Poop DOESN"T Happen...

Well, here we are again at Tenwek Hospial in Bomet, Kenya. As we flew away from RDU, Hugh said, "Look at how everything gets smaller as we go away from it!". With reflection, I realize he was so insightful. The things that seem so big and important on a day to day basis really are so small in the scope of life. This trip so far, has not been without its kinks, and I use the term literally.

As most of our family and friends know, after 13 years of struggle, last year Scottie was diagnosed with Celiac Disease. While in medical school at UNC, he was told he had Irritable Bowl Syndrome. During Residency and Fellowship at Johns Hopkins, he had various trials and errors, from X-rays and an MRI, to a Colonoscopy, and a possible Herschrungs (sp?) theory. Yet, during all of the testing back then, one thing we did discover was that he has an impressive amount of excess colon. We hypothesized many times over regarding the possibilities and probabilities, while working around many confounders. However, we never quite finalized a true diagnosis. Finally, once in Fayetteville and after having a complete evaluation, he got the diagnosis of Celiac. All of this answer seeking stemmed from the fact that he is often afflicted with abdominal pain. We even charted out a pattern, thinking the episodes were stress related. Since the Celiac diagnosis, he has followed a strict Gluten Free diet. Yet, on at least 5 separate serious occasions this past year, while on the gluten-free diet, these bouts of cramping have still occurred. Usually, he would roll around on the floor and was successfully able to get the pain to subside, but this time we weren't so lucky.

And so, we left for Africa on Tuesday morning, and Scottie had been hurting a little for a few days prior to that. Again, we figured it was the same old problem and due to the stress of the preparations for the trip, our "pattern" theory was right on schedule. As we got a little further into our trip, the pain worsened. Leaving from Detroit to Amsterdam, he began complaining a little more and my dumb theory of the elevation "blowing up his belly" like it does plastic bottles didn't really hold for long. Once we had arrived in Amsterdam, we had a problem on our hands. Non of us had slept in a day or so and by now, Scottie hadn't eaten in two days. His belly was distended and felt hard to the touch and he was in more pain than I'd seen him in in quite some time. Keep in mind, Marcie Williams (a NICU nurse from back home was with us...thankfully). We played with the idea of getting a taxi and a hotel in Holland and going to an emergency room or even trying to reconfigure all 6 tickets to turn around and head back. We were two-thirds of the way into our trip, the flights for the next two days were packed, and it would have taken longer to turn around than it would have to go on to Nairobi, Kenya, an 8 hour flight. We also knew that John & Gerald (our Samaritan's Purse drivers from last year) would be waiting for us at the Nairobi airport. We knew between the two of them, the Guest House where we'd be staying, and all of the faces of folks we knew from last year's trip would be able to direct us better as to what to do from there. We pressed on. As the flight continued, Scottie's belly grew. He was moved up to first class to stretch out (which he later said he was sad he couldn't enjoy) and again didn't eat or sleep. We arrived in Kenya around 9 pm on Wednesday evening, and after getting our 18 pieces of luggage, we headed to the Guest House, inquiring about the Nairobi Hospital along the way. Our hope was that if Scottie could stretch out and maybe roll around on the floor a bit (like he always had in the past), that this thing would resolve itself again. Throughout the night, he never could lie down or sleep and by this point, he truly looked pregnant. By 5 in the morning, we had called a taxi and were headed to the ER in Nairobi.

Graciously, Marcie came over to our room and stayed with Wallace and Glenn, while we took Hugh with us. After arriving in the ER, Scottie was seen as "the American doctor needing help," (he was wearing his scrubs - for comfort - and his skin tone helped as a give-away!). He got an X-Ray and was given 2 different types of enemas, neither of which worked. Meanwhile, God was good, as Hugh slept for nearly 4 hours on a gurney. None of us had slept in 3 days, and by this point, Scottie hadn't eaten anything and had very little to drink. The X-Ray showed what we'd hypothesized and feared. He had a Sigmoid Volvulus, which is basically a kink in his colon. The way I described it to the kids was to say it's like a garden hose that gets a knot in it and makes it so that the water can't pass through it. The "extra colon" that had been detected back at Hopkins had finally turned on itself worse than ever before, and this time it couldn't be flipped back over by rolling around on the floor. The surgeon in Nairobi told us Scottie would need surgery.

