Value

Last month in one of my counseling times, I was challenged to make a list of what I value and then look at my life and if it lines up with those values. Obviously our values are going to adapt and change over time. I made a list a few weeks back and pulled it back out this afternoon. I am not usually a new years' resolution kind of a girl, but I thought re-reminding myself of my values at the New Year was a good thing. I decided they should have a spot written out where I can see them every day, so that is what I did.
What do you value?

I am sure this list will change and I can add to it as the year (s) go by. But it has been a good exercise in my life.

Happy Merry Christmas

I have been the biggest slacker in the blog world in the last 10 days. Between working, traveling home, being at home and some craziness that I can fill you in on later, life has been busy and honestly my mind has been far from here.
In the midst of having to work today, my least favorite day of the whole year to have to work, I tried to keep in mind what today was. When you are in the hospital at work it really doesn't feel very Christmas-y. Families are in the hospital, children are alone, people are experiencing sadness and stress and discomfort, I am feeling alone and sad to not be with family.... In the midst of all of this, plus my own grumpiness of the day :), this verse about the coming of our Lord seemed appropriate. We all have somewhere in our life, even it is simply our sinfulness and inability to save ourselves, that we need to have someone speak comfort and redemption to.
Isaiah 40:1-2
   Comfort, comfort my people, says your God. Speak tenderly to Jerusalem, and proclaim to her that her hard service has been completed, that her sin has been paid for, that she has received from the Lord’s hand double for all her sins.
  Merry Happy Christmas!

 

Christmas

I haven't shown you our awesome decorations yet! I love our tree. As always we take the cheap way out and go to Lowe's to get it. But they always deliver and our tree, per the usual, is gorgeous.
Adrienne and I decorated while watching the Grinch, which has become our tradition. Crazy to think that this has the potential to not happen next year. But I am pretty much avoiding that thought right now :)
Our tree feels very Kenyan this year with the likes of these...

Angels and Kisuri bead snowman from Mom's store (and Adrienne's favorite ornament in the background)

This is my Tenwek Angel...getting one each year, I have decided :)

And of course the front...the inflatables are out as usual. I have stepped up my contribution to the Georgia house a bit this year. I intended to put lights on the roof but that never happened. Oh well.

Sadness

I have been reading through a book called The Voice of the Heart. It is about living abundantly by acknowledging our hearts, thus enabling us in relationships with others an God. It spends a lot of time on acknowledging feelings, which is something I am trying to do a better job with.
This last chapter on sadness hit home in many ways. I have always been one to shut down my feelings particularly ones I have labeled as "bad." Sadness and anger have always fallen into this category but I am learning to not place any emotion in that category.
Anyway this chapter on sadness eded with some self reflective questions I thought I would throw out there:
What are you sad about?
What wound has been unable to heal because of the sadness you aren't feeling?
What sadness is in your life that you fight against?
What have you been dreaming of doing that you haven't risked because you might lose?

More Advent

This passage is from Russ Ramsey's Behold the Lamb of God. He is telling the story of Moses and the Israelites and their journey through the dessert. (It is on Day 9 if you are reading it too!)
 Still, for all Moses' greatness, from the day God sent him to lead, the people complained about him. This wasn't because Moses was a bad leader, but because in order for people to be led, they must leave something behind-and people grow fond of home, even if they've only been enslaved there. For every step Moses led them to freedom, they found something to lament and complain about.
Um, yep, this pretty much sums up Me! How much do I fight where God is leading, how much do I complain about what I don't have in my life or what I want, how much do I resist listening, how much do I ask for more when God promised to give me what I need for the day?

Precious

My head space has been commandeered for the last little bit with life details. But I did come across this George MacDonald quote posted by the Rabbit Room folks:
  I would rather be what God chose to make me than the most glorious creature that I could think of: for to have been thought about, born in God's thought, and then made by God, is the dearest, grandest and most precious thing in all thinking.
  The holidays are always tougher for me in terms of believing that I am in the right place in general in life...it is easy for me to look around and see what others' have in life and wish for that. I think in general Christmas lends us to a lot of expectations that end up not being met...it is easy to forget about the one who loves us so intently and get caught up in whatever may be your struggle during this season.
  But I can rest in the fact that I was created to be me, which I am learning a lot about these days, and that to glorify God in all that I do I must live freely from the place of being me. And it is a dear, grand, and precious place to live.

Day 1/2

I am going to try and keep up with Russ Ramsey's Behold the Lamb of God and The Jesus Storybook Bible so I'll be sharing stuff from both of these throughout the month.
This is from the first chapter of TJSB. So good! Thankful for such truth and love today

Advent

I saw this link on Pintrest and thought I'd post it. We got our tree today and things are starting to feel more Christmas-y in our house. I even put the lights up-I am still no match for Leah and Mark but I am getting a bit better.
It's advent season and this is a good read if you have the Jesus Storybook Bible. Apparently there are 24 stories in the Old Testament section of the Jesus Storybook Bible. Each ends with some reference to the coming of Christ, preparing us for what needs to happen. And then the 25th story is the birth of Jesus. Maybe she knew that and planned the book this way, but I think it is pretty awesome. And since I already love The Jesus Storybook Bible it all works out :)

Me

I have been learning a lot about who I really am and how to return to that place and find freedom in that place. This could be a way longer explanation but essentially in order to be the me I was created to be, I have to learn to be vulnerable, to let others' see my weakness, to not need to control everything. This is tough stuff! But also incredibly freeing stuff. In the moments
This blurb on courage sums it up well:
  It will always feel courageous to live from your true self, because it is letting down your guard, showing up with what you really have, it could be too much, it could be too little. It is what you have. It also may mean that I do not get the acceptance I was working so hard to get from others.

