itty bitty baby/worms…

Recently, I had a really rough weekend.  The ER was relentless with one patient after another, the Infirmary was jam-packed with sick people, and the OB ward proved to be steadily occupied.   And so, Saturday morning it was fitting when Bertha came in to the obstetric ward for a labor evaluation.  I grabbed her chart and looked things over.  Her dates showed that she was way too early to be having her baby, only a little past 31 weeks of pregnancy (40 is normal, right?).  I figured she must be having a few Braxton Hicks contractions (just some warm-up practice contractions).  However, a quick exam revealed that her cervix (the opening to her uterus) was dilated.  So the bad news was that it appeared she was in early labor with a baby that was going to be very premature.  Worse news was that the measurements of the baby appeared even younger than we thought.

Now in the States, a 31 week old baby usually does just fine in the Neonatal Intensive care unit.   However, with our limited resources this was going to be a sketchy endeavor if the baby was to come.  And if she was actually closer to 29 weeks there was virtually no way this baby was going to live.  After some counsel with Drs. Issac and Anne, we started the process of trying to delay the delivery.

Over the course of a full day we pumped her full of medications and prayed for the best.  Unfortunately, little by little, she declared that the baby was coming.  The cervix kept opening.  So, by early Sunday morning we were preparing everyone for the delivery of a very tiny baby that probably wasn’t going to survive.

Finally, the baby came and I caught her little 3 pound body and sent her over to Dr. Isaac to resuscitate.  And, (Gracias a Dios) the little girl cried.  And she kept on breathing.  And so, we started a little NICU (neonatal intensive care unit) at Loma de Luz.

She has now been here for almost 3 weeks, accompanied by Bertha who has proven to be an extremely attentive and vigilant mother.  However, the care that is required to maintain a baby like this is very labor intensive, and a round-the-clock job.  She has required feedings with syringe, bottle and through a tube into her stomach every 1-2 hours.  Also, she has required ongoing supplemental oxygen to help support her very immature lungs.

We had a scare in the first week when she stopped breathing and almost died.  Luckily, Dr. Peter was nearby and started CPR which resulted in a quick recovery.  We surmised that she had aspirated (choked up her stomach contents which then went promptly down into her lungs) and this is what caused her to stop breathing.  So, we decreased how much we were putting in there, and how fast, and voila, no more almost dying…

As with almost everything that goes on here, her care has been a group effort with so many contributions.  It was quite a relief when Dr. Judy got back from a trip and was able to add her wisdom to little ‘Isis Milagro’s’ care (her middle name means ‘Miracle.’)  Likewise, with her initial care, Dr. Isaac and Anne’s experience was crucial.  We had a couple short term missionaries arrive last week and they have been spending their days with Milagro and her roommate (a little 2 month old baby boy who has been severely neglected), feeding and caring for them all day long.  Many of our long term nurses have also been working harder than expected to care for these two little ones.

Keep them in your prayers, Milagro is actually now taking most of her nutrition from the bottle, so we have a light at the end of the tunnel for her.

On to another noteworthy perusing:

Some of the other missionaries here think i’m messed up, or maybe just mentally deranged, for bringing up fecal topics on my missionary blog.  But my motto is, ‘To thine own self be true,’ and so if you know me well, this is a natural expression.

With that being said, I am sure I am not the only one down here who now routinely  scrutinizes his own feces with a keener eye than when I lived in the states. I mean, sure, I always looked at my poop before, but now I really give it a good long eye-balling.  Why?  Well, it’s because I’m looking for bugs.  Yes, parasites.  It’s quite a common occurrence, especially with our parasite-naive stomachs.  I fully expect to one day look into the white porcelain pool and see worms writhing in my excrement, like children making wintertime snow angels.  One of my patients last week matter-o-factly mentioned that she coughed up some worms.  I think we were going down a list of symptoms, like, ‘do you have a cough, constipation, headache, nausea, fevers?’  No, No, Yes, No, No.  But doc, come to think of it, I did barf up some worms the other day.  Is that bad?

It is very telling when you look at our Clinic Consultation intake questionnaire.  In the states, one of these questionnaires takes about 3 hours to fill out.  We and our government want to know a lot of stuff, such as if your 3rd cousin on your mom’s side of the family ever suffered from an extended case of syphilis, or whether your dog’s girlfriend has hemorrhoids, whether you are secretly hiding a hunting rifle under the floor of your barn, if you enjoyed the smell of rubber cement as a child, and if you have ever consumed free range chickens that were raised by a family that allowed spanking.

