Back in home in Chad

     We are finally back in Chad after our saga with my kidney stone leaving here Aug 21, spending our wedding anniversary (Aug 22) mostly in the air, partly in Paris (layover in the airport) and arriving in Oklahoma City the evening of Aug 22 and getting a CT the next morning and seeing the urologist.  Apparrently the stone passed about the time we got to Oklahoma but there was still hematuria which cleared after a few days.  Maybe the vibrations and changes in cabin pressure etc helped the stone to pass besides the pain meds.  At least I did not have to have lithotripsy  (special ultrasonic blasting of the stone) or surgery for it.  
     We got to see Ron (Dolores’ brother) while he is still alive but his condition is terminal with throat cancer (squamous cell carcinoma of the tonsil primary).  He is now on hospice and taking huge amounts of morphine for his pain.  He probably won’t live past 2 months.  He has a tracheostomy and a gastrostomy feeding tube.  He is a knapper (person who makes arrrowheads from rock) and is trying to go to one last knap-in this weekend to see some of his knapper friends (“his other family”).  We were trying to help him make some final arrangements for some of his equipment and materials while we were home and to be sure his wife had some different arrangements.  She does not want to stay where he was.  They were living in our house.  We have made arrangements for and paid for cremation and he wants some of his ashes scattered in a certain place on his folks old place on the hillside.  We plan to have a memorial service for some of his friends and family when we come home again next June.  The service will be probably the last weekend of June 2013.  We hope to get pictures from some of his friends to put together for that.  It was hard to leave him knowing we will not meet again on this earth but as we parted we said that we plan to meet again when Jesus comes again and sounds that trumpet and calls forth the dead to meet in the air to go to heaven where there will be no more pain, suffering, or death.  
     While at home I went to Pasco, Washington for a orthopedic course on SIGN fracture which is a system for internal fixation of long bone fractures even without the C-arm capability esp for use in developing countries but is being introduced in the US now also.  There are some who have put in a few hundred of them in high trauma areas such as Bagdad, Manila, and a few other places.  Dr. Lewis Zirkle developed the system and distribution of it and relies a lot on donations so that it can be available in the poor areas of the world.  Many areas of the world have a per capita income of less than $2/day but yet they have broken bones that need quality care.  It costs a few thousand dollars to sponsor a system someplace.
     Our trip here was a bit different.  We flew OKC, ATL, Paris, N’Djamena ok then took an 8 hour bus ride over very rough highway (the only “paved” road in the country) to Moundou with our baggage.  There was miles of water covered countryside and lots of people camped on the edge of the highway to get out of the water.  Many mud brick grass thatch roof “houses” have literally melted down in the water.  Different organizations are doing relief efforts for food for some of these people.  There are villages near here in Bere that have been staying in Bere to get out of the water.  They say it is the most rain of rainy season in at least 50 years.  Thurs we left our baggage in Moundou with Dr. Appel. We had 6 checked bags and each had 2 carry ons.  We had weighed our bags carefully and each weighed 51 lbs which the check in person said was ok then when I began to give my credit card to pay for the extra bags, only allowed 2 each or one on Air France, she said there was no charge and “have a good day”.  Normally would have been a few hundred dollars for extra baggage. 
     We got a ride to Kelo then we got on motorcycle taxis to come to Bere.  Dolores got her leg burned on the exhaust pipe of the cycle.  Along the way we had to cross some open water over the road in a canoe for perhaps a half mile.  There were many other areas where the water was only a foot deep or less so the motorcycle could get through.  Also several small detours through fields.  The road from Kelo to Bere has not seen a grader or any type of repair for many years so the water holes get deeper and deeper.  It is possible to get stuck in the mud even in 4 wheel drive.  Anyway we finally made it back to Bere.  It is supposed to be about the end of rainy season now but it has rained hard Fri and Sat nights which will prolong and make it more difficult for people to get in and out.  The water level has gone down some from its high point.
     It was good to see Lyol and Zane and hear “nana” and “papa”
     Friday I did some surgeries including a mastectomy, some hernias, bladder stone removal and helped Danae with a C section (another partial ruptured uterus).  They said these all just came in and that surgery and the whole hospital has been quite slow because people have not been able to get here.
     The construction project is coming along in spite of much rain.  Part of the slabs have been poured after the dirt work was done.  We are certainly looking forward to when all the buildings will be completed including our house which is not started yet.  Lack of roads have been hampering the project.  Apparrently there is a back way that sometimes can be navigated to Moundou without having to take the canoes.