I Am

This song has been running through my head all day. It is one of my favorite Jill Phillips', I Am...so many great reminders of truth.

  O weary, tired and worn
  Let out your sighs
  And drop that heavy load you hold, cause mine is light
  And I know you through and through
  There's no need to hide
  I want to show you love that is deep and high and wide 

  I am constant, I am near, I am peace that shatters all your secret fears
  I am holy, I am wise, I'm the only one who knows your hearts' desires.

Weary

I think the events of the last month all hit me today at about 6 pm. I feel suddenly weary from all the busy-ness of the last month. I feel I haven't allowed myself time to process from being at Tenwek. I have been running from the stillness that I know my heart craves.
I am very much praying this verse for myself this week:
  Come to me all who are weary and heavy laden and I will give you rest. Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls. For my yoke is easy and my burden is light. Matthew 11:28-30

Thanks

Geez, I have been a slacker this week!
I think I am about footballed out so thanksgiving break must be coming to a close.
In our small group on Tuesday we were talking about the verse in 2 Corinthians that talks about boasting in our weakness. In our discussion I realized that if I truly believed all things come from God, I would be more thankful. I probably wouldn't describe my usual posture as this. I have my days and moments but I usually have to remind myself to stop and be thankful.
I am thankful for so much this year. After what has been a very challenging year for me I am once again thankful for God's faithfulness to me. It continues to blow me away.

All Time Faves

This will be one of my favorite memories from Tenwek. Her beautiful smile. Her eagerness to share her heart. Her free spirit. Her lack of concern for what others' may think. Her desire to praise God. Love it.

Quote

This quote seemed to put great words to God's love for each of us:
“Then there’s a third way: to live as though you believe that the power behind the universe is a power of love, a personal power of love, a love so great that all of us really do matter to him. He loves us so much that every single one of our lives has meaning; he really does know about the fall of every sparrow, and the hairs of our head are really counted.  That’s the only way I can live.”
– Madeleine L’Engle A Circle of Quiet

Wonder

Our last night at Tenwek we had a quick wrap up meeting. At the end of our meeting, Russ prayed for the team, prayed in thankfulness for the 2 weeks that had happened and lifted up our continued involvement at Tenwek. During his prayer he basically praised God for caring enough about these few patients out of all the people in the world that he would reach down and work miracles and heal their hearts. It really is astounding. The idea brought tears to my eyes...that God would love any one of us so much that he would do such a mighty thing. These events are clearly a big life event for our patients, but it is amazing to me that He would give me something as simple as a sunrise or a bird singing or a moment to not be busy during the day to rest. They are all big deals and I speed through life not noticing the magnitude.
That is one thing being at Tenwek always teaches me...pole pole. This is the Swahili phrase for slowly. It is funny because we hear our Kenyan nurses saying it a lot-to our patients, to each other....everyone walks slowly throughout the compound, there are numerous chai breaks during a day. There is a lot of time for slowly and it always takes getting used to when I first arrive. But now that I am home I miss that. I don't like the constant busy, the constant entertainment world we live in of smart phones and distraction and noise. I want the quiet and slow pace back. Even though I work like a dog while I am there, this pace is in the background and it impacts life.
A week ago Dotta passed away, so I thought I would include some photos of him. I could never get him to smile for the camera or really to even look at it. These are a few of him during the first week when he was in the unit before surgery. I continue to pray for his mother, Deborah and the rest of their family in Tanzania.

Baraka

I am back in Nashville...got home this afternoon and have a load of laundry going...back to the real world. I am really tired, so I am sure these won't be the most coherent thoughts...more once I process and sleep :)
Our last day of surgeries Friday went great-2 more sweet faces-Kibet and Chepkorir. Both did really well.
We had a wrap up meeting Friday night and the mutual feeling was that it was a great trip-things we needed to improve upon from the previous year happened, the teamwork was great, there was a lot of education progress..all in all a good 2 weeks.
On our way back from Tenwek to Nairobi it started raining. Our driver said rain is baraka, or blessing. I sit here, exhausted, jet lagged, worn out feeling like I have been showered with baraka over the past two and a half weeks. From our patients, to witnessing miracles of healing, to our teamwork, to the hilarious things the nurses and patients say, to the beautiful surroundings of Tenwek, to every busy shift and night without sleep, all the many meals of avocado and rice... I feel so blessed by the time there.
More processing and pictures to come, but I'll leave you with Mary-she stole all of our hearts with her absolute cute-ness! (headband is courtesy of us:)

