26 Aug. 2013

It seems as though there is nothing new but as we listen about various ones back home having heart attacks and having stents put in and having cancer surgery and some dying from their heart problems maybe it is safer here than there.  We just have to be concerned about malaria and parasites mainly.   Oh yes there are people here with cancer also usually too advanced to do much about.  Although I recently saw one that I had done a mastectomy and axillary node dissection a year ago and she still looks good with no sign of recurrence yet.  No chemo or radiation available here.  

Today we had the 4^th little boy with a calculus lodged in his penis in the past two weeks.   Also had one 3 days ago.   Last week we had a c-section for prolapsed cord and the baby lived amazingly.   Also had a c-section for footling breech (foot waving at us ) but she had twins the second baby was transverse and they both lived and went home ok.   Also a c-section for an arm waving at us and only 4 cm dilation cervix.  They did well also.  The Pediatric census has decreased the past few days.  It seems the malaria and typhoid tends to come in waves.  

Sabbath evening we had some unusual cloud formations.  The sun was getting low in the west and there were some very large thunderheads but above them were these bright clouds coming over them like over a mountain top and they had various colors of the rainbow in them.  They also had like waves in them.  We did get pictures of them.  They were very beautiful.  There was even some lightning to the side but did not get any pictures of that.  Then during the night it rained very hard all night

Dr. James Appel was here this weekend with two senior students from the Union College Physician Assistant program.  I did not know I was supposed to speak for church until just as we were ready to go up front.  I thought they wanted me to have prayer or something until I was asked what my text was for the  message.  Fortunately I had some notes in my Bible.  I preached on “The Bride of Christ” and Dr. Appel translated Into French.  I guess it went ok.  With translators you have a little time to think between each sentence.  

My right shoulder has been almost immobile the past week since apparently injuring it playing volleyball last weekend.  I still can not abduct it but minimally but it is a lot less painful than it was.   I’m not sure if it is a pulled muscle or stirred up arthritis or possibly a partial torn rotator cuff.  Maybe I will get a MRI next April when we come homeon annual leave as there is none available in this country and it is getting better so maybe by then I won’t need anything hopefully.  We are in good health otherwise.

Progress report:  we have electricity in our new house although not all finished yet.  Jamie plans to have the electric and plumbing done in it by next week.  Dolores has been busy painting in Danae’s house also cooking meals for a German boy here the past month but he left today.  

Our emails are:  drbland@sbcglobal.net  and  dfbland01@gmail.com  

Love, Rollin and  Dolores

August 17, 2013

The big news is that we have a new granddaughter, Addison Noel Netteburg, born Aug. 13 and weighed 7 lbs 15.5 oz to Danae and Olen.   She joins her two brothers Lyol and Zane as “missionary kids."   She was born in Bay State Hospital, Springfield, Ma where they had done their residencies before coming to Chad.   The bad part is that everyone else will see and hold her before we get a chance to do so but they will all be coming back to Chad in Oct so then it will be daily.   For a good description of the birthing go to  www.missionarydoctors.blogspot.com

I have done 3 skin grafts in the past week although one was a repeat.   I caught this nurse diligently changing the dressing and scrubbing where the graft had been put or I might not have known what happened to the graft.   I did not kill the nurse but . . .some just aren’t very smart and did not read the orders that said “pas change dressing.”  He was one not usually on the surgery ward.   I have since given a short talk about skin grafts to all the nurses at the staff meeting.  Two of the grafts were on legs that  had had a severe infection with necrosis of some of the skin and tissue that was debrided and now granulated in so hopefully the grafts will take and cover the areas involved.   The hippo bite mangled leg that we put in a intramedullary SIGN nail in the tibia so far is doing well and amazing don’t see any purulence draining anywhere yet.   A c-section for arm presentation that was waving at us even though the dilation was only 4 cm, is doing well both mother and baby.   It seems we are averaging about one vacuum extraction per week also and occasionally a forceps delivery.   This afternoon we had another strangulated hernia that was barely in time so did not have to remove some bowel.   Also this afternoon we had a urethral stone that had to be cut out of the base of the penis.   It was our second in a week.  Both boys had stones about the size of two garden peas and the stones just would not come on through.  

It is raining two or three times per day lately.  They all say that is good for the rice so they don’t complain even though the “roads” are big deep water holes.   So far we are not having the flooding like they had last year.   Of course the humidity stays high and things get moldy if not used including the interior of our car.   The temperature has been very nice in the 70 and 80’s.

