Gluten-full sugar cookie time

We have always made sugar cookies, cut them out, and decorated them for as long as I can remember. So today Mom made the dough and we let it cool in the fridge while we enjoyed another tradition (boys excluded): watching the Nutcracker.
Then came the rolling out, cutting and decorating...my favorite part.

Mom bought a few animal cookie cutters this year, so there was some Kenyan style with a giraffe, lion and elephant.

Sugar Cookie Recipe
1 1/2 powdered sugar
1 c butter, softened
1 egg
1 tsp vanilla
1/2 tsp almond extract
2 1/2 c flour
1 tsp baking soda
1 tsp cream of tartar
Combine all but dry ingredients and blend until smooth. Add in dry ingredients. Chill in the fridge for 3 hours. Then roll out with powdered sugar/flour and cut. Bake on lightly greased pans at 375 for 7 minutes

Gluten Free Dairy Free Delicious Sugar Cookies

Merry Christmas to Rebekah and Adrienne because these are the best subs I have found yet. I surprisingly got the recipe on a land of lakes website.
1 cup sugar
1 cup butter (or dairy free sub)
2 egg yolks (or egg replacer)
1 1/2 tsp GF vanilla
2 1/4 cups gluten free flour (used Bob Mills Gluten Free Baking Flour)
1/4 tsp salt
Combine sugar and butter and blend until creamy on medium speed. Add egg yolks and vanilla and beat. Reduce speed to low and add GF flour and salt slowly. Beat until well mixed.
Chill in refrigerator (I had to chill for several hours to get it to roll out, but if you want to just make round cookies you could bake immediately)
Preheat oven to 350. Roll out dough sprinkling with gluten free flour to 1/4 inch-ish and cut with cookie cutters.
Bake for 9-12 minutes until lightly browned.

Merry Christmas

From the Georgia House

Mark upped the ante with lights on the roof...must match that next year. Bigger and better every year, that is the idea. Though Leah has automatically got me with the blow-ups.

Supalla's side

My lights flash but at different times, which is my favorite part...gotta find some more of those post Christmas sale time!

O Holy NIght

Always has been one of my favorites...here are a few of the lyrics

Long lay the world in sin and error pining,

'Til He appear'd and the soul felt its worth.

A thrill of hope the weary world rejoices,

For yonder breaks a new and glorious morn.

Fall on your knees! O hear the angels' voices!

O night divine, O night when Christ was born;

O night divine, O night, O night Divine.

Christ is the Lord! O praise His Name forever,

His power and glory evermore proclaim.

His power and glory evermore proclaim.

 

Advent

Adrienne and I have been reading through an Advent book this season...it was written by one of our pastors and is called Behold the Lamb of God. I guess I was anticipating a lot of stuff from the gospels, but we are on day 11 and we have been in the Old Testament the whole time. It has been great to see all of the stories pieced together...I forget that each of the stories of Adam and Isaac and Jacob and Moses are all connected with this common thread. And hearing them all brings new meaning to the season of advent...of waiting, anticipating, remembering, preparing and longing. As all these stories are unfolding you hear the promises that God gives the people and how they trusted and clung to the promise and waited. And how that applies to us even now, as we wait and anticipate and prepare and long.

Who I Am

Tuesday night at our group we went through Isaiah 62 together and pulled out all the names of who we are in Christ. I wrote them all down, but figured a digital reminder is always good too, so here is our list:
Transformed
Beautiful
Beloved
Delighted in,
A city not deserted
Filled
Advocated for
Married/unbroken presence of love
One flesh
Protected
Heard
Redeemed
Not forgotten
The holy people
Sought out
Redeemed of the Lord
  Just a little reminder of who we really are.

You want me to do what?

I started reading through Matthew/the Christmas story. In reading I was amazed by all that God was calling Mary and Joseph to, but specifically Joseph. God first called him to stay with a girl who was pregnant which I am sure was a huge deal then, especially in a small town. Task 1 that he probably wasn't too crazy about. Then once the baby was born, Herod was out to kill the baby, so God called him to travel from Bethelehem, where they were, to Egypt. I had never really thought to look at a map, but I did this week....it is a long long way. I would guess hundreds of miles to travel by foot or horse or whatever with a newborn. Task 2 he probably wasn't too crazy about. Then after they had settled in Egypt, Herod died and God told them it was safe to return to their land, but Bethlehem was not safe, so instead they traveled further north to Nazareth, so another super long journey to live in a new place with a baby. Task 3 he probably wasn't too crazy about. And I am guessing that he and Mary hadn't really spent much time together prior to their marriage so add marriage into that equation. Matthew then jumps to John the Baptist and Jesus once he is grown. But I still kept thinking about all the wildness God was calling these two ordinary people into.
So then it got me thinking about the things I grudgingly do that I think God is crazy for asking of me and it makes me look at it differently. And it makes me remember that I am being called into different things because of my weakness and inability as an ordinary person...that he has great plans for things and he is the one at work and I simply bring my inability and follow. Sounds so easy, right? If only my fears and my stupidity and selfishness didn't stand so firmly in the way of this. 

A Few Faces

Giving some thanks

I think every year when I return from Tenwek there is of course a different processing process. The first year I worked through different things than I have this year. This year was a little strange and I have to admit a little gross to see where my heart has been leading since coming back. A lot of times when I come back I am overwhelmed by all that I have and all that people there don't have. Which I think physically speaking is still the case...I have come back thankful for some of the things I have. But I have felt this glaring hole in places where I don't have what I think I need. So instead of coming back thankful I have come back maybe bitter is the right word for it. Which, like I said is gross. It is good this week was thanksgiving because I think that forced me into some genuine thankfulness by, oh Friday morning. And I think God has used some of my past few days off to remind me that in saying he has given me everything I need he is also saying he hasn't given me the other things that I may think I need. This doesn't totally take away some of the pain of the gaping hole but it does begin to mend things a bit. And hopefully my heart will continue to come around in time.
I think this year a lot of the hard stuff hit me harder...seeing patients around the hospital who died, seeing the kids and adults who we couldn't do surgery on...those things I had a lot harder time coming to terms with. Maybe before I have never really let myself think about them too much because it is hard to think about that stuff. It is really hard to think about people who will die because of something they don't really need to die from...if only they lived somewhere else. But I do come back to the truth that God knows each person and each heart and what they and those around them can handle and need in their lives. I don't think beyond that I will ever have any sort of answer for how hard a reality that is.
I am finally going through some pictures so here are a few.