Maggi

The rest of our night on Wednesday went well after Dotta's passing. Our little Truncus repair, Ian, whom I love, did great. I think he will be a runner some day because all night long his feet didn't stop moving. He got his breathing tube out right before we left in the morning. They also did 2 cardiac cath cases, which is a first and both patients did amazing. Their sweet smiles were a gift during the sadness of that night.
Last night, Leah and I got our booties kicked...it was really busy. There were 3 surgeries yesterday-Mary who is also the cutest little 9 month old, Kipchirchir and Chepkemoi. Between the last two we got asked for maggi or water about 100 times. Chepkemoi got her breathing tube out around midnight and it is like the child has never had a sip of water in her life. At one point she tried to stand up in bed because she said she was going to walk to the faucet to get some. (We have to wait a few hours after they get their breathing tube out before we give them water and then have to go slowly so they don't get sick to their stomach...try explaining that to a 2 year old) Kipchirchir was another miracle. He had a tricuspid valve replaced (for medical folks it was Ebstein-like) and they really didn't think he would be able to come off pump. When he came out of the OR he was sick-on lots of meds for his BP. Somehow we weaned those down enough overnight that he was ready to get his breathing tube out by about 5. Before then he was asking for water. When I told him he couldn't have any because of the breathing tube he said. Will you please take it out so I can have water. He is 8. Very sweet, patient boy. So we took it out and all he wanted was maggi. It is like they have never drunk before. The rest of the morning you just look over and his sleepy hand is beckoning someone to come get him water. He also requested bubbles as soon as he was extubated...hilarious!
When everyone came in this morning they were shocked to see him without the tube and off most of the meds for his bp...lots of people were praying for him last night. I believe that as much as we can do with our skills and our hands here, we can do equally as much in prayer for these patients. I have seen it work again and again-miracles happen, God provides in miraculous ways. I am astounded and grateful.
Made it through my night shifts. I am up again and will go up and stay til later tonight-they are trying for 3 cases to round out the week.
I can't believe I will be leaving this place I love so dearly again tomorrow. Praying about how God wants me to move and work with with the gifts he has given me.
    Ephesians 3:20 Now to him who is able to do immeasurably more than all we ask or imagine, according to his power that is at work within us

  

Dignity

Tonight has been a hard, sad night. The patient who we did surgery on Monday, Dotta has not been doing great. He came to us last week for a few days so we had gotten to know him some last week. He was an old man in a 12 year old body...very shy, observant and stubborn. On Monday when they saw his heart everyone realized it was sicker than they thought, but we proceeded to try and help it as we could. He was doing okay the day after surgery until the afternoon and developed some GI bleeding. Then this afternoon he arrested. They got him back but he was so sick after. By tonight we knew there was nothing more we could do for him-he was on so many blood pressure medicines and still he was on the verge of arresting again. So we decided to withdraw the medicines and the breathing tube and let him be with Jesus.
I think he would not have lived much longer if we hadn't tried surgery. And I think that we did all we could for him. I will never understand how God works, but tonight I felt a lot of peace in the situation. We allowed him dignity-a chance to fight to live and a chance to die with peace and not suffer any longer.
It was an emotional night. His mother, who has 7 other children, was so strong all day. She finally lost it and just wept and mourned outloud for her youngest son. Those of us here shed  many tears.
Dotta loved to be prayed with, as did his mother. I know he is with Jesus. His mother told me the day of surgery that she trusted God and that he knew Dotta. I know that God knows Dotta and knew how his life would play out. I am confident in that.

Manna

I have been feeling discouraged this week. I think the weariness of last week, the weight of all these patients and only so many days and hours to work to fix them have been wearing on me. I am forgetting who is my strength, forgetting who is doing the work, forgetting who is my stronghold, my fortress and my deliverer.
I emailed a friend last night just to ask her to pray. Then we went back to our place and stayed up too late laughing...my soul needed the laughter and silliness.
My friend emailed me back and reminded me about manna, how God provides. So I looked up Exodus 16. Here is what it says:
Then the Lord said to Moses, “I will rain down bread from heaven for you. The people are to go out each day and gather enough for that day. In this way I will test them and see whether they will follow my instructions.  On the sixth day they are to prepare what they bring in, and that is to be twice as much as they gather on the other days.”
God will provide what I need, what our team needs for this day. He will rain down his provision. I am not to worry about tomorrow, or even my night tonight (we are doing the smallest child and the most complicated surgery we have ever attempted at Tenwek).
Praise the Lord for this... 

Boys

Last week we did surgery on primarily women. This week we have 3 boys in the unit. Our first patient from yesterday did awesome and left early this morning. Our second patient, Dotta is still in the unit and doing okay, but having some complications this afternoon. Then today we did 2, one who did well and will hopefully get extubated soon and the other is still limping along a little. Pediatric cases are just a lot tougher than adults. It is hard not to feel a little disappointment that things are slower going and that we are not getting through as many cases, but we are here and I am trusting we will get to the children we need to. One of the big criteria when we select patients is will they be alive and operable by next year.
I am tired...feeling the long days back to back. My patience was wearing thin by this afternoon...I was not feeling like teaching and was frustrated that I have to explain things when the nurses shouldn't really know these things yet. It is challenging.
Praying that God will give me strength for each day, patience for each moment of teaching and rest that feels longer that it actually is. I work nights again the next 2.
Here is a pic from the top of Montego...sorry it isn't more. Tomorrow I should have more time to post since I will have the day free.

