From our house to yours . . .

Tomorrow . . . the New Year's Resolution!

The Weary World Rejoices

We had just received Christmas wishes from Australian nurse Deb Louden aboard the Africa Mercy when I found this on her blog, "Deb's Heart in Africa".  I just couldn't reblog this for Christmas.  It hurts, but it's real.  It's life in Africa.  

When I saw her for the first time, she was being held on the bed, throwing her head side to side screaming. It was fear. She was afraid of needles, like many of us. The nurses around her were trying their best to keep her calm. As I walked over I saw her face and the tumour protruding from below her ear. It was big for her small 7 year old frame. The nurse looked at me, defeat in her eyes, compassion written over her face, “Every time I get her vein, she jerks and it blows.” I bent over her bed, patting her chest and wiping her sweaty brow. “Shhh….”

 

Once we got some medicine to calm her down and our nerve back up to gently hold her down once more, the IV was quickly inserted. The CT was ready for her. I scoped her up, still cocooned in a sheet, sweat beaded on her head, part of the tumour now scraped raw and bleeding on my scrub top. She was light in my arms, much too light for her age. Her papa walked with us and stayed by her side while her small body lay still on the CT bed, injected with contrast, moving through the scanner.

 

When it was done, I scooped her up again, cherishing a little cuddle as her papa and I walked back into the ward.

The next I saw them, they were back in the ward. Her haemoglobin was in the 50’s (5. something for the Americans) and we needed to give her some blood before taking a biopsy of her tumour.

 

She sat on her bed, dressed in the same dress I had seen her in a couple of weeks prior but the blood stain where her tumour had bled was gone. Her hair was neatly braided off her face, a shy, sweet smile appearing now and then lighting up her face.

 

Over the next couple of days she received blood transfusions and had a biopsy in the OR, recovering well, but we all knew our next steps would come from the histology results. With the way things are set up over here, you can’t hold your breath for the results because we’re SO far away from the countries that report to us.

 

She wasn’t a child who immediately abandoned her papa and her bed to play with us, but she did curiously roam around the room, quick to ask me for a balloon and just stand near. I bet if I’d had more time, she would have sat in my lap and cuddled for hours.

Recently she was readmitted to the ward because she was having high fevers. We couldn’t find the reason except for knowing that she had this tumour and wonder what it was doing to her body.

 

She lay in her bed, no appetite, crying for being pricked again for another test, sweating through her fevers. I think my heart broke a little more each time I saw her sweet little face, knowing what I’ve seen with my eyes in the past years in Africa.

 

 Today her biopsy results came through.

Malignant.

 

That horrible, horrible word. For us on the ship it means that we don’t treat them.

 

 Tonight I can’t get her face out of my mind. I went down to the ward to say hello, but she was sleeping and it was too late for her to be waking up again tonight. I waved to her aunty who is here with her. She smiled and waved back. I sat on a stool next to the computer where I would sit during my shift as a charge nurse and spoke to the current one working. We chatted briefly about a few other things but as soon as I mentioned the little one’s name, the tears welled up again. I sat on the stool, unable to form words, afraid the moment I did the tears would flow in a steady stream, giving me away to a ward full of patients, caregivers, nurses and day crew. The charge nurse and I looked at each other, knowing neither of us could keep dry eyes, knowing each other’s thoughts, knowing God was breaking our hearts for what breaks His. I slipped out quietly, walking quickly down the hall to the safety of my cabin to let the tears fall. There I was wrapped in a hug and a sweet prayer whispered over my heart and our precious girl.

It’s Christmas, a time of joy and hope. I know this season is full of pain for many.  A few friends have lost loved ones and I’m sure this season is one of the most difficult times of the year. There is no use pretending that everyone is happy, but we have hope for our future!

My favourite Christmas carol written in 1847 sings,

“Long lay the world in sin and error pining
'Til He appeared and the soul felt its worth
A thrill of hope the weary world rejoices
For yonder breaks a new and glorious morn.”

