Baby Fred and Big Fred (In appreciation of my work, this new mom named her son after me!)
What a day! Or is this a week now or a month? I am not sure. The days are fuzzy. It seems like one long day. Time is for me a point of reference, a tool, used to measure things, not a constraint. It does not dictate when I can eat, sleep, etc. I eat when I am hungry and there are no patients to see. I sleep when I am tired and there are no patients to see. I take care of Noah when he is awake and my wife is working. I work when my name is written down on the schedule and or I am called over. It is my life.
#1. The call was straight forward, a transfer from an outside clinic. The story, 38 weeks pregnant, in labor and stuck at 5 cm (need 10 cm to deliver). Fetal heart tones are present and strong. A “no brainer” I thought. The history is blurry and not clear. She has been seen twice at a government clinic during her pregnancy, which in itself is not unusual. The patient is fine but saying she is only 7 or 8 months pregnant. To the ultrasound machine we go. Can you say twins at 31 weeks and 4 days?!! This is not straight forward anymore . . . steroids, magnesium and antibiotics. Delivery occurred 2 days later. Babies are still with us, and doing fine.
#2. 7 year old boy admitted for persistent fever X 10 days. Work up is negative for malaria. However liver enzymes are 5000 (normal is less than 50). Hepatitis B and C are negative. Liver ultrasound is normal. In the U.S. the next steps would include further blood tests and a possible liver biopsy. Treatment would depend on the diagnosis and would be tough under ideal situations. Here there is nothing to do. The boy dies 2 days later during the night shift.
#3. A young women who is pregnant at 35 weeks, started seizing this morning. She is transferred to us. On admit she has a short seizure. Recovery is slow for her but the baby, by doppler, is doing well. Her mother and mother-in-law are by her bed side. The history is, like most histories, blurry and unclear. We start her on magnesium, steroids and antibiotics and pull out the ultrasound machine. Can you say twins at 30 weeks?! Mom seizes again during the ultrasound, fetal heart tones drop, to c-section we go. Delivery occurs immediately. Babies are still with us and doing fine.
#4. 35 year old man with known Hepatitis B and bad ascites (fluid in the abdomen). He is struggling to breathe. However with a little bit of oxygen he is doing better. After taking a history, I am frank with him. I tell him there is nothing we can do for him, and that he will die. He asks when. I tell him I do not know. I ask him if he knows God. He says he does. We pray. He dies 12 hours later.
#5. Another OB transfer, known twin gestation at 29 weeks. Reason for the transfer, mom has high blood pressure. Work up gives mom the diagnosis of severe pre-eclampsia with severe thrombocytopenia. Babies are both breech (butt first). To a c-section we go. Babies are still with us and doing fine.
#6. 13 year old boy admitted for seizures. History is unclear, seizures are atypical. Patient has tetanus. Treatment protocol in the states would probably include sedation, paralysis and ventilation to stop the seizures. We cannot do that here. We treat the best we can. The boy dies 6 days later. This is the 2nd person we have lost in the last couple of months due to tetanus. The other one was 8 days old.
#7. A patient known to us. We had seen her in OB clinic at 22 weeks. She had ruptured her membrane. We told her, at that time, that she most likely will lose her pregnancy and that there is nothing we can do. However, if by God’s grace she was still pregnant in 4 weeks, she should come back to us, and we would do all we can. Today she is 33 plus weeks and has been sleeping on the OB floor for the last 7 weeks with daily monitoring. The baby appears to be doing fine and growing appropriately. We plan to deliver her by c-section at 34 weeks. We are praying for a healthy baby.
#8. She is a beautiful young lady who is once again pregnant. She is here, in OB clinic for her second visit. She is HIV positive, newly diagnosed. It is my job to tell her. I have done this before. I hate it. The news sucks the life out of people. It ages them. This is no exception. I am close to tears.
#9. She came to the OB deck at 25 to 26 weeks complaining of contractions. She was 4 cm dilated. We treated her with magnesium, antibiotics and steroids. She slept on the floor of the OB ward for 10 days prior to delivering at 26 to 27 weeks (normal is 37 plus weeks). The baby is still with us and struggling. We have resuscitated him once.