But down here we only ask 6 questions.  Just 6 on the form:  What is your problem today? Have you taken any medicine for it?  What medicines are you taking?  Do you have any allergies?  Do you have diabetes or hypertension?  and finally, WHEN WAS THE LAST TIME YOU WERE DE-WORMED?  This last question makes the cut of the 6 most important medical questions to ask someone down here.  And so it has become obvious to me that contracting parasites is a very real and probably inevitable threat to my bowels.

And so in conclusion, I will continue to survey my poo on a regular basis, and twice on Sunday.  And I’m going to look at my boogers too after I blow my nose.  So there…

photos:

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Nurse Liz caring for our sweet lil’ lass, Milagro.  She stayed up with her all night feeding her, reading her book.  I think she was reading 50 shades of gray…  I kid!!

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cute little tootsies

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In my exam room one morning, I spyed out of the corner of my eye a flash of gray, which sped behind the dirty linen bin.  I found this gal, just chillin’.  Had to chase her out.

 

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Milagro, early in her care.  Posted with Permission of her mom.

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Owen looks smart

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Soccer (futbol) game in Jutiapa, a town about 45 minutes away from us.

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This is some good times here. waiting at the Customs department in La Ceiba, to get an extension on our Visa’s so we can stay another month. A wonderful way to spend the day… 🙂

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Palm tree ‘flower’

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bug of the week. Cicada.  My new favorite/least favorite bug.  Very cool looking, but ear-shattering loud at night.  see video below

The following is an example of the serene quiet of the jungle.  Until the next time my friends…

 

12 thoughts on “itty bitty baby/worms…

  1. Chris Kearby says:

    It is a treat to read your blogs and really get a feel for what you all do.
    It’s refreshing! Have a fabulous day Moultray family.🚕💨💨

    Like

    • rmoults says:

      Thanks for your encouragment Chris, glad you have enjoyed the blog and get a little taste of this experience. It has definitely exceeded our expectations. We really appreciate your support as well. Look forward to connecting with you all, we will be home in a couple weeks to do some fundraising, I’m going to work some, and to recharge our batteries. 🙂

      Like

  2. Susie Woodin says:

    The love and care you are giving to the people there is making such a difference. God is working in mighty ways through all of you. God bless you and stay safe from worms!

    Like

    • rmoults says:

      Thanks Susie, we sure hope so. We believe it. Our motto here at the hospital is ‘Dios Obra aqui’, which basically means God does special work here. We do the best we can, but it’s fun to see God take our meager efforts and do something great with them.
      We will be home soon, so we look forward to seeing you all!

      Like

  3. Michelle says:

    I’m so proud of you Brother! Your dedication, compassion and strength is amazing. We miss you you so much but understand how important this is to you. Can’t wait for you to get home… You need to pick a Husky game to attend with us!!🏈. Give my love to everyone.
    Love you Ryan😘
    Shell

    Like

    • rmoults says:

      wouldn’t that be nice?
      I’m looking forward to seeing you all soon, we arrive in texas in a week to do a little missionary training, then back in Yakima on the 16th. See you soon! In Jesus…

      Like

  4. Becky Bond says:

    Ryan and family, I’m so happy that your there helping all of these people in need. This really put a major perspective on premature babies. You know Brooke was born at 30 weeks 4 days. We were fortunate enough to get steroids on board before hand. Which by the grace of God she weighted 5lbs 14 oz at birth 18 inches. We did IVF so we knew for sure her due date. She was born on a Sunday and home by Friday. When she should of been 31 wks. The fear this mom had, I know it well. Could our bible study group send anything down to you and your group for babies, premies & healthy babies? Like clothes, diapers..cloth or disposal. This is really touching what you and Heidi are doing.
    Please let me know what I/we can do to help. Either through financial donations, baby gear or sending over formula.. (like have a formula drive) anything we can do.. try to keep these worms at bay. LoL

    Like

    • rmoults says:

      Becky, thanks for the comment! Aren’t we fortunate in the States to have all of those resources if needed, right? Thank you for the offer of help, absolutely we always need things for the newborns. Many people send down newborn clothes, hats, diapers, etc. All of it is welcome and needed. Also, we realized we don’t have much for preemies, and we really could have used some Preemie bottle nipples, and pacifiers.
      We are going to be back in the states in a week, so if your Peeps want to send anything back with us when we head back down, we will deliver it. Thank You! We are coming back so we can fundraise and I am going to work some, to keep our train rollin’. So, maybe we can connect in the next month? Thanks Becky, Blessings to you, Jim and the girls!

      Like

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