Monday, again

Whew! I am beat! We did get a bit of rest in yesterday...all our patients were out to the floor by lunch time on Sunday and my alarm clock broke Sunday, so I got more sleep than I was supposed to, which was pretty awesome.
The rest of the team is here and yesterday we had a big group meeting to go through the patients for this week. They had a list of 28 patients, which was not including many patients who they have either decided are too sick for us to do, are too well to need it now, or who are too far past us being able to do anything. It is really hard to sit there and make decisions-not that I am really making decisions-but it feels like such a heavy weight. I know we are not ultimately the ones making decisions, that God has placed certain children here and certain children on the surgeons hearts and minds, but man it is really hard to know how to make these decisions.
Before the week got crazy we decided to go for a sunrise hike up to Montego, the hill about an hours walk from Tenwek. I have been up there several times and it is gorgeous, you can see for miles around, plots of land, the hospital. But sunrise was unreal. It was amazing! We had to get up and start hiking at 430, but it was worth it. Eventually I'll get some pictures on here (I put a few photos on heartsofeastafrica.blogspot.com).
We got back in time for me to go get 6 of our patients from last week to go get a follow up ECHO. They should have all gone home today, but transportation was an issue for many. I love those ladies..their smiles, how they greet us. They are so thankful and praise God for all that He has done. It was a good morning.
We got a bit of education in before the patients came out.
We got through 2 cases today. A sweet VSD who came out with personality, yelling at us because she had been pricked too many times and wanting water. She got sweeter a few hours later and is doing great.
The second case went differently than we thought, but the patient was doing okay when we left the ICU tonight. Prayers for his night.
I am struck over and over by how we are not in control here. It can feel like we are and that we have all this pressure to decide on these, but we are not. I went out to pray with our second patients' mother and after we finished praying she said in Swahili, essentially that God knows her son, that he loves him and will take care of him and do his will. 
Going to get a bit of rest!

Week One Down

Saturday evening here and I am sitting in the unit with our last 2 patients-Charles and Chepkoech. They are both doing well and could really go to the floor but there isn't space. We were hoping it would run smoothly so those of us staying over for the weekend get a little rest.
Today we went around to see all our patients on the floor...this is one of my favorite things to do. Their faces light up and the love to give a hug or a handshake. Today was extra special..I have been trying to take some videos of our patients for Hearts of East Africa and I was interviewing my favorite patient, Dorothy. I asked her about her faith and her church. She told me she loved to sing so then she asked may I sing and proceeded to sing some lyrics from her favorite song. I am going to try and upload it tonight when the internet is less full. The song revolves around God healing and bringing one through trial. Such a sweet song for her to love.
I know I have written about Caroline, the awesomest nurse, but we spent some time hearing from her on how the week had gone. In September Dr. Galat, the surgeon who is with us brought a skin and bones team (himself, a perfusionist, an anesthesiolist who doubles in the ICU, 2 nurses-one for days and one for nights). Caroline was here during that week, as were a few of the nurses. She told us this past week has been really nice to have so many nurses and ICU physicians in the room so that we can do more teaching. The September week she said it was crazy and she was having to pull teeth to get nurses to come and work during the week. So she has enjoyed having extra staff who can teach and spend time with each one of them. This is encouraging to hear. This year we have made so much progress in terms of the nurses learning, taking over care of the patients and getting used to the care so they can manage the valve replacement.
My brain is so fried right now, so I will try to be more coherent tomorrow.

Hillary with Amy and Cynthia

Chepkoech, our final patient, getting some recorder time this afternoon

Med Supply-looks just like home, right?

Nights

I just woke up from sleeping...it is 2 pm here, nice gentle rainstorm for me to write to as I sit on the porch. Hopefully I can rest some more this afternoon before going back in at 7 pm for a nightshift.
Last night went well. I had gone up to the unit during the day to give them lunch relief and to take some pictures of our patients. When I went up I heard that the patient in the OR, Hillary-a 19 year old boy-was having a hard time in surgery. He was not a mitral valve replacement...he had a place right by his aortic valve that was bulging that they were to remove. The tricky  part about this is your coronaries, that feed your heart muscle, lie in the spot they were to remove, so they had to mess around with those, first, one wasn't long enough to stretch when they removed the portion of the aorta, then they think part of it kinked...basically the patient had a lot of arrhythmias and time where the heart muscle wasn't getting good oxygen supply which can permanently damage your heart. Everyone was very concerned. They ended up taking a piece of blood vessel from the leg to bypass this coronary, so the procedure was long-he was in the OR around 11 hours. This was the scene we walked into last night.
Since that case was taking so long, Russ (the Tenwek surgeon) went ahead and did the mitral valve replacement on his own in the second room, so both patients came out right around 645 pm.
The valve replacement, Sabina, did well. And Hillary had a great night, woke up, was asking for his breathing tube to come out, came off blood pressure medicines and by the morning we took his breathing tube out! In many ways a miracle. I think he will still be slower to leave the hospital but all in all he is doing better than he should be!
We worked with Cynthia and Aaron in the ICU last night...neither is normally in the recovery or ICU for that matter, but they are catching on fairly well. They can do all the steps right, they just don't always put the pieces together in terms of I am seeing this, I should tell the doctor or I should think about doing this...this is one of the pieces that is really hard to teach because I think it is a cultural thing...something they have never been taught to do.
It is crazy it is already Friday and that some of our team leaves tomorrow!! It flies by here once we get going! There will be 4 of us left here to man the ICU but hopefully all of these patients today will do well.
In the midst of all this busy-ness and spending so much time and effort teaching I feel weary in my brain by the end of a 12 hour shift. But being here with such a strong group has been encouraging and seeing moments of breakthrough has been encouraging. Glad I am here with others who continue to remind and encourage me in what we are doing...Hebrews 3:13 But encourage one another daily, as long as it is called “Today,” so that none of you may be hardened by sin’s deceitfulness.