This is Eunice...she is a trip! She had a harder post-op course and was still there when we left. She was the one who told me I was pounding her like maize while I was doing her respiratory treatment. I love that smile, though...it lights up the room!

This is Kiprono, or Kip from the first week. He touched a lot of people. He is I think 16 or so and when he was seen in the clinic Michael, one of the non medical guys helping out in there, was immediately drawn to him and knew he needed help. When they started anesthesia on him his heart was so sick it stopped and they brought him back. Once Michael heard this he went to the hospital chapel and prayed for him for a long time. The surgeons debated on whether or not to go on with the surgery. They finally decided he would die soon without it so it was worth trying. He did amazingly well...and proceeded to wear this Michigan hat Russ White gave him constantly after surgery.

More later!

Adjusting

Back in Nashville...seems fitting that it is rainy and gloomy outside. Our travels were good, though of course long (6 hour van ride, 2 8 hr flights, several layovers and an 1ish flight). Even though I have done this so much I still forget this adjustment time...this time of feeling a little bit numb to all my feelings, of not wanting to be back at home even though I love my life here, of being sad, of missing the green hills and warm smiles and hot ICU with all its Kenyan sounds and smells, of working til my body and mind are exhausted but knowing my work is not in vain. I feel confident that my life is here and not supposed to be thousands of miles across the ocean at this point in life. And I also feel confident that this experience is a part of my life in these few weeks every year. So I am hoping for some time to process and to allow my feelings settle in, to allow myself time to let my experience settle in since it whizzed by so fast.
I will post some photos maybe by later today if I get around to my camera. Until then Ephesians 3:20:
Now to Him who is able to do far more abundantly beyond all that we ask or think, according to the power that works within us. 

Heading home

We are waiting to leave..very bittersweet. Things ended out well. All the kids were on the floor by last night and Vincent one of the nurses had us to his house for tea. Very sweet. We had a good last evening of fellowship. And today we took a hike up to Montigo a big hill that overlooks the area. It was a beautiful morning. Now we wait and then travel a lot.
Last night was a sweet way to end things with tea and dinner together, laughing about our sweet new friends and remembering all that has happened these two weeks. So thankful yet again to get to be a part of this project.

Winding down

It is Friday morning here and things are winding down. Wednesday's cases did okay but one had to go back to the or thurs. we also did another complete tet repair and a double chamber RV, both older kids. The icu has 4 patients remaining all who are doing well and should be to the wards by tomorrow.
I am tired and having a mild RA flare up but still holding up. Marek found some new meds here for me to try :) This 2 weeks has been long but it is nice to be here and get so much accomplished. Russ said we have done more congenital cases this week than so far this year in Kenya.
Today Mary and John are working with us in the unit..they are two of my favorites. Mary is all about tough love.. When we asked if she would be here when we come back next year she said yes as long as Christ has not come by then. And John has some awesome phrases too. They both work hard and want to learn a lot.
We will spend the next bit of time inventorying. We gave the nurses a bunch of gifts today for their children which was fun and will save the passing out gifts on the wards for the nightshift crew. Ate some ugali at the canteen. Not much going on here. Part of me is ready to come home mostly to sleep and get some rest but the other part of me could stay here forever. So much joy and difficulty but good. This year I have had a harder time realizing how many people we cant help while we are here...we could do surgery for weeks and not run out of patients! It is hard when you put sweet faces with the hearts and names connected to them. But god knows each of them and their hearts and what their lives will look like.

Already Wed!

Wow. The week is going fast. Yesterday I flipped back to days and didn't work but for a few hours which was needed. Our patient from the first day, sue, had to go back to the or today because the vsd wasn't totally fixed and there was a spot on the aortic valve that needed fixing. She went back today and is doing okay still on the vent but looking good. Our other patient from yesterday was tony who we did a partial fix on two years ago and finished fixing yesterday. He looks great! Yesterday's other patient still needs some tuning up. Last night he screamed for water telling anyone who would listen and volunteered to walk over and get it himself. He has some feistiness to him. The plan is still to do two more cases today a shunt and a double chamber RV. We will see it is almost 6.
Today I donated blood at tenwek which I have never done before. We have had to give more of our patients this year so after walking to the blood bank one morning to get blood for someone and seeing how little blood they have I braved it. Nancy was great and it was a fun experience. I even convinced 3 people who have never donated to do it. So I made them stickers and we took tons of pictures.
One thing I have noticed here is how stoic these patients are. They rarely complain. There are so many things I love about this culture but I do think they could learn a little about expressing suffering. Or maybe suffering is so much a part of their lives that they expect it and don't need to scream about it like I do. Or maybe they scream to each other about their pain and don't need to complain. I know I need to talk about my suffering to let others in or it becomes a giant monster that runs wild. I am thankful that I have people who welcome that. And thankful to see how suffering is an expected part of life with God.
Some of our patients from last week are going home. Duncan left...he has been ready to go for a week. And the others are getting there slowly by slowly.
As always it is so beautiful here and I love my moments outside. More later.