Praise God we have someone to hope in. When death, disease, sickness, life’s troubles overwhelm us with sadness and despair, we have the God of the universe to hope in. He has not left us alone to battle this out on our own. He sent us His son and the Holy Spirit, our comforter and friend. He told us he would never leave us, or abandon us. (Deu 31:6)

Whatever this Christmas season looks like for you, troubles or carefree, sadness or joy, I’m praying you know His abundant, overwhelming love for you.

Did you know . . .

that Uranus is the seventh planet from the sun

 and that it was the first planet to be discovered by scientists

and that teenage boys pronounce it much more differently than their moms?

We had quite the laughs last night!

2014 Zupke Family Photo Review

January - Micah

February - Feed My Starving Children - Margo

March - Eating Our Favorite Greens - Margo

April Fool's - Sam

May -Matt's New Truck - Matt

June - Red Robin - Sam

July - Sand Creek Adventures for Happy Matt Day - Matt

August - Surprising a Neighbor - Sam

August Two-Fer - Sam

September - Matt

October - Three out of four family members got new cell phones - Micah

October Two-Fer - Sam upgrades to a portable phone - Micah

November Mug Shot - Margo

December - Merry Christmas! - Micah

We do have NEW family plans for 2015!  

Three out of four family members are excited to . . . 

stay tuned!

December Family Photo

MERRY CHRISTMAS!

In case you miss it, the blob of pink on my shirt is the dog's tongue!

She made the photo!

And Matt's bed head?  Well, he's been sick the past two days.

Surgery!

On snowmen!

This morning I helped Sam's fifth grade class make snowman candles just like this!  And I became surgeon extrodinaire!  Nose running?  Got it!  Nose too big?  No worries!  Too small?  Easy fix!  Eyes crossed?  Eyes too close?  Eyes running?  There was no problem I couldn't fix with my sponge, finger and a bit of paint!  We had a great morning! 

 

It's a wrap!

Dad waited until we got home this weekend to wrap his Christmas presents so I could do it for him!  He had wooden ornaments for his children, grandchildren and great-grandchildren, along with a cash gift.  We started with the great-grandchildren and discovered that we had given one great-grandchild ornaments, but no cash.  Can you believe we guessed the right one on the first try and only had to open one of their packages!  It went down hill from there and the good news is - the presents are now all officially wrapped and we haven't laughed that hard in a long time!

Only Sam . . .

Sam has three district observations this year and his first one was this past week with his friend Helen.  They had their pre-observation meeting on Monday, the observation was on Wednesday and his post-observation meeting was on Friday.  He came home Wednesday just bummed saying it was his worst teaching ever - he even made the embarrassing mistake of writing "boob" on the white board rather than "book".  So he really wasn't looking forward to meeting with Helen on Friday. 

Fast forward to Friday and so many teachers were out sick that they had to cancel all art classes so the art substitute could teach in a grade level classroom.  Who had art?  Sam.  But during his art time, he had his meeting with Helen.  Helen brings a sub with her, also a friend of Sam's, Bev.  That meant that Bev had to teach art for Sam's class.  Sam actually had an art project that he needed done on Friday - he was working with his students on a surprise Christmas gift for their families and he had no idea when he would find time during the day to do it.  All of a sudden, he didn't have to find time.  Bev could do it during Sam's art time!  

Sam came home all smiles because once again, he got out of teaching art!  I honestly think in almost twenty-five years of teaching, he hasn't taught art yet!  He also got an excellent review from Helen along with a smile for the "book" mistake.  And the kids got their art project done so that I can come in tomorrow and help them finish up!  Yay, God!

Merry Christmas from the Africa Mercy in Madagascar!

Remnants of a Sunday afternoon . . .

Today I found the frosted chair - how did we not notice that for four days?  And the sprinkled floor, not to mention the frosted floor?  Obviously the dog wasn't doing her duty! 