Lillian, all smiles!

Nightshift crew

Wednesday

My blog titles are pretty boring here, but I don't usually end up posting until the day after and I am trying to keep up as much as anyone else :)
About a year and a half ago our perfusionist, Tom met another perfusionist, Bob while both being involved in a legal case. They somehow starting talking about Tenwek and Bob has now been coming as a perfusionist. He is a part of our team this year. Before he even came, he sent a pallat to Tenwek that contained, among other things, 2 newer heart lung bypass machines (the one here is 20 ish years old, these are about 8 years old). That pallat got stuck in Mombasa (on the coast of Kenya) for literally this long. Ever since we got here on Friday we have heard that it may be released so we have been praying that it would get released while we are here. The palate arrived here on Tuesday, complete with the pumps. This has allowed us to up our surgeries to 3 a day. Because we have two pumps, while one case is finishing up in OR 1, they are already bringing the next patient back and getting them ready to go on bypass in OR 2...basically it cuts out a lot of turnover time for the room to get cleaned, for anesthesia to get the patient ready, for the surgeon to do all the work before they are ready for bypass.
Sorry, long explanation, but all that to say I don't doubt that the timing of this pumps arrival was a part of God's plan for this week. We had 2 successful days and felt comfortable pushing to 3 cases for the rest of the week. Yesterday, as the rest of the week went very well: 2 more women with mitral valve repairs, Julia and Chepkorir and a man who had TB in the past that caused the sac covering his heart to become thickened (this should feel like paper but his felt more like thick leather-yes we got to touch it). They went in and took out this thickened sac so that his heart now has space to pump effectively. All have done very well.
I know I will never be able to put into words what it is like to be here, to be surrounded by so many people who sacrifice and work so hard to not just try and help people heal, but long for their souls to know a God who loves them so deeply. I am always so struck by it and desire for my life to look more unselfish.
We have been doing nightly nursing devotions, which I have really enjoyed the time for us to all be together since we all work different hours, to stop, to hear a bit of someone's heart and to be still and pray with each other.
Last night Amy shared from the Jesus Calling episode from the day I left...what stood out the most to me was this: "He chose you because of your weaknesses. He knows you needed Him. Depend on Him for everything." I am so arrogant to believe that God chose me because I am particularly good at one thing or another, but the truth is, he chose me because I am weak, because I need him for all, because I can do nothing out of myself. Big reality to think on!
I work nights for the next two, so today I will be trying to rest...I am really bad at this.
I think this years' trip is going to be a bridge to some changes in how our trips look since they are starting to get the hang of things on their own, which is amazing. So prayers for wisdom as we discuss these things.

Peris and me prior to taking her to the floor yesterday

Jet Lag

Today is the first day I have woken up way early in the morning..I thought my time clock was past the time change, but apparently not :) It isn't too bad because I work at 7 so I would have to wake up soon anyway.
This year our surgeons and turnover times between cases have been faster so they have been finished with the second surgery around 5 or so instead of the 10 or so of years past. So today we will do 3 cases. I don't live in the reality of the cardiologists in the clinic and honestly I am kind of glad to avoid their tough job. They screen countless patients and are at the point where we have found plenty of patients for the week and are now telling patients that they can't have surgery right now. Last night they were weary from the burden of their job. And I don't blame them. So we jointly decided to push things a little and try to do 3 cases each day for the next 3 days to get a few more cases taken care of. I would rather be really busy and have helped 3 more people. They have scheduled a few patients who they expect to be very sick for Thursday and Friday, which are the nights I am working :)
Yesterday I felt myself getting frustrated towards the afternoon, not at anything in particular but just felt my patience waning. Sometimes being there all day, teaching the nurses while making sure the patients' are getting good care, answering everyone's questions, etc just puts me over the line on patience. I am praying that the Lord would bring me the patience I need...I know it is not something I can muster up. Even in the midst of that yesterday I laughed at my impatience when I looked around and saw 4 sweet Kenyan nurses at the foot of the new patients bed working on charting, asking about their pulses....God is doing great things here and I am blessed to be a part of it.
Our second patient yesterday, Agnes, is a young Mom. As soon as she got her breathing tube out she was literally praising God. She wanted me to pray for her. Then she kept saying "I am so tired, so tired, praise God" in her sweet Kenyan English. Agnes has had symptoms from her Rheumatic Heart Disease since 2005. Our first patient, Lillian was a bit sicker for a few hours, but she turned the corner and got her tube out and of course immediately wanted water. She is also a mother (yes, so far we have done all female patients ;) of 4. The oldest is 14 and the youngest a baby. She lives in Eldoret. I look forward to getting to know these two ladies a bit better today.