Week 2

The weekend was quiet which was a blessing. All our patients were on the wards by Sunday after lunch so had some downtime! The new team got here Sunday afternoon and we got all their supplies unpacked and the icu ready. We did some more teaching today while we waited for the or. Our two patients today did great. I am working nights with Leah tonight and things have calmed down. Blessing our first patient was a 3 year old tet repair. She is feisty and from the Congo so only speaks French. Sue is our other patient who is an 18 month old vsd repair. She is also doing really well. Both are resting coughing and stable so good start to the week.
I am tired. I think all the nights and days are catching up to me. I know when tired my patience and love tend to be harder to come by so just praying that I can rely on god for strength rest love etc in this next week.
Not much to report today. More later

Tenwek

For every house is built by someone, but the builder of all things is God. Hebrews 3:4
I came upon this verse yesterday before going in to work at the hospital last night. It reminds me of Tenwek's motto for lack of a better word which is We treat, Jesus heals. Before each surgery the team in the OR prays with the patient, entrusting the outcome to God. This verse is applicable to really anything in life but has been a particular reminder to me here as I fight for control of everything. I have lead up the nursing portion of this trip ever since the second trip here. Those who know me well know I tend to carry responsibility heavily at times (something I have been able to see more and more lately, especially with the help of friends pointing it out...yes walking in community is a joy, right). In my role here I am asked a million questions about how to do this, where to find this, can we get this med or this piece of equipment. But I tend to carry the responsibility further in terms of is everyone having a good trip, do they enjoy this, is it overwhelming, are they doing everything right, how will this all reflect upon me? So yes, I may be in a leadership position, but ultimately God is in control of each patient we care for an is in control of each person on the team and their experience and in control of my idenity. I am glad I do not have to carry that weight.
I sit right now in the ICU. Kristen let me borrow her computer for the long nightshift. Long because all of our patients are doing so well and are resting. We have four left in the unit but hopefully they will all go to the floor by tomorrow so we will start the week fresh. Our patients from Friday, Jehosophat (or Jo-Jo as Anna nicknamed him) and Micah both had great nights and great days. Today they did one surgery on Chelea and repaired her mitral valve. She has already taken chai and sat up in bed.
Last night I went through all our patients' charts to learn more of their history. I learned about how many years (yes years) they have been experiencing symptoms of heart failure. What this means in real life terms for them is that they cannot work or go to school or have a job. Many have had symptoms for four or so years and have just been on medicine to try and help their symptoms. Having this surgery means literally new life for them.
Crazy things happen in this place...patients do remarkably better at a faster rate than we see at home. As I witness this each year I still wonder if it is the Kenyan people or simply God working in each case to enable many to get helped during these weeks. Eunice, one of our patients who sleeps in front of me now had work done on multiple valves and had horrible lung pressures before her surgery and was on bypass for four hours (a very long time) yet she got her breathing tube out a few hours after surgery and was drinking water and talking.
We are a skeleton crew this weekend...the first week people have either gone home or are on safari and the new team will be here tomorrow. Today I pulled my hair up into a bun before work and when I got here both Kenyan nurses asked me if I had shaved my head...they are fascinated by my coil as they call it.
We went to see all our patients tonight and all are doing well. Duncan suffered a small stroke but his symptoms seem minimal...he wanted to make sure we knew what had happened and kept lifting up his weaker arm over and over. And he wants to know when he can go home. We went by the women's surgical ward to visit 2 of the women and had to shake a ton of hands and got a huge good-bye when we left. That is it...hoping the rest of the night will go by quickly!

Pole (pronounced po-le, in Swahili)

Pole means slowly in swahili. The Kenyan nurses will say it to our patients as we get them out of bed or give them water. They will say pole pole. I think I need to write pole and post it on my wall, my mirror, in my car...I need this reminder to slow down.
Yesterday I was walking somewhere and in my usual way was speed walking. I didn't need to walk fast...my patient didn't need the lasix from the pharmacy stat, but I was walking quickly. I got stuck behind three Kenyans strolling through Tenwek and I realized how hurried I always am even in day to day life. Not to mention in my mind or in how much I want to run ahead of God.
Our patients from yesterday are doing well. Eunice got off the vent right before I went to bed last night and as we were pulling her breathing tube out she was already saying water (or wata as they say it). So she perked right up and had a good night. Right now she is sitting in a wheelchair with beads on playing a recorder.
Teresia was our second patient of yesterday who had her mitral valve replaced. She came out of the OR last night extubated and is also doing well.  She is still pretty sleepy but I am sure she will perk up today.
Beauty is still with us and is looking a little more alive today. Everytime you say her name she says hallo. Our other friends moved onto the floor today. Caroline walked outside before she left and was ready to run.
They are going to try and do 3 cases today to make the most of the week, so hopefully they will be fairly speedy as I will be the only nurse in here after about midnight tonight.
Going to get some rest now before I come back tonight. This weekend there are a few of us running the ICU so prayers for our patients having no complications and for good working dynamics and rest for each of us in our time off. The next group of people will arrive on Sunday.
This morning before the nightshift nurses left Caroline called them over and wanted to pray with us. I have no idea what she said, but it was so heartfelt and dear. I love getting to spend this time with each of these sweet people.

Still one patient left to come out of the OR. I am taking a dinner break and will go back up to the unit to help admit the next patient.
Today was a good day. I got in to work at noon to find all three of our patients out of bed in wheelchairs with Hope for Hearts tshirts on. Caroline was decked out in her mardi gras beads playing a recorder. Kipkoech (the second case from yesterday) was out of bed with a Michigan hat on just grinning away. And ole Beauty was up out of bed but she is just still very tired. I think these older patients just have a harder time bouncing back. But she is doing better. Things are a lot more like normal.
As always it is so fun to work with the Kenyan staff. The nurses are picking up on things really easily and we are working with many different nurses than in previous years. The other ones have all graduated to be head nurses or work as first assists in the OR. They were really quiet when we did education Monday but now they are asking questions and picking up on stuff left and right. They are all so dear. Eva is one of the dayshift nurses and she is great...jumps right in with things. And has a great sense of humor. We spent a lot of today laughing.
Went to visit Duncan (or big D) today and we couldn't find him in the surgical ward. We then saw hand shoot up in the air waving us towards him. He had spotted us first. He looked better and had a sparkle back in his eyes. He told me I was a good woman! I think he misses all the attention we gave him.
Caroline has become my new favorite in the unit. She is 28 and lives 20 km from Tenwek. She told me today that she has been unable to pick tea leaves for her family and she is looking forward to working when she leaves the hospital. She has 4 children and wants to have another boy. She started singing spontaneously today a song blessing us. She also kept playing her recorder spontaneously. She is feisty!
Oh yea, our first case from today is Eunice and she had work done on three valves. So far okay but got some work to do on her.
I feel very humbled to be part of this trip and a part of all these experiences. I am reminded so much of how I am not in control and it is amazing to look around me and see what is possible if I am willing to get out of the way.

Day 2 and 3...much better!

