Sept 22, 2013

It definitely is raining less now than it was and things are beginning to dry up a bit. It is possible that the bus service to Bere  may start again in perhaps 2 weeks if the road continues to dry up somewhat. We have not been anywhere but that is what we are told.  

People are getting out into the fields more or the snakes are beginning to move around more as we seem to have someone with snake bite in the hospital most of the time now.  I lanced a big toe this am to drain off some fluid that was tight. The toe had been biten a few days ago.  

I did a c-section for a baby that I knew was dead but was unable to get it out with a vacuum or with forceps even though it was her 7^th pregnancy.  She had been referred from another clinic than I finally got the information that she had been given IM oxytocin.  The light finally clicked on my mind so I knew what the problem was.  It was as suspected a ruptured uterus with lots of blood in the abdomen.   I’m glad I was not successful with vacuum or forceps.  I think she will survive but we did a tubal ligation on her.  We considered doing a hysterectomy but was able to repair the uterus ok. That makes the 5^th ruptured uterus I have had since December.  I did have two others that were beginning to rupture when we did the c-section but I did not count them.  I often wonder how many babies and perhaps mothers that have died because of being given IM oxytocin before the baby is born.  Oxytocin is a uterine stimulant to make it contract more. 

Sometimes you think what if I had done whatever or maybe I should have. I had a girl that had swallowed a candy stick and was having severe laryngeal stridor. I could not find any foreign body with the laryngoscope.  She was getting better on IV steroids in fact she went home then they apparently took her to Moundou a day or two later and got an x-ray and went to a clinic there then developed worse stridor and died there. They did not do anything for her there they say.  I wonder if I had done a tracheostomy here maybe that would have been  prevented. Hindsight is always better.

I sometimes wonder what kids have been told or what they are thinking about the “nasara” (white people).  When I was coming to the Ped ward to make rounds this am one 5 year girl went screaming to the other end to her mother when she saw me in the doorway.  Maybe she thought I was a ghost or that the “nasara” would get her.  Almost everyone on the ward was laughing at the incident but she kept with her mom and would not look up.  

Dolores has canned a few tomatoes and continues to paint trim etc. There are 4 banana trees that are blooming and putting on bananas in Danae’s yard now.    

Donations for the project here can be given to the Jay Seventh Day Adventist church and marked for the  “Bere Chad Project”      The address is 13717 East 390 Road, Jay, OK 7436.

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

Love,  Rollin and Dolores

15 Sept. 2013

Nothing too exciting the past week except that we have been ill.  Dolores had chills and fever and aching Friday so began her Malarone and took her Fansidar today.  She is feeling better today and back to sanding and painting.   Neither of us felt like going to church Sabbath also we were the only “nasaras” (white people) on the compound.  Jamie and Tammy are in N’Djamena to meet some new people that are coming, three public health workers and three student missionaries.  Hopefully they can get through the road.  It takes about 1 ½ to 2 hours to go the 25 miles to Kelo.  It has very deep holes and water  over parts of the road.  Last year it was totally impassable for some months so it is not as bad as last year.

I had some kind of “cold” with cough and sinus drainage the past 3 weeks then a week ago had fever to 101.4 so began Malarone but did not improve so began quinine.  I also began some Augmentin for the sinusitis about that time.  Someone thought I had typhoid even though I have had the typhoid vaccination.  The typhoid test was positive but it should be with the vaccination.  But vaccinations are not 100% so I began the Cipro along with the quinine.  The respiratory and sinus thing has cleared. I think I have had several of the side effects of quinine such as palpatations, tinnitus, partial deafness, stomach upset, crazy dreams, not able to sleep well, bitter taste in mouth, no appetite, etc. but today I’m beginning to feel better as now I am off the quinine.  I ate well at noon and supper or at least better.  Maybe the “cold” was actually malaria coming on or something and should have begun the medicines sooner.  I did not see patients for 3 days but did do rounds today and probably will do some surgeries tomorrow if I feel like it. I still have weakness but hopefully will get a good night’s rest tonight and be stronger tomorrow. This is the first time that malaria if that was what it was has bothered me much.   Maybe it was the combination of that with the respiratory infection as I had a productive cough which has now cleared.  Fortunately the hospital census is low now.  Maybe the malaria epidemic has subsided. 

All four children and their families got together this weekend in Oklahoma.  The two oldest grandchildren were off to college, Rachel at Southern Adventist University and Robby at Southwestern Adventist University. They did email some pictures of the grandkids to us.  Of course they are all beautiful and handsome and very intelligent.  Little Addison is so cute and chubby.  We are looking forward to seeing her next month along with the rest of her family. 

Continue to pray for us and the hospital project.   

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

Love, Rollin and Dolores

Sept 5, 2013

My shoulder is much better now although still a twinge of pain if in wrong position ie. extend it back too far.   I’m not taking any more ibuprofen for pain now.  Have been able to do surgeries ok.  Have you ever tried to play volleyball with only your left hand when you are right handed?   Not trying to do much of that although I have learned to serve a fair left-handed serve.  

The hospital work seems to be ho-hum or same things recurrent.  Oh yes we had a 3 inch bladder stone the other day, several prostatectomies and urethral stricture dilations.   A c-section every so often for various indications including two the past week that the uterus was beginning to rupture.  One had a live baby and the other baby had been dead for awhile.   One patient was quite different.  A lady had an apparent mass in the abdomen that turned out to be a greatly enlarged hypertrophied stomach and almost no visible intestines; very atrophic.  I was not sure what to do so I did a pyloroplasty opening up the outlet of the stomach (the duodenum was visible).   Amazingly she is recovering and eating and the abdomen appears more nearly normal now so we let her go home today.  We had a ruptured appendix a few days ago doing well and went home today.  The malaria and typhoid seems to be letting up a little bit although we are still getting rain almost daily.   

Today was a different kind of day. We got a call about 0800 wondering if there was some way we could help the MCD (district medical officer, the guy that has given so much problems to the hospital in the past).  He had taken the 4-wheel drive high clearance ambulance with its driver out to a remote village and got stuck in the mud.  He spent the night out in the bush with the mosquitoes etc.  Several people had tried to get it out of the mud but it was pretty thoroughly buried when we got to it.  Jamie took the hospital pickup and I took our Toyota 4 runner (which has a winch) out to where they were at.   If one got off the “road” at all it was like quicksand very soft mud.  We had to go through water was almost to the top of the wheels especially the last kilometer.  We fastened the back of my car with chain to a nearby tree and hooked the winch to the ambulance and we were able to pull him out with some difficulty.  Jamie had to be pulled out also as he had gotten out of the “road” slightly.  Then we had to back up through the deep water to a place where we could turn around.  After that I got in a soft spot and had to winch ourselves out.  We had just gotten back to Bere when there was a call that Augustine with his car and a pickup bringing a bunch of pipe to the hospital were stuck near Kelo so we took off again.  It turned out that the pickup had worked out of the mud when we got there but Augustine had run out of gasoline.  His gauge does not work.  I had my gas can with me so we went back to a spot that had some gasoline and bought some and took it back to Augustine.  The trip back to Bere was uneventful other than the deep belly dragging holes and water over the road in places.  The MCD now says that I am his best friend and was very profuse in his thanks.

Dolores has been busy painting the walls and rough cement floors of Danae and Olen’s house. It involved a lot of stuff moving so could do all the floors.  She painted the shelves under the kitchen counter tops in our new house one day this week.

We are in good health other than minor aches and pains sometimes. 

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

Love,  Rollin and Dolores