First Day of Surgery

Yesterday was the first day of surgery in our "adult" week. What most adults need surgery on here is not vessels that are blocked with plaque but valves that have become sickened due to rheumatic heart disease. Because people here don't have access to antibiotics like we do, they can get an infection like strep and left untreated it will attack their valves causing narrowing of the valve. This leads to heart failure. These patients are weak, get out of breath quickly, some have heart rhythm problems, fainting spells, constant coughing...the list goes on. One of our patients for later this week (potentially) has been having these symptoms for 7 years. I cannot imagine living life like this...unable to do so many things you long to do.
I digress. Our first days of surgery went great. Our first patient is Dorothy. She has rheumatic heart disease which has ruined her mitral valve, so the surgeon replaced it. Dorothy did amazing after surgery. Within 2 hours she was telling me about her little 3 month old boy Caleb and her desire to work as she has gone to University.
Peris is our second patient. She, like Dorothy, has rheumatic heart disease which has ruined her mitral valve, so the surgeon replaced it. She also did great. She was still pretty sleepy when I left the unit around 9 but was doing well, already drinking water and wanting to sit up.
Our nursing devotion yesterday was on taking time to be still and resting in God. This is especially hard to do here because it is go go go all the time. Today I have the luxury of going in at noon and working until midnight, so I got some sleep and have time this morning to go for a walk and be still. It is still a hard thing to do when you feel like there is work in front of you. But I need to rely on God, who is my source.
There aren't words to describe how beautiful it is here...I am sitting outside our room and it is green everywhere...such amazing beauty. I can hear the voices of school children reciting something and birds singing. God did quite a number here!
Today there should be two more patients. I think they are Jillian and Agnes, though they may have changed the plan for today. Prayers for their surgeries. Yesterday we started with cases we knew should do well, now we are getting into the more complex cases...ones that have a lot higher risk of having complications post operatively or not surviving the surgery. Continue to pray for wisdom as our team makes decisions with each patient.

Dorothy getting set up in the OR with Luke

Surgery has begun!

Recovering the first heart...look at our amazing Kenyan nurse team!

Teaching moment

Shots from Sunday

Families from Nairobi who are coming to be screened.

Patient discussion/selection last night

Start up tomorrow

The second group of folks arrived. We are mostly set up and ready.
Today I spent a little time with the patients being screened. They scheduled a small handful of patients to get ECHOs. 16 showed up. Then 12 more cam from Nairobi-mostly babies and small children. Needless to say they didn't screen all of those patients but we did select our first two patients. They didn't give names but they are both young ladies...a 25 year old and a 24 year old. I met one today. She has a beautiful smile.
All of the pediatric patients came with ECHO reports from Nairobi and I flipped through them. Again I am struck by how hard it is that we will not be able to help so many of these patients. Several of these pediatric patients are beyond what we can do here (Truncus with a single coronary). It is hard to meet the children, see their faces, shake their mother's hands knowing that we can't help (I have a picture of some of these sweet face that I will hopefully post later).
Thankful yet again that God knows each of these children and mamas and what he has in store for their lives.
This was one of the scriptures from church this morning. Thought it was a great way to start out the week
2 Chronicles 29:10-13
 Praise be to you, Lord, the God of our father Israel, from everlasting to everlasting. Yours, Lord, is the greatness and the power and the glory and the majesty and the splendor, for everything in heaven and earth is yours. Yours, Lord, is the kingdom; you are exalted as head over all. Wealth and honor come from you;  you are the ruler of all things. In your hands are strength and power to exalt and give strength to all. Now, our God, we give you thanks, and praise your glorious name.

Morning Walk

Some of the sights from my walk this morning. Sundays are quieter here too like they are at home...

These Dogs are Barking

If you haven't seen Planes, Trains and Automobiles then sorry for the title. Basically I am beat! We worked from 8 until 6 organizing and unpacking today. We managed to make it to the Canteen for a Stoney (my favorite drink ever...think really ginger-y soda) but otherwise worked through.
Pictures do better than words here. There is a storage place at Tenwek called the cages. All our Cardiac stuff gets stored there in between our trips. We started the morning off down there going through what is there and hauling it up the ramps to the Recovery Room, OR and new storage room for the Pumps and perfusion supplies.
Once it was all up it was a mess! But we powered through and managed to get everything organized neatly (which required taking everything out of their usual storage space in the recovery room to fit our stuff) and neatly labeled, thanks to Michael. We are ready for the next wave to arrive tomorrow with more supplies.
We have newly donated monitors and vents so life is looking better than it usually does at this point!
The wireless is being pretty slow, so I'll have to add pictures tomorrow morning if I can.
The words to Mumford and Sons new song Below My Feet have been running through my head all day.
   Let me learn from where I have been; 
   Keep my eyes to serve, my hands to learn
 That has been one of my prayers since hearing these great lyrics...that God would keep my eyes and my hands open to where he wants me to be. I love this place so much, but I think for the first year I am open to where God has me going and where he desires me to be, whether that is returning here year after year or digging into something new. Like so many things in life right now I am trying to learn to hold onto what I have less tightly, to be open to what the next steps in my life are, to be open to the fact that things in my life may need to change.
  We were talking about the Kenyans' faith today, how they see everything as coming from God and not really thinking of much coming from their own work. How different that is from how I view my life..I think I have earned something so how could I ever think of letting it go.
  Okay, off to bed. Will try to post again tomorrow and maybe get some pictures in there if the internet is better.