We have the poles set and the net up and the court marked off so that we can play some volleyball when we have time or it is dry enough.   They are getting the interior metal paneling and insulation done on the housing.  Jamie has been working on the electric on our house to be and plans to get the plumbing and water hook up to it within a week or so.    Dolores has been painting interior of Danae and Olen’s house.  

Our emails are   drbland@sbcglobal.net   and   dfbland01@gmail.com

Love,   Rollin and Dolores

August 8

When one thinks of acute pain in abdomen you usually think of
appendicitis, cholecystitis, perforated gastric ulcer, aortic aneurysm
and things like that but here it is more likely to be perforation of
distal intestine secondary to typhoid.  Yesterday we had an acute
abdomen secondary to bleeding in the tissue all through the abdomen.
He had a history of snake bite on the foot 5 days previous but no
swelling  or reaction of the foot.  We opened the abdomen and closed
it after we saw what it was.  We gave antivenem and fresh blood even
though the antivenem probably is of no value after 5 days.  His
prognosis is not good.  We do occasionally have perforated gastric
ulcer and appendicitis and ruptured ectopic pregnancy and tubal
infections with abcesses.
Every bed in the hospital was full yesterday including the extra beds
in the building that is supposed to be eventually lab and pharmacy.
Surgery, Peds and medicine beds were full.  Perhaps a few empty beds
on maternity.  We have a neonatal tetanus that is finally looking
like he might live.  He has been fed with NG tube but yesterday he
was sucking a little from breast.  The little boy that we grafted
skin on his leg after previously taking some extruded bone off is now
getting stronger and trying to walk and his family is very happy on
how good he looks.  The graft looks good so far.  He had not walked
since his fracture leg 2 yrs ago.  We also released some of his
contracture but he still has somewhat deformed leg but useable.  We
have several in the hospital that are somewhat long term with various
abcesses.  We had a 5 yr old boy a few days ago with a lodged stone
in his urethra at the base of his penis.  I could not get it to move
so had to excise it from there and repair his urethra.  Apparrently
he had a bladder stone that tried to pass but could not.  He is doing
ok now.
Aug 9 next day.  The man with hemorrhagic abdomen after a snake bite
died last night.  Not suprising!  We did another laparotomy for acute
abdomen today that was full of blood but he was oozing blood from
cancer all over his upper abdomen.  His liver was full of tumor so he
won’t live long.  Two more people with huge abcesses and necrotic
areas on their leg are looking better now.  We debrided them and they
are beginning to granulate somewhat.  Maybe they will be ready for
skin graft end of next week.    We had another C-section this am for
severe small pelvis and baby was having some meconium(we found when we
opened).  Mother and baby are doing well so far.  WE also did an
orchiectomy and hernia repair on a man with a large hernia but also a
large tumor of his testicle.
This afternoon I gave a basic talk on pulse and blood pressure (how to
do)  to some people from some other villages that wanted to be able to
help their people some.    Then we went to a “fet” given by our night
watchman for us.  He is a Moslem but a very nice man and more honest
than a lot of other people.  Yesterday was end of Ramadan (the Moslem
fast for a month and don’t eat during the day but can at night).
Mohammet, our night watchman, has a new young wife so was giving the
“fet” for us.  He fed us some Chadian food that was very delicious.
His new wife is age 14 and Arabic and petite.
A lot of people have gone home the past 2 days esp from Peds.  The
Peds census is down in the 20’s.  The surgery ward is still pretty
full.
Go to www.parkers4bere.blogspot.com for an interesting story about a
chained man.
We are still “hurriedly waiting” for the Netteberg baby that is due
almost any time now.  Still no progress on that from Massachusetts.
I am always glad for Fridays and Sabbath for more time for reading and
getting together for “potluck” and theoretically less work in the
hospital.  Although often it makes up for it on Sat night.
Our emails are  drbland@sbcglobal.net  and  dfbland01@gmail.com
Our phones are    Rollin      235  62674586        Dolores    235 68824768
Hopital Adventiste de Bere,  52 Boite Postale,  Kelo, Chad,  Afrique

Some have asked about how to get donations to our project.    One
option is to send to :
    Jay Seventh Day Adventist Church
    13717 E. 390 Road,  Jay, Ok.  74346

Earmark for the “Bere, Chad Project”
Thanks for all your prayers.
Love,  Rollin and Dolores