Two points of View
When will this end? How long can I keep this up? How did the old missionaries of the past do this alone with less resources? On the other hand, what a wonderful job! What great experience! I cannot wait until tomorrow comes!
A question
Am I nuts?
God Bless
You folks have a tuff job but I know you are giving it all you got
Wow, I bet you never saw so many twins in such a short amount of time! You’re doing great work, Fred.
Incredible reading !!
I am sure Fred, in the past these people would not have done so well, at least with you and Lydia (and the team), you give hope and compassion. However, I am concerned you are definitely over-working so we must continue to pray for more medical support and for you and Lydia to find the rest you need.
I absolutely loved this post – it made me want to be in Togo working along side you! Lord willing, I’ll see you in January 2015 for 3 months. It definitely sounds like I could keep myself busy as a pediatrician (haha I’ll definitely have to brush-up on my neonatology knowledge)! I miss you guys!
We pray for you guys! We know that God is using you there and we ask Him to continue to do His work in that challenging environment. Only God is God and you can only do what you can do. God is and will continue to honor that work. We love and miss you guys! Give Noah a hug from the Bairs <3
FRED AND LYDIA AND NOAH… BOY,,, WHOOSH……WHAT A SCHEDULE… I HAD ECLAMPSIA IN 1971.. SEIZED FOR 2 DAYS EVERY FEW MINUTES… MY OB/GYN DECIDED TO RETIRE SHORTLY AFTER THAT.. THAT WAS 43 YEARS AGO.. REGULAR BIRTH. NO C SECTION..ALL THESE THINGS REMINDED ME OF THAT…KEEP UP THE GOOD WORKS AND PRAYERS FOR EVERYONE… TAKE CARE AND BEST WISHES, MARGARET AND THE FAM….WHAT STORIES YOU CAN TELL LATER ON…..
PS… DO YOU REMEMBER KARL AND KATHERINE ULRICH FROM THE 5 MILE LAKE RESORT.. SHE WAS 103 AND PASSED TUESDAY…UP IN THE EDGEWOOD AREA…???
It has taken me several days to read this post because I could only get through one or two of the patients at a time and then would break down. I have no idea — besides the tremendous, flooding grace of our God — how either of you are able to handle the extreme situations in which you and your patients find your/themselves. Please know that each day your name is on the schedule you are being prayed for, hour upon hour (and sometimes, thanks to your nephews, during the night and early morning as well!). Here is a passage I was reading and praying over today….
Psalm 27:7-9
New International Version (NIV)
7 Hear my voice when I call, Lord;
be merciful to me and answer me.
8 My heart says of you, “Seek his face!”
Your face, Lord, I will seek.
9 Do not hide your face from me,
do not turn your servant away in anger;
you have been my helper.
Do not reject me or forsake me,
God my Savior.
Love to you both and to that sweet Noah-guy too.
wow. how overwhelming. praying for strength for the day. (and yes in the world’s eyes you are nuts. the smart move would be to settle down, raise your family in a nice neighborhood, set aside money for college fund and enjoy the financial blessings of your careers. Following the Lord – and setting aside family, friends to move far away and serve Him at cost… Amazing and beautiful. but nuts. Love that you would do that).
seems the real answer is, they are blessed to have you. So wonderful you have listened to God’s call and what a blessing you have eachother to share this with. the ups and downs and our prayer for you and Lydia is that there are many many more ups then downs and what a wonderful example you are to your baby and I am sure that Lydia got the same example from her folks. Thanks for sharing.
Only by Gods grace you listened to His call and for that God honors you and blesses your life but staying in that pressure cooker is nuts if it wouldn’t be for the Lord. Not by might nor by power but by my Spirit says the Lord. I am so thankful that you and Lydia are there extending Gods hand to the people of Togo. My prayers are with you. I know that Temple sent a care package. Hope you get it soon. love Deanna Walker. Give Noah a kiss for me.