Well, last time I wrote I know I left a lot of things hanging. To pick up...surgery did finally proceed Tuesday but the mood around the hospital was tense and somber. Everyone was affected by Roger's death. They operated on a middle aged woman and replaced her mitral valve. She came back late and was really sick all night long. The team last night worked really hard at staying on top of everything with her but compared to our previous years she was sicker than most patients we have taken care of. In general I was just left thinking what is going on this year...things are not the usual way. All around us we were witnessing death. There was Roger. Before Roger there was a patient who was ECHO-ed on Sunday as a potential candidate. They admitted him (Edwin was his name) to get tuned up a bit because his heart failure was severe...well Monday he arrested and passed away Monday night. Then last night while we were recovering our patient, Beauty, a gunshot victim came in who eventually died. Then today I briefly went by to see if they needed help on another young man who passed away. It has just brought this reality back of how much we have at home...how many resources, how many priveledges that we assume we should have. And here it is so very very different.
Back to our world..Beauty, who is a mother of 3 from Zimbabwe, turned the corner around 1 today around when I got up to the unit. We finally got her breathing tube out which was a fiasco to say the least (almost got it back because she had gotten too much morphine prior, there was some vomit that may or may not have gotten all over me, and lots of humorous situations) but she came around and is doing much better.
Then today the 2 cases have done beautifully. First there is Caroline, a 28 year old Kipsigis from around Tenwek who had work done one two valves. She got her breathing tube out after a few hours and of course was immediately asking her for water. A friend gave me some Mardi Gras beads to give out to patients so I brought some over to her and asked if she wanted them. The nurse translated for me and she replied yes, i want you to place them over my head. Ha...she is funny. I know she has atleast one child, a 7 month old girl. Our second patient was a young man who is so skinny from his heart disease. He is fifteen and weighs about 80 pounds...just these scrawny little arms and legs. His surgery started out rock but he is doing great so far. I left around 11 and he had been back for a few hours and had no bumps. After his surgery the mood has shifted and everyone is feeling much more upbeat and okay about things.
There have been some other challenges along the way but all in all today has been a very busy, but good day. I have been working a swing shift to make sure we have 3 nurses there to admit the second patient who comes out after dinner so I am on the weird time schedule. But it has been working out well.
There have been the usual enjoyable moments here of meeting patients families or other patients and receiving their warm smiles and appreciative handshakes. Of hearing funny phrases like she looks smart or instead of saying xray the man says exposing. For some reason I love that.
I wish I could post a photo but Duncan, our first patient the 62 year old had to go to the floor today. When I came in to work at noon I went over and said hi and are you feeling better today. He said no. The Kenyan nurse nearby told me he didn't want to leave the ICU and go to the floor. So on his way out tonight we wanted to take a picture with him. So here are four of us crowded around him and his face is grump-tastic. It is amazing. I will post it eventually.
They are going to try and do some cases Saturday which I think we will be able to handle. But whew I forget how busy it is here and how it is pretty much work and sleep work and sleep. Tomorrow I am going to wake up early before going in to walk around the compound some.
Sorry this is  a long one.

Day 1

Yesterday was the first day. As I said we decided to do 2 cases Monday instead of Tuesday. While they were doing surgery in the OR we had a day or 1/2 day of nursing education for staff. Things went well...we talked about Rheumatic heart disease, valve repairs, basic heart info, respiratory info, some hands on to assess breath sounds and heart sounds and then we did a nursing lecture for their education requirement on how a patient goes from start to home when they get surgery at tenwek. The first case was slow going luckily so we got everything taken care of.
Our patient is Duncan a 62 year old who had coronary artery bypass. He did pretty well in surgery and was off the vent in 2 hrs and on some mess for his blood pressure overnight. He is a very sweet man and great to work with. There was the usual craziness when they first get back of figuring out which monitor can do everything we need and losing battery power on iv pumps but all in all good.
They decided to proceed with the second case evn though it was close to 5 when the first case finished. We went home for the night and came back this morning to find it had been a very bad night. The patient got out of the or at 2am and had trouble in the or but was doing okay. Had a lot of fluid on his lungs which was exPected and some prOblems with his blood pressure. Then around 4 am the oxygen in the hospital shut off. I guess we had over exes the system with the two long cases and used all of it and the back uP. The Parker arrested and oxygen was really the thing he needed most to help with his lung problems. So without that nothing they did could bring him back. So Roger, our sweet nurse patient from the Congo, passed away this morning.
This issue has brought things to a halt this morning all over the hospital and in thee or stopped all over and they have been working on the problem. They finally decided to do one case today and have gotten us back up oxygen tanks for our icu (the one we had last night was quickly emptied when the problem started).
It is a very hard way to lose a patient to something so easy to find at home. It is a hard way to start the week so prayers for our team here and for oxygen supply to be constant. More later.
Oh our patient today is named beauty and should get a mitral valve replaced.

We are here!

We have arrived...after 36 hours of travel. Travel was fine (other than being long) and all our many many suitcases arrived. We are set up mostly in the ICU and will do a partial day of nursing lectures tomorrow...only partial day because we are starting surgery tomorrow instead of Tuesday (I had a feeling this may happen).
It feels a little crazy because we just got here and tomorrow is so full. And we are a bit short staffed...but I feel it is in these ways that God shows up in big ways doing things that we could never do on our own. And that is a reminder I need in a huge way right now. As my heart and head are feeling stressed and full of details to remember I instead need some time to stop and remember who is doing every detail of this week...to take the pressure of myself and to enjoy the ride. So glad I got this chance to jot a few words down even to remind myself of some truth.
Prayers for rest for us all and a smooth first day. Cases are a CABG (yes, you peds people you read that right) Coronary Artery Bypass and then an aortic valve replacement and mitral valve repair for the second case. Be praying for these patients to feel at peace tonight in the anticipation of tomorrow (they found out around 6 pm tonight they would be operated on today) and for their recoveries as they start tomorrow.

Whew....Here we Go!!