Made it!

We have arrived. It is around 6 here in Tenwek, I think around 10 AM in Nashville. Our travel time is complete for now and my swollen ankles and tired eyes are happy for the break. We traveled from Nashville to Atlanta to Amsterdam, had a  8 hour layover that we spent walking around the city, then got on another 8 hr flight to Nairobi. We go into Nairobi at 6 AM and then got on a van and after making a few stops for snacks and to pick people up we rode for 4 hours to Tenwek....it is good to be here.
All our travel was smooth, all our bags made it !! and everyone is settling in and getting ready to eat. Tomorrow we will start unpacking and organizing.
There are some things that no matter that it is my 7th time in this country, I am always amazed to see. Kenyans have so much hope and so much pride, even though compared to our standards they have little. I love the colors here...from the red dirt to the green hills, to the smooth dark skin contrasted by white teeth, to the colorful fabric, the bright red the masaii wear...it is all so beautiful year after year.
I am happy to be here again, happy to see what God has in store for this year-for how we will grow the program, teach, be taught, help and be helped...
Here are a few shots from the road (if they will load!)

A trip to Nakamat-grocery store

Great Rift Valley

Add caption

Road stands

View from Tenwek

Time

In Ecclesiastes 3 it talks about there being a time for everything under the sun. 2 of the things there is a time for is to reap and a time to sow.
Right now feels like a time to reap. I got cleared from PT today; a lot of sowing went into that process. I am leaving for Kenya today; a whole lot of sowing went into getting everything ready for this trip.
So much has happened in my heart and mind in the past 4 months. It feels like there has even been some reaping from all the challenges and working through learning more about myself work that I have been doing.
I am excited to see what God has for me in this reaping season. Here we go!
I should get to Tenwek by Friday lunchtime-ish so hopefully I'll be able to get to a computer and give an update.

Living

"Each little step toward the center seemed like an impossible demand, a demand requiring me to let go one more time from wanting to be in control, to give up one more time the desire to predict life, to die one more time to the fear of not knowing where it all will lead, and to surrender one more time to a love that knows no limits. And still, I knew that I would never be able to live the great commandment to love without allowing myself to be loved without conditions or prerequisites."
Henri Nouwen (The Return of the Prodigal Son)

Can't Wait

This is one of my favorite pictures from all my years at Tenwek. It so captures the spirit of Kenyan's...their joy, their faith, the way they trust and follow, how they welcome us to their home. This was one of our older patients in 2010 and has several children. He needed to have surgery so he could provide for his family.
Can't wait to meet each of our patients this year!!

Fall Colors

Each time fall or spring rolls around I claim it as my favorite season. So for right now, fall is my most favorite season :)
Some of the leaves are changing here and just driving around I catch my breath at how amazing some of the reds and yellows and oranges can be. Never ceases to amaze me.
On Saturday Leah and Natalie and I went out for a day hike and saw some of the colors. I think one more week and the colors will be even more vibrant...hoping it happens before I leave the country!

Perfectionist

I have never thought I was a perfectionist. I have always been able to find someone in my life that fits into the box I have considered a perfectionist. But I am learning, like innumerable other words in my life, that perhaps my definition is not quite accurate.
In our girl's group book, The Gifts of Imperfection, by Brene Brown, she defines perfectionism. One part of her definition is this: perfectionism is more about perception – we want to be perceived as perfect. Again, this is unattainable – there is no way to control perception, regardless of how much time and energy we spend trying.
This is the aspect of perfectionism that I am learning has been ruling my life. I don't think in my head I am bothered if I don't perform the absolute best or "perfectly" however I want others to perceive me in a certain light, maybe not as perfect but as pretty darn good. The dictionary definition of perfect is: Having all the required or desirable elements, qualities, or characteristics; as good as it is possible to be. So if I use this definition then, yes, I guess I want people to perceive me as perfect.
When this goes unchecked, I live out of fear, I live out of shame, I feel judged, I zap all the freedom out of my life. I am incapable to live out of who I am because I let fear and shame guide my steps.
I am learning that part of living out of who I was created to be, living out of who God longs for me to be, is acknowledging my imperfection, of being okay with it and embracing it as part of who I am. I cannot walk in shame and fear and also walk in my calling because I am bound by making a mistake not by living freely.
Maybe some of this makes sense. In my head it has been transforming and freeing, even in spite of being made more aware of my inability.
In Brown's book she quotes a Leonard Cohen song: "There's a crack in everything. That's how the light gets in." Can you embrace the cracks in yourself?

Amani

Right now my Dad is hiking the AT. He does a hike each fall to raise money to support some sweet children in several homes in Kenya. Sweet children who are being loved by those hoping and praying that someone will let them into their home.

Happy Hiking Dad!!

Joined

Romans 7:4: Therefore, my brethren, you also were made to die to the Law through the body of Christ, so that you might be joined to another, to Him who was raised from the dead, in order that we might bear fruit for God.
 I have been spending a lot of thought and prayer towards really analyzing my life...where is my time spent, why, etc. I read this passage this morning and got stuck here. I am not going to go into all of the things that I came up with, because I didn't come up with a lot except several questions for me to think about. The first question has stuck with me today...I think I have been doing many things in my life because I "should"-meaning I haven't really died to the law...it is still alive and kicking. But over the years as I have tried to not do things just out of shoulds, I swing the other way to apathy or selfishness, but I know that is not the answer either. Which leads to question 2 and 3 and 4...

