Saturday 29 September 2012

Acromegaly

Two new posts in one day???  I am on a roll...

This is my friend (and patient) Agnes.  


She has a condition called "acromegaly" or "gigantism."  That is one of those things that I learned about in med school but never saw in America.  Basically her pituitary gland in her brain is malfunctioning, producing too much growth hormone.  Agnes has quite a few of the classic features and symptoms.  She has an enlarged jaw.  Her facial features are course, her forehead and nose enlarged.  Her hands and feet have also grown.  She has chronic headaches, symptoms of carpal tunnel syndrome, and amenorrhea.

 Acromegaly is usually caused by a tumor of the pituitary gland.  A CT scan would confirm the etiology.  A relatively simple surgery could potentially cure her.  Well, the only CT scan in PNG is in the capital city of Port Moresby.  And that is where the neurosurgeon also resides.  Agnes's family has been saving for a plane ticket but they haven't been able to afford the trip quite yet.

In the mean time, I am doing my best to take care of her medically.  I started her on bromocriptine and OCPs.  A TSH showed that she also has hypothyroid, so she is on levothyroxine as well.  She stopped by this past week on the way to get a follow up blood test.  And she was very excited that some of her symptoms have improved!  Hopefully someday she will be able to make it to POM and get definitive treatment.  Until then, I sure enjoy seeing my friend in clinic :).

That's all, folks!

Girls' night in

As part of the nurse-pastor vision, the College of Nursing has instituted a Big Brothers/Big Sisters kind of a program.  Groups of nursing students are paired up with missionaries and nursing staff for support, discipleship, and sometimes just a bit of fun.  Beck and I have six little sisters this year:  Lalo, Esther, and Grace are 1st year students; Susan is in her 2nd year and is new to us; 2nd year Marilyn and 3rd year Daphne were in our group last year.  The girls come over to our house about one Saturday evening a month.  I cook soup and homemade bread to give the ladies a little something different than the routine sweet potato and ramen noodles they get in the cafeteria.  Then we have a Bible study or do some other sort of activity--singing with the guitar, making cookies, pizza and movie night, etc.

This past week, we had a fabulous "girls' night in."  Since there were three monstrous heads of broccoli ready in the garden, Mom's broccoli soup was the main course for dinner.  Deeeeeeeelish.  Beck lead a Bible study on Adam and Eve, God's original design for marriage.  It was a great time of sharing together!

Our activity for the evening was just about the most fun I have had in a long time.  We gave each other facials, complete with mud masks and cucumber eyes.  (I got the idea from my friend Elaine, who gave me my first facial ever when I visited her family on my home assignment.)  In case you are wondering, chilled cucumbers are VERY nice on the eyes.  We so enjoyed pampering each other.  Our faces glowed with the joy of laughing together.  LOVE my little sisters!







"Your beauty should not come from outward adornment, such as elaborate hairstyles and the wearing of gold jewelry or fine clothes.  Rather, it should be that of your inner self, the unfading beauty of a gentle and quiet spirit, which is of great worth in God's sight."
~ 1 Peter 3:3-4

Tuesday 18 September 2012

Nurse pastors

Nazarene College of Nursing (NCON) at Kudjip enrolls about 75 students in a three year diploma program.  Over the past couple of years, the NCON has been partnering with our Bible college to train these student nurses as lay-pastors.  In fact, they receive a certificate of lay ministry in addition to their nursing diploma.  The hope is that our graduates will become missionaries in their own country as they take health care and the good news of the Gospel to some of the remote areas of PNG, places where foreign missionaries will never go.

As the school has increasingly focused on spiritual development, the Holy Spirit has moved and a revival is taking place among the students.  Many have made new or re-commitments to Christ.  Some have answered the call to full time ministry.


Sunday, September 16th was a very special day.  Sure it was PNG Independence Day.  But that wasn't the best part... 9 of the NCON students were baptized!  After a special church service, the musicians led a large group of witnesses down the cow banis hill, through gardens, steep and muddy slopes, and across small tributaries to a pool in the river.  (I'm not kidding about the steep and muddy slope.  I really thought I was going to fall and kill myself!)  Each young person gave his or her testimony of God's amazing grace.  They were baptized by Pastor Philip and Chaplain Moses.  And we were all baptized by the light rain that was falling, but that did nothing to dampen our spirits.  What a day of celebration!

Susan is one of the students who was baptized.  She is "little sister" to Becky and me.  We are so excited about what God is doing in her life!


"We were therefore buried with him through baptism into death in order that, just as Christ was raised from the dead through the glory of the Father, we too may live a new life."
~ Romans 6:4

Sunday 16 September 2012

Wonderful Women of WONCA

Earlier this month, I had the opportunity to attend a meeting of the WONCA Working Party for Women in Family Medicine (WWPWFM).  

First of all, let me tell you about WONCA.  No, it has nothing to do with Willie or candy factories or umpa lumpas.  It is the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians.  The short long name is World Organization of Family Doctors just in case the long long name is too confusing.  (I'm definitely confused.  Are you?)  For any of my fellow family docs out there, you are indirectly a member of WONCA if you belong to your national organization i.e. AAFP.