Part of our team leaves tomorrow for Kenya. Some of you know the back story to these amazing trips, but I will give a short recap.
A physician who used to be at Vanderbilt went to med school with a physician who was living and practicing as a surgeon at Tenwek hospital in Kenya. They started dreaming about what could be done to help kids with sick hearts in Kenya. See there isn't a reliable way for them to get surgery to fix their hearts. Nairobi has a cardiac surgery program but half the time they cancel things or it is way too expensive for anyone to afford. They do a handful of cases in a year. So the dreaming continued and 4 years ago we took our first team to Tenwek. We had a bypass machine and a ton of other equipment shipped over. Our first team was small...I think around 10 people total to cover the OR, the ICU and clinic. We finished that week off doing I think 11 surgeries to help children and young adults who have congenital heart defects or valve problems resulting from Rheumatic Heart Disease and have gone every year since. The trips have continued and have grown not only outside of Vanderbilt but our patients each year are coming from further away.
This year we are expanding the trip and doing two weeks of surgery. The first week will be primarily valve related older patients and the second week will be kids with congenital heart defects. Some of our group leave tomorrow and some leave next week and some of us (that would be me) are there for the whole trip.
I am going to try and blog while there and fill you all in on the journey.
Here is our nursing team across the two weeks (minus Lisa)

You can continue to pray for safety for the team traveling, for our patients who are getting ready to be operated on...for peace for them and for our interactions with them, for our team...the first week we are a little short on staff so we will all be working extra hard, and for each person on the team and their experience.
Can't believe that we are already heading out!!
Will write again early next week once we are there after our 2 days of travel and settling in! We may do our first surgery Monday afternoon...either that or Tuesday morning.

Still

As I finally chose to sit and be still today (it is almost 7 at night) I am reminded as always how much my heart needs these times of silence...that I spend so much time avoiding my thoughts and fears and in the case this week nerves. I guess I think if I don't sit and spend too much time thinking about it they aren't as real, which really seems like the mentality of a 3 year old (I won't go into the nursing theory behind this), but I guess that is still where I am. Acknowledging these fears really does the opposite for me...it reminds me of the truth, it reminds me of who is in control, it reminds me of my inability in, well in everything, and my need to rest on God. Yet I run and run until I am worn out and forget that the Prince of Peace is beckoning me to come and sit, come and eat, drink, enjoy and rest and be freed of the worry and fears that I carry with me.
One of my favorite Psalms is 62:5-8
My soul, wait in silence for God only,
For my hope is from Him.
He only is my rock and my salvation,
My stronghold; I shall not be shaken....
Trust in him at all time, O people;
Pour out your heart before Him; God is a refuge for us.
(For Adrienne and Danielle, there is a Selah at the end of it too).

Kenya...so far we are a go people

This week has been busy. Period. I have decided I have entered into that pre-trip phase of getting little sleep and having my mind be filled constantly with things related to it. 
What I was not expecting was that the actual trip and if it would occur would be questioned. I won't go into the details too much, but basically on the Somalia Kenya border there has been some unrest related to a rebel group within Somalia kidnapping some relief workers at a refugee camp on the border in Kenya. Kenyan troops have retaliated by entering Somalia. That has spurred this rebel group to threaten Kenya. All this has happened in the last week and suddenly I was seeing headlines on CNN saying terrorist threat to Kenya.
So this week has been filled with a lot of asking questions of safety from people living in Kenya, lots of prayers for wisdom and guidance and resolution of conflict and lots of attempts at trusting God within all of this.
I know we never know what the future holds but this makes that even more evident. And has made it even more evident how little I trust and how much I want control over everything in my life. But God has different plans...he calls me to trust him, to listen for his voice and his leading, and to follow. Even if this goes against what I want to do or even if the risks seem great. I can trust His voice and His hold over my life and the direction that he is taking me.
John 10:27-28
My sheep hear My voice, and I know them, and they follow Me; and I give eternal life to them, and they will never perish; and no one will snatch them out of My hand.

But first...

A couple weeks ago I posted about making room for imperfection. I love seeing how lessons come in the right timing...exactly when I need  it, usually to prepare me for the next thing (even though I have no clue what that next thing is). This is another good example of that. All that being said...I promised a few pictures from what had been bringing a lot of this to the surface when it came to leadership and not being in control. Habitat builds...

 Stella, the soon to be owner of a new house

Get it, Leah.

By the end of the day we had framed exterior and interior walls of this house and I had suddenly become thankful for all the challenges this had thrown my way. Funny how that can work.

Fall Festivities

One of my favorite things to do in the fall is go to the Pumpkin Patch in Franklin. I love walking through the rows and rows of pumpkins on the vine and finding a good one. So pretty much every year I make my friends come along :) And strangely every year we go on a day where it is really warm..hence the tank tops and shorts people have on.

Kristen and Ben got some awesomely big pumpkins...on the vine they are still green and will turn orange as the sun ripens them. I was into the little guys this year and I love these light orange ones.

Oh and check on the giant squash that I picked out of the garden last week. I think that the summer garden is over now that we have had some cold days. But our potatoes are sprouting again and the lettuce I planted is starting to pop out of the ground.

More on Kenya updates next blog...it is coming up so soon!! If you have been looking at the news there is some unrest going on on the Somali Kenya border so just pray for peace and wisdom as we continue preparing to go.

I am not as good as I would like to think

I live most of the time thinking I am not such a bad person. I live in denial of the grossness of my heart and my inability well really to do anything with God. Last week I felt like God was hitting me with bomb after bomb of reminders of how gross I really am. I won't go into too many details but let's say I was shown my failures in relationships, in communicating, in patience, in judgmental-ness, in love...etc etc. You get the picture.
In the midst of all of that exhaustion it is easy for me to get caught up in shame...in feeling like I need to apologize to every person I encounter for all my yuck and to feel like I owe God something. Well, of course, in typical fashion, I show up for church Sunday and essentially this was the topic of the sermon: our un-godliness. Randy talked about our tendency toward selfishness, control and destruction. And then we had some sweet time for repentance and worship.
Repentance.
Tim Keller defined gospel repentance as this: "But in the gospel the purpose of repentance is to repeatedly tap into the joy of our union with Christ in order to weaken our need to do anything contrary to God's heart." I like this definition...I think I used to think that if I repented I was saying I will never do this again. But I know I will learn this same lesson over and over. In my coming to the Lord I am saying my desire is to find life in you alone and to remember how you provide for everything I need.

