April 26, 2016

My thoughts about rainy season arriving a bit early have diminished as it has not rained more and it is still hot although humidity has been up part of the time. 

Some have been concerned that they heard that I was ill and vomiting and could not do surgeries. I did have vomiting one day, secondary to severe labrynthine dysfunction which makes you feel as if the world won't stop spinning. It is improved some, but improves with rest. It is probably the variant called BPPV (benign paroxysmal positional vertigo). If I don't move my head much it is much better. Some positions are much worse than others. This condition sometimes can last a month or more but hopefully will clear soon as it is improved already. Don't have any meclizine (Antivert) for it but Benedryl seems to help a little. Basically we are all healthy. Danae has had to take up some of the slack in OR.

We had an unusual case yesterday with a 1 year boy presented with intestine contents coming from his umbilicus and very foul odor for the past week yet he was not vomiting and was eating some. We did a laparotoomy removing his umbilicus which was a strangulated hernia with a strangulated Meckel's diverticulum that had necrosed and sloughed through the skin. Inside his abdomen was clear. Another patient we did an AKA (above knee amputation) for a leg cancer of bone today. Sabbath was a long day in the OR with an OB case previous c-section and bleeding a lot. Lots of scarring and the bladder was in the abdominal wall almost to the umbilicus so the dead baby was delivered "through the bladder" which was later repaired. The uterus would not contract down and had much bleeding and partial rupture so a hysterectomy was done. She had an abruptio placenta so dead baby and lots of blood lost. 

Dolores has been freezing and drying and canning mangoes besides taking care of the grandkids.
Our emails are drbland@sbcglobal.net and dfbland01@gmail.com

Rollin
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile, Chad, Afrique
Blog www.weareamissionarybland.blogspot.com

April 15, 2016

We have had several amputations lately. One was a diabetic dead foot so a BKA. Yes there is some diabetes here also. Another was a necrotic hand with severe infection so an amputation midforearm. Another was a dead arm with just bones sticking out and all covered or "dressed" with cow manure. It was amputated mid humerus. We had two strangulated inguinal hernias yesterday. We recently had a 35 day old baby brought in very distended and "had not had a bowel movement yet "but had "passed a little bit of gas." It was amazing that he was still alive. So I thought there must be a little bit of passage somewhere. With a finger or blunt instrument could not find any but saw a small possible passage. I used a urethra guide wire (that was given to me by a urologist in OKC) and was able to pass it easily through an apparrently very stenotic rectum congenital about an inch (2 cm) above the anus. I passed dilators over the guide wire and finally was able to dilate it more with cervical dilators. Immediately he began passing a large amount of stool which he continued to do much of the night. We also have a baby with meningocele that otherwise seems normal. Also an infant with a large mass or lump on her occiput which I aspirated some cerebral spinal fluid from. Maybe we will try to remove and close it. We also have a young man with minimal evidence of trauma to head that is now paralyzed on left side. We did anothyer small intestine resection and reanastomosis for a large obstructing cancer of the intestine today although had large mesenteric nodes. Recently we did an antrectomy (lower part of the stomach) and gastrojejunostomy (hook small intestine to stomach) for an obstructing tumor of her lower stomach. Probably not curative although no nodes or liver nodules. We recently had an Arab lady that we took out a large cancer in her pelvis but could not get it all but in the process her ureter was cut and had to be repaired so we kept her in the hospital a few weeks. She and the family were so very nice. She would always smile when we made rounds even though it was very evident that the cancer was coming back with a vengence. She finally went home and today the husband called Danae saying she had died. The husband had helped Danae with the camel also. Sometimes we are the ones that are helped in some situations.

Maybe rainy season has arrived. It has rained a few times but only about 0.2 inches at most each time but the humidity is staying up much of the time over 50% so the 90F at night feels hotter as you sweat more but don't cool much.

Dolores is still working with lots of mangoes when she is not watching grandkids.

Our emails are drbland@sbcglobal.net and dfbland01@gmail.com.
Rollin and Dolores Bland
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile, Chad, Afrique

April 3, 2016

They say there is a "strike" among the health care workers in this country now because some doctor was fired because of something he did but I don't know the alledged offense. Anyway now we have had a lot of maternity cases the past few days. One was a lady that came with a prolapsed cord for several miles from another facility but the baby was still alive. It was also a hand presentation that maybe prevented the cord from having the circulation stopped. We have had some stillbirths and a ruptured uterus. We had an above knee amputation for a dead foot and leg but had to pack the stump open because of a huge abcess around the femur which will need some time to get rid of the infection before it is closed. Yesterday we had another strangulated hernia but surgery was soon enough so no intestine had to be removed. 

 
The shower that we had only cooled us for a short time and now it is back to 100F to 110F (39C to 43C) in the house in the day time. It cools down to 85-90F by early morning . Of course April is usually the hottest month here. 

 
It is mango season now and mangoes are falling on the ground which means there are more flies now. Dolores is cutting some up to dry now that the humidity is less than 10%. The humidity in NDJ is 2% today. 

Everyone has recovered from their malaria now. Danae had it last week but is back to work now. 

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

Love, Rollin and Dolores Bland
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile, Chad, Afrique
Blog www.weareamissionarybland.blogspot.com