Our emails are: drbland@sbcglobal.net and dfbland@gmail.com
Pray for us.
Love, Rollin and Dolores

Update 10 Sept 2012

     It seems we keep busy but don’t get everything done that we want to do. Of course we want to spend time with Ron and communication is slow as he is unable to talk so has to write everything that he wants to say. He realizes now that his time is short and is accepting of it and says he is ready for whenever and whatever happens. His tumor mass is growing rapidly and one can almost see a difference each day.  Even with his tracheostomy he gets short of breath very easily. His oncology team at OU Health Center finally got together with him and Lisa (his wife) Sunday 9-2-12 and spelled it out that the chemo had not really helped and that radiation would not be beneficial and were recommending hospice and we brought him home that same day. I had talked to the oncologic radiologist the previous Thurs and Fri after we had seen Ron’s condition and asked that someone besides family needed to discuss end of life issues with him and Lisa.  Perhaps everyone was in denial to what was really happening but it is very obvious now and they are accepting of it. Ron says he is ready. Jesus' coming can’t be too soon when death and pain will be no more. Ron was a great knapper (a person that makes arrowheads from rock like the native Americans).  He has quite an inventory of different rocks that he was planning to use but now will have to sell in next few days. Some other arrangements for various things are being made including cremation after death.  He is requiting a lot of pain meds and is feeling lots of pressure in his neck. It is closing in on his carotids and jugular. It is possible he would pass before we go back to Chad but I expect a little later.
     Dolores and I are in good health and eating huge amounts. It is almost overwhelming to go into a store and see so many different choices. We have been drinking large amounts of fresh squeezed orange juice. So good!!!  Also eating lots of fresh grapes and apples and strawberries.  Dolores has been working on stuff in the house that we did not have time to do before we left in Jan. I have repaired a barn roof, repaired fence, and various odd jobs around the house such as cleaning out freezers that somehow got unplugged etc.  Of course we have spent time with each of our kids.  
     Just two weeks we will be headed back to Chad. It has been about 100 degrees since being here except the past 2 days in the 50’s to 80’s and the grass growing again since we got some rain the past 2 weeks after almost none the previous 2 or 3 months.  I have had no more pain or other symptoms from the renal stone.
Hopefully the rain is slacking up back in Bere, Chad so that the roads can be opened again. They have had the wettest rainy season in 40+ years. Our container with our things is at Mondou, Chad waiting for the roads to dry up so it can be transported to Bere.  
     Continue to  pray for us
Our emails are: drbland@sbcglobal.net and dfbland@gmail.com  
Snail mail: Hopital Adventiste de Bere, 52 Boite Postale, Kelo, Chad, Afrique
Love,Rollin and Dolores

Date: Sunday, September 2, 2012, 10:14 PM

     We stopped by the Okla Health Science Center in Oklahoma City today on the way back from Edwin's
and saw Ron and talked to one of the ENT residents about Ron.  The chemo really did not do much and
they do not believe radiation would do much good but maybe make him sicker.  Ron had a trach placed Thurs because his airway was becoming quite constricted with tumor. If you read our blog it was rumored Friday that Ron had died so we had to make several phone calls and found out he was doing ok and was being
transferred to from the ICU to a regular room Fri afternoon. I had talked to the oncologic/radiologist Thur and again Friday and told him and his office that I thought someone needed to discuss end of life issues with Ron and Lisa.   Apparrently the team got together and talked to them this morning and Ron and Lisa now seem to have a better picture of what is really going on.  
     Ron does not want any more treatment and is ready for hospice care.  He probably will come come Tues or Wed.   We probably will go back to OKC to pick him up and bring him home. I had already contacted the hospice used to work some for last Monday.  One or two of them already know Ron and one only lives about a mile away. We will get a hospital bed set up in the family room so it will be close to the bathroom and not have to climb stairs.  
     Today he is on O2 and PCA morphine and is fairly comfortable. The mass hasn't broken through the skin yet but could almost any day.  The radiologist sent some notes which showed the tumor is actually bilateral and has encased his carotid and jugular on the right and his larynx.   There is also a mass by his carina in the mediastinum.  Ron was asking today "How long do I have?"   The ENT gave a vague answer like few months to yr. I really doubt he lives past Christmas and almost certainly not until next June when we were planning to come back on our annual leave. 
     I believe my kidney stone was providencial so we would come home and help in this situation. Hopefully the rains begin to slack off there a little so the water can go down.  They finally had a rain here 1 wk ago and again yesterday and it is beginning to green up a little bit.
   Love ,  Dad (Rollin) and Mom (Dolores)