Best Pumpkin Bread

I can boast about this recipe because it is not my own. We made this recipe in 4th grade in class with my not so nice or favorite teacher who will remain nameless. I do love this recipe though and made my first batch of the fall. I usually stock up on the pumpkin so I can keep making it long past the fall season.

Here are all the ingredients assembled: (note...this recipe makes 2 loafs or a lot of muffins so half it if you want...I freeze the other half of my pumpkin for the next batch)
3 cups sugar
4 eggs
1 cup oil
   Blend these 3 together, then blend in:
1 can pumpkin
Slowly add the dry ingredients:
3 1/2 c flour (I use wheat flour)
1 t baking powder
1 1/4 t salt
2 t. baking soda
1/2 t cloves
1 t. cinnamon
1 t nutmeg
1 t. allspice
   Blend well, then blend in:
2/3 cup water.
  The batter will seem wet but this is what makes it m-o-i-s-t (as much as I hate that word, this bread is that)

Pour into 2 greased bread pans or muffin papers and bake at 350. Bread 55 minutes, muffins 18 minutes.
  It smells amazing in my house right now! Yay fall!

National Arthritis Day

In honor of National Arthritis Day (which was yesterday)I decided I would talk about my newest endeavor in the world of RA....acupuncture. I have been thinking about trying it for awhile and finally decided to bite the bullet when a friend gave me a recommendation. I don't fully understand how acupuncture works but this is my understanding as of yet. It is an ancient Chinese tradition that works with the body's energy, or Qi (yes, the infamous scrabble word we all use at some point). It doesn't claim to cure disease but relieve symptoms and help put the body back to a balanced state of health so hopefully the symptoms don't reoccur. It is used for all sorts of symptoms.
I went with really no expectations. The first treatment I was a little freaked out but since then I have found it to be the most relaxing thing I have ever experienced. Yes, sounds insane that laying somewhere with a bunch of tiny needles can be relaxing but it is. And no it doesn't hurt...every once in awhile when he puts one in it pinches a little but you really don't notice them.
One of the most annoying symptoms of RA for me has been fatigue...I walk around feeling like I got 4 hours of sleep even though I have had 9. But since starting the acupuncture my energy has increased and I feel, most days, way more like normal. And I have been able to come down on my steroids. So they may have made a believer out of me.
Happy Arthritis Day!

Getting Ready!

Departure for Kenya is less than a month away! Kenya has become a place that is dear to my heart...a safe place, a place of rest (well heart rest, not body rest really), a place of fellowship, a place of joy, a place of learning...it is a special place. I am starting to lose count but I think this is my 6th time going to the country and 4th time going to Tenwek to lead up the nurses on our cardiac trip.
At this point every day my brain is thinking of things that I need to remember to bring or have forgotten...we have hit crunch time! And I can't wait to get there.
One of the big jobs we have is bringing all the medical supplies we will need to run the ICU for 2 weeks. So last weekend some of the nursing crew got together to sort through all the stuff we have collected.

So much stuff!! Today I also got some stuff from this great place called Project Cure.

They are a non-profit that collects supplies from hospitals and then sorts it and ships it to third world countries. I have volunteered over there some and our group of nurses volunteered over there. So they let us take a few things that we need for our trip. Thanks, Project Cure!!
Soon this will be my view

Actually, more realistically this will be my view. But I am okay with it!

Making Room for Imperfection

The past few weeks I have been learning the tough lesson of putting aside a lot of my expectations and ideas and submitting and trusting. Eesh...I have failed pretty badly at it. I have been in charge of organizing some stuff and things weren't working out as easily as planned. I know in my mind I had this ideal scenario of how people were going to be running to participate and loving every second of what came out of it. Well, the first problem was people were in no way running. And suddenly my ideal plan was taking on a shape of its own that I wasn't too crazy about. In the midst of the process I found myself bitter, angry, blaming others, trying so hard to hold onto my picture of things.
Long story short everything turned out great...I was just the one having problems letting it turn into what it was going to turn into. I had trouble giving up control; I had trouble letting go of my ideal expectation; I had trouble being okay with things not being perfect and laying my pride to rest; I had trouble not feeling like I was letting people down by not having it be this certain way. I had trouble making room for imperfection. And the imperfection that came out of it was a beautiful picture and one I could not have created on my own.
I am sure there are many other areas in my life where I need to make room for imperfection....dare I ask for those to be revealed?
Once I have a few pictures from the experience I will post them.

Blog Anniversary

I started blogging a year ago from yesterday. I missed my blog anniversary since my day was filled with the teaching of the students. But today I have had some space to relax and enjoy and be still and think, among other things, about this blog.
I am glad I started this ole blog...I know it doesn't get much traffic, but it has been a therapeutic place for me. I have been able to live life, to bring words to my heart and head and to have some fun posts too. It is good for me and so I will continue on in my postings, though they are more rare then in the past. I have always been someone who journals but I mostly journal my prayers because my mind tends to jump around a lot. This is like a journal to me too (though, lucky for you, not as vulnerable as the paper one)...this one is just easier to go back and find certain trains of thoughts. It serves as an Ebeneezer to look back and see trials, growth, learning. And maybe it serves others too. Who knows.
The following was part of my original post and part of my impetus to start blogging. My diagnosis of RA had turned my life in directions I didn't know were possible. And the lyrics from Andrew Peterson's song were (and still are) words that spoke deeply to my heart to remind me of truth.
 Love below me
Love around me
Love above me
Love has found me
Love has found me here

Yes but No

The other night I was talking to my dear friend about life right now...how I have found myself in charge of a lot of things and how I have been feeling the tension of being in charge, but not being ultimately in control. I was telling her of this struggle...this desire to be in control that is so strong within me I fight hard to let go of it. She laughed and said "Not being in control is exhausting!" We laughed really hard about the irony of this statement, and how we were both seeing that in our lives. But I am finding there is so much truth to it in terms of how I feel. Not being in control should bring such freedom and a lightness to things but that is not my experience of late.
This whole idea is going to take a lot of time and listening to get to all the inter-workings of why I fight to relinquish control. So I am asking for that to happen (yes, scary thing to ask for).
In the meantime I have been re-reading Isaiah 55 for a week or so and this one little verse has been speaking some goodness into me.
v. 2 "Listen carefully to me and eat what is good. And delight yourself in abundance."
I have to be open to hearing and listening. I can chose to live in self pity or carry the weight of responsibility or play the martyr or victim or believe that I am on my own or I can eat what is good. And lastly I can delight in all that I have been given and in the promise that I am given all I need even if it is this very struggle.

