohawk you have ever seen. Makes him look TOUGH! He has been receiving his antibiotics intra-muscularly and his feeding was turned off. We worry that he isnt getting any fluids. By morning, our relief arrived in the form of a nurse from the states who is here with another team and did not intend to do any clinical care. Her team is painting and repairing doors in the hospital. Not her though. She was a little nervous to care for such a sick baby since she has been in administration for many years but we reassured her and set her up for a good day. Then, it was time to make a plan. What do we do from here. How long can we keep this up in light of the fact we are supposed to travel to the islands tommorrow for clinic x 3 days. We knew we would have to cancel that trip or just one of us go....we couldn't just leave him with no one to bag him and just let him die because we had other plans. We were over his bedside explaining this to Penny and then it happened. Miguel Angel extubated himself (pulled out the tube.).........

Quick Update

I have lots of things to say but dont have enought time to say it all. Baby Miguel Angel is stable. Maybe doing better but hard to be too optimistic. Continue to pray. He is getting some breastmilk through his feeding tube now and his xray today looks much better. Hopefully extibation in the morning. We will write a full update tomorrow. Thank you all for your love and prayers. I could "feel the love" last night. Blessings, The Team

Bedside Vigil

I am composing this thought at the bedside or our now 11 day old pneumonia patient. His name is Miguel Angel. He is a beautiful Honduran baby with lots of dark hair and big eyes. He is so sick. I learned his name today so that if he dies, I want to say I knew him. Amber and I are praying hard and doing all we know to do to help him and he is fighting for his life. It is 1:35 am and Amber and I cant leave his bedside. We have been here at the hospital all day already. We were able to sneak a quick nap in this afternoon...I know what your thinking....NAP?! Well, let me tell you it was much needed. Since my last post, Amber and I returned to the hospital in the evening to respond to a crisis with Miguel Angel then we went back home for 2 hours of sleep. Up at midnight to return to help John with a delivery (Healthy baby girl at 0105 9/19) then back home for a few more hours of attempted sleep (Amber had Richards snoring, I had a monkey howling at me all night!). Up at 0730 to head back to the hospital....Whew! So, we needed our nap! Ok, back to baby Angel. He has continued to decline with more episodes of decreased oxygenation and color changes. We have to "bag" him in order to bring his sats up and we have had to do this more and more. God brought us to Honduras for baby Angel. Of this I am sure. The nursing care here in Honduras is very different than in the states. the Honduran nurses do NOT have the same training as we do and are unprepared to care for such a sick baby. Plus, they are incredibly overwhelmed with patients currently. It is now 0206 on September 20th. He is doing better. Equiptment down here can be unreliable. You have to make due with what you have. we were using a very old and used baby saturation probe that only gave us an accurate reading when the wire was in one place. Very frustrating when you have such a sick kiddo. Richard went on a hunt and miraculously found an adult finger probe that, with some manipulation by Amber, worked much better. Now, we are running out of O2. The oxygen compressors which are supposed to produce 5 liters dont appear to be working that well. Everytime we have weaned Angel to 5 liters or less we try to switch to the compressor to conserve the cannister oxygen. When we do, his sat levels drop and we have to start all over again. So, he has to stay on the cannister O2 and we pray it will last until someone brings the new full cannisters. 0520 am, Making progress with Angel. We just had to leave him alone! He is septic (infection is in his blood) so stimulation causes him to desaturated. Sats are stable however, when he is resting and not stimulated. He is even sucking on his oral catheter (a tube into his mouth down to his stomach). What a good sign. A little ray of hope. Thank you Lord. Now if we can just keep the Honduran staff from messing with him! So, now it is 4 pm on the 20th. Amber and I slept from about 930 to 2ish. When we left Angel, the pediatrician was in and our replacement was an american nurse anesthetist (sp?) so we could sleep well knowing he was in good hands. But, he also wasnt doing as well he had been because of all the morning noise and activity. (blood draw, xray, ect.) Quick report from Richard is that he is fairly stable. We will be heading down soon to check on him. Our prayer is for healing for baby Angel. This is a hard place to live and he is strong, but he is still just a newborn. He needs all our prayers. The Lord has a plan and we are fully ready to participate in the plan as he sees fit. We just so want that plan to be healing. Well, this is the end of a very long post. I tried to import pics but with no success. Will definitely be checking with my geek friends to try to figure it out. Have lots of pics to share so far.
Hug your children, kiss your family, and count your blessings....The Team

Busy, Busy, Busy Day

Whew! Day one is over and my goodness it was a busy one! Amber and Lori hit the ground running this morning and spent the day at the hospital doing a number of things. We helped care for a 10 day old baby with GBS pneumonia. The family walked 6 hours carrying a sick baby in order to get medical attention. This kiddo is SICK! He has had a couple of episodes of very low sats and requiring some manuel ventilation (bagging) to bring his sats up. Nurses....you would be freaking out. I want to transport him to our NICU. I would if I could. He is getting all that we can provide. IV antibiotics, IV fluid and now has a makeshift "rebreather" in order to maintain sats. Pray for him. He has all that is available so its gonna have to work. We also helped with suturing for a machete wound to the shin and a laceration from a motorcycle accident. We also did some wound care today! something Lori hasnt done since nursing school, and Amber hasnt done for years. Lots of learning. Its been great. Our "jack of all trades" Richard was busy preparing for his big steel project. Church tomorrow and prep for the week. The plan is for some Ob/Gyn clinics in the mountains and out on the islands. More updates to come and hopefully we can figure out how to add pictures!!!! Keep watching. God bless you all. We ask for continued prayer for our safety and that He will use us in a glorious way.

Leaving on a Jet Plane

The team were dropped off for their flight day today. Due to low cloud at San Fran their first flight was canceled. So instead of flying through New York, they will be flying via Houston. And so the adventure begins!!

Packing

Last week the team packed all the wonderful donations ready for the trip. They are so grateful to everyone for the wonderful thoughtful gifts.