At the Post Office yesterday . . .

Fortunately, I had just enough time to run to the Post Office yesterday morning before our Christmas Bible Study brunch.  Unfortunately, when I arrived, I found out that the Post Office didn't open for another 15 minutes!  Fortunately, the first person in line was my neighbor Tom who took my Christmas cards and said he'd buy my stamps, put them on, and let me pay him back later!  No "unfortunately's" there!  Thank you, Tom!

Y Aquatics Christmas Cookie Baking

Was it just two weeks ago that we were asked to host the Y Aquatics Team Christmas Cooking Baking at our house?  And while "No way on earth!" floated through my brain, "Sure!" came out of my mouth.  God was good, oh, so good, and we're here today to tell you all about it!

Micah and I started baking at 1:00 yesterday afternoon, doing cut-out sugar cookies, so that when the crew arrived at 3:00, they'd have something to do.  It was sweet to watch the kids "color" the cookies with frosting - check out the end results!

I do mean kids - somehow they all escaped before I took this picture!  Because it was in the kitchen that the serious action took place!

We made peppermint candy canes, chocolate covered pretzels, 5-ingredient fudge, chocolate caramel cracker bars, pretzel ring cookies and award winning chocolate chip cookies!  When we were utterly exhausted, Dominoe's delivered!  

And yes, we'll be swimming laps all week long!  

When the truth is stranger than fiction . . .

It is December and we are in Minnesota and while I was out with Annie, our dog, this morning - in the dark - I found a man picking up earthworms!  He proudly showed them to me!  And he's not going fishing!  Whoever lives in his aquarium is going to have delicious mid-winter snack! 

From a Physical Therapist to You . . .

Reblogged from "Adventures in Life" by one of the physical therapists on board the good ship Mercy.

This is a glimpse of what I do in a work day here. We are in full swing now with many patients on the ward, several returning for the first follow up appointment after surgery, and several continuing to receive Ponseti style casting for club feet. As is common anywhere, we can lose perspective. We see forests instead of individual trees.

This week, I was reminded of the miracles we are seeing and part of doing. One of the people who work in communications, Eunice, came down to interview the Vanya as it was her first cast change after surgery. Vanya's legs were exposed yet stable in splints. Eunice began crying happy tears when she saw the Vanya's leg straight for the first time. The Vanya's mom sweetly gave Eunice a hug in celebration. Although the rehab process is just beginning, it is good to step back and remember what the legs were like before.  Perspective...miracles are happening by the Grace of God we get to participate.

Vanya while she was still on the ward (photo credit: Mercy Ships)

Ambre's mother expresses joy each time her daughter's casts are changed. Her feet are moving and flattening each week. Her mother's laugh is contagious and brightens my day and Ambre is cute herself.

Kalinda mobilizing a club foot prior to the casting. (Photo credit: Mercy Ships)

My buddy Ismael came for his first outpatient visit after surgery and was so brave. He only cried briefly when the staples were removed. Bubbles still are his favorite and calm him down quickly. He is standing and walking independently with the cast. 

Several teenagers are on the ward now. It is so different working with them than the young children. I have been enjoying reading French and English children's books with Mariette during her breaks while walking long distances in the hallway. She has a huge smile when I come to her bed with a new book. We have read Finding Nemo, Aladdin, Daniel and the Lion's Den, Paddington Bear, and the like.

Nestore is one of the teenagers, He wants to be a doctor and has gotten an early start on his dream (Photo Credit: Mercy Ships)

Here we encourage walking very soon after surgery to help facilitate the bone growth. With younger children we start with walker. Depending on the age, we progress to crutches or hand held walking. Next is walking independently. For the older children, we try to begin with crutches.