Cooking Ventures

I feel like I should write more about living and enjoying food in my limited spectrum in the DF, MF (dairy free, meat free for those up you not up on the slang) world. The comment I hear most frequently is "I could never give up dairy...I love (fill in the blank with milk, cheese, ice cream)" too much. Then people usually proceed to go on talking about all the yumminess I avoid. Well, yes, I love those things too. But the reality hasn't been as bad as you would think and obviously knowing that it makes me feel bad is the easiest way to avoid it. That being said, the other night I tried a new and delicious vegetable. I had been hearing about this from several friends at work and then saw it on sale so decided to try it. What is it, you may be wondering?
Spaghetti squash! It was great and really easy to cook and once cooked almost turns out like spaghetti. Once the inside gets cooked and soft you can take a fork and make it stringy like angel hair pasta and scoop it out...pretty fun.
Okay here is what you do. (I did not take pictures as I made it because it was after work and I was starving!! (image from mscollegefoodie.wordpress.com))

You can either cut the squash before you cook it, but it is tough, so I stabbed it like you do a baked potato and baked it whole in the oven at 375. After it had been baking for 20 minutes I took it out, cut it in half, scooped out all the seeds and then put it back in the oven for 20-25 more minutes. Bake it until it is soft.
Then when you take it out, rake a fork through it and scoop out the insides. That is it.
I am told you can cut it in half before hand, scoop out the seeds and then microwave it for about 5 minutes in water and get the same results.
I served mine with pesto I had made and frozen earlier this summer, but you can do it with pasta sauce, butter/oil and spices...whatever.
It was delicious and apparently low in calories and a good source of vitamin a, folic acid and potassium.
Maybe I will post my pesto recipe sometime soon.

Many Vacations

I have never taken so many vacations as I have this summer. Not complaining at all...it has been really nice to have a lot of breaks from the real world. And with my job it really isn't too hard to swing...I just haven't been great about planning them.I didn't do a great job of taking pictures on the most recent but this is the idea from a previous year...

Lots of reading, lots of sitting and thinking, lots of beach walking, lots of down time. I think all my vacationing has been good in terms of hopefully helping me set a more restful tone to my usual week. I have realized the deep healing that comes from uninterrupted time in silence or time without the worry of the usual days. When my days are jam packed here there is no space for me to hear God speaking. So this will be my hope as I go into non-vacation stretch.
My next trip will be to Kenya, which I don't really count as vacation, even though it is refreshing in it's own working-your-tail-off sense.

Promise

"Be still before the Lord and wait patiently for him" Psalm 37:7
Oh waiting...the most difficult task ever. I couldn't wait for the slow granny in front of me in traffic today. So waiting to see how God will work seems an impossibility. I came across this verse this week and I have been re-reading and spending time with it.
Be still to me is: don't take it into my own hands, stop rushing about, sit, like Mary at His feet, don't worry, allow my spirit to be calmed. And wait with patience. I think this means wait with hope too. Most of the time I don't believe in his promises and don't believe that he is for me or knows me or loves me enough to give me what I need. So my waiting is either short lived or non existent because I am trying to fix things myself because I don't believe. I need help with this, like I need help with everything else in my life. Humbling. Yet so true.
That's it..short and to the point.
(This picture has nothing to do with this idea other than the fact that I really like yellow roses)

Faith

Tim Keller:"The critical factor in my faith is not it's strength but it's object."

Romans 8:24 "for in hope we have been saved, but hope that is seen is not hope; for who hopes in what he already sees? But if we hope for what we do not see, with perseverance we wait eagerly for it."

When I get frustrated in my unbelieving I usually find myself thinking, even subconsciously, that I need to do more, believe harder, should have done better, etc. Faith is a hard thing... it is hard to believe in what we can't see or believe in promises we read but don't always feel. I like this Keller quote. To me it takes me out of the equation in terms of how hard I believe, it takes the guilt out of it, it gives some handholds to this difficult to grasp thing called faith. It isn't how hard I believe, but what I believe or where I am placing my hope. Which then leads me to the next question: what am i believing or where am I placing my hope?
It is so much easier for me to believe in the things I can see or feel or touch. I am at his mercy to even start this process. What I bring is my helplessness, my need, my inability and my desire to be in this place of faith. It is a fight most days to have this posture, to loose the control I think I have, to be willing to let him work and to see my need.

What is the object of your faith today?

Friday Cabinet

I thought I posted about this months ago, but I was mistaken. I know I was waiting for awhile because I wanted to complete it a bit more before showing photos.
The back story: I bought my first place a little over 3 years ago. At that time my parents wanted to get me some kind of housewarming gift. Well, I didn't really know what I needed or even what my sense of style was at that point so I held off. Mom kept her eyes open and kept pressing me to find out what I was liking or thinking would be useful. Through Amani opening their store she has become a regular at this store called Lost in Time...it is a kind of furniture/antique/random collection of items...a truly classic place. You never know exactly what you might find there. But, she has gotten to know Jerry, the owner, and he started looking out for Mom for me.
What they came up with is amazing... I love it!

And one of the things I love most about it is the story behind the furniture. This is called a Friday Cabinet. So when this was made, carpenters used to make pieces out of a certain type of wood each day of the week. For example Monday pieces were made of Walnut, Tuesday made of Pine....etc. But on Friday they would use all the leftover pieces to make a cabinet..hence the name Friday Cabinet. So it is very unique...you can see some of the different pieces and grains of wood, but it all blends so beautifully together.
And the fun part was filling it....