WONCA has several working parties and special interests groups that focus on specific issues within the organization and family medicine--such as rural health, cancer and palliative care, ethics, quality and safety, and young physicians.  The WWPWFM, also known as the Wonderful Women of WONCA, is one of those groups.  This working party focuses on gender equity, support for women family doctors, and women's health in family medicine/general practice.  

The WWPWFM gets together about every three years, one year before the big WONCA conference.  I was awarded a bursary to attend this year's meeting at the Australian National University in Canberra, Australia.  Our activities for the week included building an action plan for the working party, finalizing gender equity standards for the organization, medical writing workshop, and a full day conference on domestic violence.

There were 25 ladies from all over the world--Canada, Nigeria, Columbia, the U.K., Burma, Sri Lanka, the Philippines, and Spain just to name a few.  Many of these women were leaders in family medicine in their countries, and most of them were involved in academics.  Being a missionary from the bush, I was definitely the odd gal out.  Despite our different experiences and beliefs and focuses, we all shared the same passion:  women.
















As I take care of patients with cervical cancer, complicated OB, victims of rape and domestic violence, sometimes I feel like what I do is such a very small drop in a bucket with a hole in it.  I was encouraged and inspired and challenged by the Wonderful Women of WONCA, who are fighting similar fights across the globe.  It was so good to have my passion for taking care of the women of PNG re-feuled.  God sure chose to do that in a rather unexpected way!  I pray that He will continue to strengthen me in His work.





The week in Canberra was mostly work, but we did have a little time for play.  We had lunches at the National Gallery and Botanical Gardens.  One afternoon we drove to see kangaroos that were hopping around in the wild.  Another evening we had dinner in the Great Hall of the university.  The main course was kangaroo sausage.  No, it did not taste like chicken.  I did a little shopping, mostly at Target and the grocery store.  You would probably have a good laugh if you saw the random things that came home in my suitcase :).




My favorite extracurricular activity was an overnight in Sydney on the way back to PNG.  I had never stayed in Sydney before, and I couldn't do so without seeing the famous landmark.  I checked into my hotel, found the train and figured out how to buy a ticket, and headed to the city center.  (Very impressive for a FOB.)  I spent about two hours running all around the Opera House and over the Harbor Bridge.  It was magnificent!


"Let us not become weary in doing good, for at the proper time we will reap a harvest if we do not give up."
~ Galations 6:9

Saturday 15 September 2012

All the days

Last year I wrote about some very special kiddos... our "heart kids," or children with congenital heart disease.  Susan is our pediatrician and she usually follows these patients.  She also helps to make arrangements for some of them to be seen and have surgery by a special team of doctors (Operation Open Heart).  When she was on home assignment last year, I took on that responsibility.






Baby of Sandra was one of my heart babies.  Isaac, as he was named, was born at our hospital.  He had trouble breathing from the very beginning of life.  In fact, every time I took him off oxygen he turned blue.  My working diagnosis was a ventricular septal defect, or a big ole hole in his heart.  Even though he missed the screening clinic in our nearby town of Mt. Hagen, I was able to transfer him to the hospital in Lae.  He was seen by the cardiology team.  They confirmed my diagnosis.  Unfortunately his defect was just too serious to be repaired in PNG.  

Sandra brought Isaac to clinic when they traveled back to the highlands.  I started him on some medicines to help his heart work a little better a little longer.  But I really didn't expect that he would live for very long.








Much to my surprise, I saw a familiar in clinic just a couple of weeks ago.  Sandra has gone back to school, so her mother is now looking after Isaac--who is still alive after a year and a couple of months.  He was looking rather blue and a bit underweight, but still alive.  Unbelievable!

I don't know how much time this little guy has left.  Papa does, for each one of his days was written before it came to be.  And each one is a miracle!









I don't have a picture of Melendi.  Since I was writing about heart kids, I wanted to ask you to pray for her.  She is about 14 months old and has PDA, or patent ductus arteriosis.  The surgery to correct this heart defect is pretty simple.  But when Melendi arrived in Port Moresby, she was diagnosed with pneumonia and was admitted to the hospital.  The docs are waiting for her to get better before they will do her procedure.  Please pray that she will recover quickly and be able to have surgery to fix her heart!


"For you created my inmost being;
you knit me together in my mother's womb.
I praise you because I am fearfully and wonderfully made;
your works are wonderful,
I know that full well.
My frame was not hidden from you
when I was made in the secret place.
When I was woven together in the depths of the earth,
your eyes saw my unformed body.
All the days ordained for me
were written in your book
before one of them came to be."
~ Psalm 139:13-16

Tuesday 4 September 2012

Pamela comes home

Start:     Nov 30, '12
Location:     Kudjip Hospital
Our bestie Pamela will be returning to PNG the end of November. She is a radiographer (x-ray tech) and will be volunteering (again) for 6 months. We are so excited that she is coming home!

Beck's 60th birthday bash!

Start:     Oct 20, '12
End:     Oct 27, '12
Location:     Nadi, Fiji
My roomie Becky and I are traveling to Fiji for a much needed holiday. And what do you know, her 60th birthday just happens to fall during the trip. 6 days + 5 nights on the beach... what a way to celebrate!