Sometimes we witness sit down strikes; sometimes screaming fests, but it leads to...(Photo credit Mercy Ships)

Moms' hard work and children learning to walk. (Photo credit Mercy Ships)

I am learning new skills daily here. We cast with plaster and fiberglass. Different techniques are required for both. I am getting better at both, but still working on making good casts. It definitely takes a team to up them on. Now that we are more than three weeks out from the first week of ortho surgeries, We are pulling Steinman pins, removing staples, looking at xrays to assess bone growth, and changing the cast to fiberglass cast when able. (We are running low on supplies as we are waiting for the container that has most of them to arrive. It was shipped ahead to Benin. When we switched countries, it did not switch as quickly as we did :) )

Translator/knee stabilizer, someone to maintain the foot position, and someone to apple casting material (photo credit: Mercy Ships)

Bubbles often help. (Photo credit:Mercy Ships)

Oh yeah, we progress walking and standing balance. The physical therapy that I am used to does not occur until a couple months after surgery when the bones or tendons have healed and the casts come off for good. This is when the range of motion and strengthening are in the forefront.

Photo credit Mercy Ships

Walking for the first time with a short leg cast (photo credit: Mercy ships)

The children have fun too. All lined up watching a movie. (photo credit: Mercy Ships)

In the evening visitor including relatives come. Stickers, bubbles, hugs and laughs with family. (Photo credit: Mercy Ships)

The babies and young children we have been casting weekly with the Ponseti method are also entering a new stage. They will be having small surgery (tenotomy- cutting the tendon in the back of their ankle) to gain the last of the needed motion. This surgery is performed under local anesthesia in the physical therapy treatment room by Dr. Frank with physical therapists assisting. The children are then placed in another cast. This one is worn for 3 weeks to maintain the stretch while the tendon repairs itself. The child then has to wear braces for several years.

One of the patients we have been casting for bilateral clubfeet. (Photo credit Mercy Ships)

Our youngest patient (Photo credit: Mercy Ships)

Changing Lives . . .

IN MADAGASCAR!

 

"MO-OM!"

When I heard that cry in the locker room this morning, I wanted to ask, "Do you need a specific mom or will any mom do?"

Bless that dog!

See the innocent looking dog . . .

who crawled under the Christmas tree and

found her Christmas present.

How did she do that?

We never told her it was there!

She opened it while we were watching the game -

all alone in the living room!

Then she brought her brand new orange squeaky tennis balls to me

and hid under the bed

because she knew what she did was wrong!  

 

In the land of yellow loogies . . .

I've seen single-sided loogies and double-sided loogies and even dual-projectile loogies this week - in the land of yellow loogies, also known as our local YMCA swimming pool!  And I'm not quite convinced that there was enough chlorine to conquer those loogies because now I'm fighting a cold!

Parents - if your children are full of snot, do the staff a favor and keep them home - no matter how much they love their teacher or they love to swim!  Do your part in conquering the "Land of Loogies"!  

Unfolding . . .

Throughout our adoption process, our social worker, Brita, was always so good about saying, "We'll see how that unfolds."  No promises, no speculations, just unfolding.  Today, we unfolded a new chapter . . .

I received an e-mail from Matt and Micah's birth mom this morning wanting information on Matt and MIcah that I was glad to share.  Her oldest daughter is struggling in school and what did I think?  I think I am ever so glad that God has blessed us with the relationship He has given us!

I had no clue . . .

I've reblogged this from my friend, Deb's blog, "Deb's Heart in Africa".  Deb is a nurse on the Africa Mercy and I hope her post touches you as much as it touched me.

The Road Ahead is Long

A couple of days ago I went to the local hospital to work with one of the nurses who is in a training program with the ship. Here are the facts. The surgical ward where she works has 50 patient beds. There are only four nurses on the work schedule. They work 24 hour shifts as the only nurse, being helped by some nursing or medical students for some part of the day. Just let those facts sit in your mind for more than a minute.

24 hours shifts.

Minimum of 50 patients.