This is my favorite shelf. I found these bottles and sifter at the Flea Market here...they are old medicine bottles. That picture is of my grandparents. I never got to meet my Grandfather and Janie Mom, my Grandmother was only alive for the first few years of my life. This is a picture of the two of them together on vacation and they just look so joyful and happy together. Mom passed a copy of the photo on to me awhile back and it is one of my favorite things.
So that is my Friday Cabinet...

New eyes

I have been working through the frustation and bitterness revolving around rheumatoid arthritis again. I feel like that same frustation can be applied to any situation that you don't want in your life. Will I view this as an annoyance or something I should be ungrateful for? Or will I open my eyes or my mind to the possibility that there is a gift or something more within it?
I have been working through this some this week. It has been a sweet time, tough, but sweet. Here is a psalm that I read during this time.
Psalm 30:10-12
"Hear, Lord, and be merciful to me. Lord be my help."
You turned my mourning into dancing; you removed my sackcloth and clothed me with joy, that my heart may sing your praises and not be silent. Lord my God I will praise you forever.
And a song quote from Mumford and Sons: lend me your eyes and I'll change what you see.
So here is to thankfulness that He can change how I see things in my life.

Am I Free?

Or maybe the better question is am I living free? Am I living in the reality of the freedom that has been given to me; in the reality of "I am alive"; in the overflowing abundance of grace and his new life for me?
I think I have been struck by that this week....of this reality that I am given a new life but many times I feel like I am still living the old life. Like a prisoner who has been set free but won't walk outside of the cell, I like the idea of comfort or control or knowing where I am versus walking into the unknown (i.e. having to believe).
This is a quote from John Gerstner:
“…the way to God is wide open. There is nothing standing between the sinner and his God. He has immediate and unimpeded access to the Savior. There is nothing to hinder. No sin can hold [you] back, because God offers justification to the ungodly. Nothing now stands between the sinner and God but the sinner’s “good works.” Nothing can keep him from Christ but his delusion… that he has good works of his own that can satisfy God… All they need is need. All they need is nothing…"
If I think this has anything at all to do with me, my abilities, my control, then I am missing the point completely. And to miss the point completely is a life as a prisoner. Help me to live freely!

Gardening Still

The heat has been a little rough on the yard this summer but mostly my yard and not our vegetable patch. Things are still blooming and we have had our spurts of a lot of veggies.

It looks a bit of a mess but in its messiness is some goodness. We still have tomatoes, cucumbers and potatoes to eat. I am still holding out hope for the squash, but I think our green beans are finished. We grew carrots and they are really cute from the top but never really made anything edible. Here are a few more shots.

 See, cute, huh?

I looked here for seeds for cool weather lettuce and such, but hadn't been able to find any. But when I was in the big Winston-Salem, lo and behold, they have seeds. Not just regular ole packets of seeds; you can buy them by the 1/2 ounce and they come in these cute packs...felt very old fashioned. But bonus was the vegetable planing guide they also gave me. So soon (according to my chart from Aug 15-Sept 15) I will plant my spinach and lettuce and hope for an extension to the veggies.

Poverty

Mark 12:44 ...for they put in out of their surplus, but she, out of her povery, put in all she owned, all she had to live on.
This is the story of  Jesus' observations of people gifts. I have read this before, but this time around it hit me in a different way. In the past I have thought more about the generosity monetarily. But I was thinking more about the woman's trust. She gave all that she had..all the money she needed to live on and get to the next day, not to mention the next week, she gave. She gave, trusting that God would provide for her needs. What trust! Not only do I not have that kind of generosity, I don't have that kind of faith.
I also know that I hold on to certain parts of my life, thinking I have control and wishing to live in that illusion, rather than surrendering all. I live in an illusion of wealth...that I have something to contribute in this whole deal.
I long to live with this kind of recognition of my need and this faith of conviction and action.

MIA

Yes, I have been MIA. Crazy week. And then I ditched the old phone and got John's iPhone, so I have been spending time trying to figure it all out. So adios ole flip phone...you lasted way longer than I thought!

Part of this week's busy-ness has been learning how to be a nursing clinical instructor, a new task I am taking on this fall, and working on plans for Kenya. I am really excited about both. But especially excited about getting to go back to Kenya. We have a great team this year and are expanding the trip. Over the past 3 years we have taken 3 separate teams to Tenwek hospital to perform cardiac surgery on kids over there. Our original team was composed of about 12 people. We have learned a lot from each trip and continued to expand and grow, collecting staff from hospitals all over the country. In past years we have done surgery for a week. This year we are doing 2 weeks of surgery and the planning has begun. It has been a lot of fun this week to shift over to thinking about preparations from that standpoint. And it has been really fun to start talking to our nursing team this year and to get to be a part of their experience. Some things are so hard to explain about the time there, but I look at each person on our team and can see what an integral part they will play and can't wait to see their eyes a-glow as they are serving over there. This is one of my favorite parts of the trip...just seeing the vision grow as more people participate. In planning for things, of course I have been looking at pictures, so here is one of my favorites from last year.

Sabbath

I have been reading Tim Keller's book King's Cross. It walks through the gospel of Mark and I am learning and seeing things in new ways. In one chapter he talks about Sabbath. I never really knew of the concept of taking a day of rest until college. At that time it felt very legalistic, almost as a means of people being better spiritually...like it was worth a lot of points to God if you didn't do homework on Sundays. So I didn't ever really give it much thought.
I enjoy doing less on Sunday and having time to think about the sermon on Sunday or just relax and not worry about the coming week or responsibilities. But I hadn't really thought about it in the terms that it is written about it Mark. It is the story from Mark 2 when the Pharisees accuse Jesus of working on the Sabbath because he and his disciples have gathered grain. In response to their accusations Jesus goes and heals someone. And says that the sabbath was made for man, not man for the Sabbath. And I think that is saying it all. That the Sabbath, this time of rest was made for me....that I need it and therefore he has made it for me.
The word Sabbath means "deep rest, deep peace...a state of wholeness and flourishing in every dimension of life." Keller writes, " Jesus means that he is the Sabbath. He is the source of the deep rest we need. He has come to completely change the way we rest. The one day a week rest we take is just a taste of the deep divine rest we need, and Jesus is its source." 

I don't observe Sabbath to check off another box but to enjoy the creator and lover of my soul. I need this deep rest and deep peace.