Rumors 31 Aug 2012

Today we got a phone call that Ron, Dolores brother, had died but it was not from the hospital and was from the pastor of Jay church. He had been told that by some other people and was calling us to see if indeed it was true.  We had not heard anything like that before. We had talked to him at the house as he was leaving to drive to Oklahoma City for check up and probably get a tracheostomy as the tumor was incroaching on his airway. So it would have been possible to be true. We immediately called several people to find out. Dolores’ sister had not heard anything either.  We did not have the phone number of the OU Health Science Center or know which place to call but I did have the phone number of his oncologic radiologist and called there. His office was very helpful.  I had talked with him the day before. They said according to the hospital census he was still alive and transferred me to the hospital ICU and found that Ron had a trach done Thur. and was being moved to regular room 426 today. He is scheduled for some palliative radiation Sept. 4. Through various phone calls we did trace where the rumor came from, an older person that gets a bit confused sometimes. So Ron is still alive but needs our prayers. We had thought we would have to cut short our visit to Texas with our son in order to go back and help take care of arrangements but was not the case.
There was another rumor that we came home because I was dying with malaria which of course was not true at all. I had had malaria in April but recovered with treatment. We are alive and well now. There was another rumor previously that I had malaria and was too sick to be moved home. When I had malaria I continued to work doing surgeries while I was taking the treatment. 
We are still planning to head back to Chad Sept 24.  Be sure to look at recent blogs at  www.missionarydoctors.blogspot.com to see what it is like there now with floods.
Love,  Rollin and Dolores
Our emails are: drbland@sbcglobal.net and dfbland@gmail.com 
Our address:  Hopital Adventist de Bere, 52 Boite Postale, Kelo, Chad, Afrique 

Gospel 30 Aug 2012

Gospel means “good news” so we have gospel.  Apparently the kidney stone that began being very painful Aug 14 probably passed about the time we got to Oklahoma City the night of Aug 22 after flying from Africa. We had a CT and urology appt the next day—no stone seen but still hematuria. Today there is no pain and the appointment with the urologist yesterday was all clear. Even the hydrocele that had come up has now gone away spontaneously.      
We are glad we came home though because Ron, Dolores’ brother, is doing poorly with his squamous cell carcinoma of tonsil that is causing airway and swallowing problems.  He has a stomach feeding tube so he can get some Ensure feeding.  He is to get some palliative radiation beginning Sept 4. We did not have any specific reports before so we did not know how extensive it is.  He is still upbeat that “I am going to beat it” but realistically prognosis is very poor.  He and his wife are still in denial it seems. I did have a discussion with his oncologic radiologist yesterday so have a better picture of what is going on.  Ron probably soon will get a tracheostomy to facilitate his breathing. He has quite a bit of pain and is taking morphine.  He and his wife are staying in our house while we are in Chad. I wish there was more we could do. They really need everyone’s prayers. 
We are leaving Oklahoma City to go back to Chad Sept 24. We have seen our children and grandchildren since we arrived in the USA one week ago except the oldest grandchild that is in Ubon, Thailand. We plan to go by there on our way home from Chad next May when we get an annual leave and will be home next June. The present trip home was not scheduled but necessary. When we left Oklahoma in Jan we were busy packing things in the shipping container and did not have time to do anything to our house etc as we left in quite a hurry to make the schedule for Mission Institute in Nairobi then on to Chad. They were needing us in Bere, Chad as soon as possible as it was their busy season although even now it is quite busy. The surgeries are a little bit less but there is more malaria etc during the rainy season. Olen and Danae will be taking their annual leave in Nov. and Dec. 
Love,  Rollin and Dolores
Our emails are: drbland@sbcglobal.net and dfbland@gmail.com
Our address:  Hopital Adventiste de Bere, 52 Boite Postale, Kelo, Chad, Afrique