Limited equipment and by that I mean, they have one manual blood pressure cuff, one thermometer and one stethoscope.

There is no oxygen, no suction, no running water and no supplies on hand.

Needless to say, the hospital is run very differently from one in the western world. There are so many differences here that I don’t even know where to begin. For a start, every morning after the doctor has done his ward round and prescribed the treatment for the day, the nurse will write out a script for the patient’s relative to take to the hospital pharmacy. It might look like this: IV cannula x1, IV tubing x1, Normal Saline 500mL x2, Ceftriaxone IV x1g, 10mL syringe x1, gauze x1 pack, tape x45cm, betadine solution x1 bottle. All these things are packed into a green and white striped plastic bag and neatly tied and carefully transported, glass ampoules and all, back to the ward for the nurse to begin the treatment when she has time. The prescription paper now not only has a list of the contents in the bag but also the price of each item bought by the family. Each precious item has a price and I heard it said on the doctor’s round, if the patient has no money to pay for treatment then they can leave and someone who has money can have the bed. That’s how it goes.

The patients in the ward all have a story. One was picking fruit from his fruit tree and thieves came, thinking he had a lot of money because of all the fruit he was picking and attacked him with a machete. He had been sliced open all over his face, head, back of the neck and flanks. He had been stitched back together in the hospital’s emergency department and actually looked surprisingly good, although in pain.

Another patient had tried to commit suicide by stabbing himself in his gut, which had led to internal damage but not serious enough to cause death. One young girl had had an abortion but needed further curettage for pieces still left inside. One boy had somehow gotten a meat hook stuck in his neck. Several patients had fallen out of fruit trees breaking one or more bones in their legs or spine. One man had fractured his spine so severely they are calling it a miracle he is alive, yet he’s stuck in bed with a spinal collar on because they don’t know how to fix him. His spinal cord is being pinched and a slight slip could mean paralysis not just to his body but to his lungs, causing death. Other patients have been hit by cars or have had motorbike accidents leaving them with head injuries or fractures. Some have had hernia repairs or their appendix removed.

While we were walking around with the doctors, there was one lady sitting on the side of her bed, gasping for air and crying out. She was clearly in distress but no one seemed to bat an eye. When we asked what the problem was, they simply said “Asthma”. Someone from the family had gone to the pharmacy to get some medication. In the mean time there was nothing for us to do. There’s no oxygen standing by, no crash cart with emergency drugs, no resuscitation equipment to rely on.

I’ve seen these same circumstances now in several countries in Africa, limited to no supplies, a huge lack of running water, power, soap, suction and oxygen. The absolute basics are missing.

A few weeks ago two of our Mercy Ships crew members gave a presentation with a lot of statistics about many of the countries that the ship has been to in recent years and others close by that we have not yet visited. Seeing these numbers and graphs with terrible statistics for overall health and healthcare systems in these countries, somehow tightened my resolve to be here. The presentation continued to tell us how Mercy Ships planned to partner with the local hospitals and work alongside them, teaching and educating, running classes and mentoring. The idea is to work ourselves out of a job. Although I’d heard it before and knew what programs Mercy Ships ran, at hearing it presented again, I felt my heart jump up and down and God whisper to me, This is why you are here. I want to see lasting change. I want to see so much change that the local hospitals will be well equipped, not just with the basics like power and running water, but with supplies and the knowledge to use them. I want to see the staff educated, supported and empowered to make changes to improve their working conditions and the outcomes of their patients.

The nurses that I have worked with from the local hospital are well educated. They are creative and make the most of the supplies they have, inventing ways of doing things with their limited stock that we would never dream of. They are hard working, uncomplaining and joyful despite their circumstances.

The road ahead is long, but we have to start somewhere. People are always asking me, How long will you stay on the ship? Well, how long will it be until we can change the healthcare statistics of the nation? Of the continent of Africa? Even though I see the road stretching ahead far into the distance, there is hope. We have already begun the journey.