Sunday, July 1, 2012

Happy Birthday Zane, written on July 1

     Zane was one year old June 25 and is taking more steps.  Of course we all had a party for him. It makes a good excuse to get together and have cake or something. He is growing and doing well. Thanks for all the prayers for him when he was ill and no one could figure out was wrong.
     The birthday of our country is here also. In spite of the fact that we are losing many of our freedoms we still have a fantastic country that is beautiful and has helped many others in the world.  I’m still proud to be an American in spite of its defects.  We still care. So many countries have a government that is so corrupt that the common people do not receive much if any of the country’s help.  Many still live the way they did a 1000 years ago except cell phones are much more common and some have a motorcycle or bicycle. They still plow by oxen and live in mud brick houses with grass thatch roof. Here in Chad there is almost a 50% mortality of children before age 5. Malnourishment partly from ignorance and partly from lack of means is common.  Malaria takes many. There is a cultural thing about not giving babies anything but water for a few days and that somehow colostrum is bad because it does not look like regular milk.  All rice diet does not help either.
     One baby was born by C-section one week ago at 27 weeks wt 1.3 kg because of placenta previa and abruptio. We thought the baby would die very soon as he had quite a bit of retraction and no suck reflex but amazingly he did not die.  So they began feeding him with an NG tube q 2 hrs and had warm water bottles to keep him warm in a little box.  Apparently he did not get all his feedings etc yesterday and he died this morning.  One of the problems we have is that nursing is not what we would like to have.  Actually we were surprised that he lived as long as he did with no NICU, no oxygen, no fancy formulas, and minimal nursing.  He was actually appearing to have a chance at surviving before yesterday.
     Everything is not bigger in Texas. This past week we took out a bladder stone that was about 7 cm diameter and weighed over a pound.  We also had a huge extraperitoneal abcess that was making her abdomen appear about 20 wks pregnant but when we cut into the abdomen we found purulence around the rectus muscles and down into her pelvis that apparently did not go inside her abdomen.  We took out about a liter of purulence from down in her sacral area. She was eating and drinking fine with only “some constipation.” I never saw one like it before. It seems lately the main thing we have had surgically has been abcesses of various sorts.  Also a week ago we had a huge huge brachial cleft cyst that we took out with the aid of endotracheal anesthesia  from a visisting nurse anesthetist and Dr. James Appel from down at Mondou. She has done well and now gone home. The bladder stone man did well and has gone home; but the huge abcess lady is still here and draining some. Overall the surgeries are less now than earlier but the peds and med wards are almost full with lots of malaria etc.  There are a lot more mosquitoes now that rainy season is here and therefore more pools of stagnant water.
     I was to help Dr. Appel with hip Friday down in Mondou.  It was a “dislocation” of 6 months but a preop xray showed that the acetabulum was basically gone with the rim knocked off and the head of femur malformed also. The man was able to walk with a cane and do his prayer kneelings, ie he could flex his hip which he said was very important to him. A total joint was not available in this country. We could perhaps have done a fusion but then he would not be able to flex his hip for his prayers so I was in Mondou without any case to help on but that was ok. I was glad that Gary Roberts decided that he needed to go to Mondou in his plane so I got a ride in it instead of having to take the motorcycle taxi through the mudholes to Kelo, then a bus to Mondou. I was supposed to drive Olen’s car back but the paper work still was not finished and the tags were not on it yet.
     Our oldest granddaughter, Rachel, is going to spend this coming year in eastern Thialand. She is leaving this month. She is to be a student missionary teaching English there.  We are hoping to be able to go by there perhaps on our annual leave on the way to or from home. 
     We are so proud of our doctor daughter and doctor son-in-law.  They are great to work with, really have that missionary spirit, and are fantastic doctors! They can do anything to get money well almost.  A little boy was brought in that had swallowed a coin two months before and an old x-ray taken 2 months ago was with him that showed the coin in the upper chest either esophagus or trachea.  It was flat view so probably esophagus and he was breathing ok except this week he was having some cough.  We had no recent xray and our film was 8 yrs old and not working even though we have an x-ray machine.  Olen had remembered reading about getting something out of the esophagus with a foley catheter and asked what I thought.  Let’s try! nothing to lose.  So Jana, ped’s nurse put down the 8Fr foley through the nose and into the esophagus. Then the 3cc bulb was inflated and the catheter was pulled up.  It had very severe resistance at the upper esophagus. Olen was looking ith laryngoscope and saw the edge of the coin popping up and grasped with a long forceps removing the coin.  The father of the child was very amazed as was everybody else that heard about it. You can read a more detailed description on their blog: .    

Our address is:  Rollin and Dolores Bland, Hopital Adventiste de Bere, 52 Boite Postale, Kelo, Chad, Afrique.    Our emails are:  and .  We try to answer everyone that writes us at least by email.

Love,  Rollin and Dolores
Taking life easy on my birthday

Yummy ball cakes
With brother Lyol and friend Cherise

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