• Have I really died to the law?

• What does it mean to be joined to Christ?

• Does my life look like one joined with Christ?

• What does fruit look like?

 

My Own Country

If any of you have read Abraham Vergehese's book Cutting for Stone you need to follow it with this one: My Own Country. Where Cutting for Stone was a fictional work clearly inspired by his life as a physician,  My Own Country is his story of being the primary physician for many HIV/AIDs patients in a rural community when the world was just learning about this awful disease. It is a fascinating story...he deals with stigmas, prejudices, death, homosexuality, his own families response, his life as a doctor being different...so much stuff.
As I am taking time to consider my own work in the hospital, some of his experiences have touched some places that I struggle with in my job, for instance we have technology but are we always using it to promote life, health and healing or why do we act like physical illness has no emotional capacity that has massive needs. Anyway, here are few passages where he captures these ideas better...
"..much of ICU care has this futile quality, this illusion of purposefulness generated by the trappings of technology and invasive procedures. A novice in medicine sees only the drama...more years in medicine and you see how suffering is prolonged, hospital bills multiplied tenfold, the possibility of dignified death diminished."
"..my training had not really prepared me to be this kind of doctor. We were trained in hospitals not in patients' homes; we were biased toward technological interventions..; words like the "soul," the "spirit" were considered dirty words..."

Blog-aversary

I missed by Blog Anniversary...it happened sometime last week. It has been 2 years since I began this journey of putting my words to paper or electronic paper and out there for people to read. I have moments of getting freaked that people read this stuff about me, but other than the fact that about 10 people read my blog :), I remember that I am okay with it. I started this blog for me and I still write it for me. It is a good way for me to process, to not be ashamed of things that I am learning or seeing, of sharing some of my heart...it is really good for me. So I will continue to write and to write for myself.
I started it in the wake of my RA diagnosis, which I continue to learn more about how it has affected me. I started it in the wake of being awakened to how God loves me and I think that 2 years later I am still amazed by how He loves me and being awakened to new aspects of that. A lot has gone down in these 2 years, a lot that has been tough but a lot that has been wonderful. I am thankful for both the hard and the good for they have both brought new understanding and realization of truth.
Thanks for sticking with me.

Sacred Journey

Frederick Buechner wrote a book called A Sacred Journey...it is one of the books I am currently in the midst of reading. It is his memoir, his telling of his life, his story, the people, the experiences, all the things that shaped him; his sacred journey. The following is an old prayer followed by his words...
"'For all they blessings, known and unknown, remembered and forgotten, we give thee thanks.'..it is for all the unknown ones and the more than half-forgotten ones that we do well to look back over the journeys of our lives because it is their presence that makes the life of each of us a sacred journey."
Last week I came up with 8 reasons why I am thankful for RA. It was a tough list to start writing but once I did I was encouraged to see these 8 things that I can be thankful for. I think I could make a longer list than that for reasons I am thankful for the past 3 months, brutal as they have been at times. In the midst of the brutality I so easily forget how to worship, how to be thankful, how to see out of the haze and I think each time that I emerge that the next time will be different. Maybe each time of pain has been a bit different, maybe my list of 8 will serve me the next time I am angry at God about my RA, I don't know, but the process of looking back, of thankfulness is an important one. It is important for us to see our lives as sacred journeys.

Confidence

^{Psalm 27:13-14} 

I remain confident of this:
    I will see the goodness of the Lord
    in the land of the living. 

 Wait for the Lord;
    be strong and take heart
    and wait for the Lord.

               

Milestone

First week back at work. Never thought the day would arrive when I started this journey in July. I have been surprised by how well my hip has done. I was afraid I was going to set myself way back but each day has felt better and better. The rest of my body just needs to get used to waking up in the 5 o'clock hour and being at work for 12 hours. Man, it is a long time!
There have been good and challenging things about being back at work already and it has just been one week, so we will see what comes of all this. Glad to be starting down a path of learning more about myself and my work and where I am best used.
More later this weekend, my brain and body are beat after this week!

Tuesday

One month from today I leave for Tenwek. Well, let's be honest, one month from today I will be finishing packing before I leave for Tenwek in the afternoon. Not afraid to admit to my packing procrastination. 
Today the new Mumford and Sons album is out! Their lyrics are something else. They have been playing I Will Wait on the radio here for a bit, so I already like this one. Here are some of those lyrics:
So I'll be bold
As well as strong
And use my head alongside my heart
So take my flesh
And fix my eyes
That tethered mind free from the lies
But I'll kneel down
Wait for now

Happy Fall

I missed it by a day, but Happy First day of Fall! This week it has felt like fall...cool mornings and evenings; sitting on the couch yesterday drinking tea with the cool air coming in; driving back through the mountains, seeing some color change on the trees. Season changing...

Fall-ish Camping

I forgot to include this on trip pictures...
Last minute I got to go camping and it was the perfect post hip surgery camping trip...I went with friends who have an 11 week old and friends who have a 10 month old. Right in line with a recovering hip.
The weather was great, it was a quick trip and I even went on a short hike. Thankful for time with friends and getting to be outside.