This is making for a long blog entry, but the entire thing has totally been God-driven, and it needs the explanation it deserves. By this point, Gerald (one of our two driver friends) was at the Guest House to take us via van to Tenwek hospital (~3 1/2 hours down the road, like last year) but kindly decided to stay with Marcie and the girls until notified. Meanwhile, John (our other S.P. driver friend) had driven over to meet us at the hospital and sit with us. Gerald had contacted Lu Lu (the S.P. coordinator in Nairobi) who had gone on to contact Robin Jenkins (the S.P Logistics coordinator in Boone, NC). The phone tree continued, and we were surrounded in prayer. There was not room in the Mennonite Guest House for us that evening, so they had planned to move us to the S.P Guest House for a night, because the next night it too would be full. They were trying to make other arrangements for us when Scottie decided he wanted to try to speak with either Dr. Russ White or Dr. Carol Spears at Tenwek before making any final decisions. (Thankfully, he had worked with both of them last year and respects both of their opinions.). We were afraid both surgeons would be on furlough, and as it turned out, Carol will be back next week. Russ, however, had just gotten back from a trip and had been to work a day or so before we arrived. He is leaving for furlough to Providence, RI, for 10 months at the end of July. Dr. White told Scottie to come to Tenwek and see him. The Nairobi surgeon waved his fees (as a medical courtesy to Scottie), hooked him up with some pain meds and an IV drip and sent us on our way to Tenwek. John drove us to meet the others (who by this point had already been relocated to the S.P. guest house). Everyone had already packed up all of our stuff (all 18 bags) and had food prepared for the road trip. We were on our way. About 2 hours into the trip, the pain medication began to wear off, and 45 minutes from Tenwek, the non-destructible "Mutato" van got a flat tire. Prayers began, and within 15 minutes the wheel was changed and we were again on our way. Gerald pulled right up to the ER door and there to greet us were Lisa and Gladys, smiling familiar faces from last year. We all prayed together and Scottie and I jumped out, leaving Gerald and Marcie with the kids. (They went on to unpack everything, settle in and the kids had a blast meeting with friends from last year. The apartment where we're staying this year is at the "hub" of activity - the guest house where the computer is - and it's right beside the hospital. What would we have done if we'd stayed in Amsterdam?! Or, flown back to the US, risked Scottie's health, had to wait for an appointment/doctor and driven back and forth to the hospital?! God was watching over us.)

Inside the OR, Russ greeted us and they got right to work. First, he got another X-Ray, and it was determined that the colon had doubled in size from the morning's X-Ray. Dr. White and Dr. Steve Bergert (a GI doctor who - lucky for us - just signed on as a full-term missionary here) stated that they knew this condition has been going on for quite a while because of the strength of his colon. It is considerably thicker/stronger than most, proving its elasticity and endurance. They said if Scottie had tried to fly back to the US, more than likely it would have burst. They went on to do a procedure where they flipped the colon back right side up and drained it. Today, he was feeling much better, at least prior to the colonoscopy. After that, he has been very groggy. Conclusively, it's as they suspected, the Sigmoid Volvulus. The decision now is to rest tomorrow and Sunday, getting his colon as back to "his normal" as possible, and to resect the "extra piece" of his colon on Monday. This is the crazy part. Apparently, this is a very rare condition in "young healthy men" in the US, but it is extremely common in Kenyan men! It is a "bread and butter" surgery for Dr. White, as he performs 3-4 of these here per week. In the US, (while at Brown on furlough) he typically has only seen it in "little old ladies in nursing homes," maybe as they have bowel failure. They want to give Scottie a Kenyan name!

Already, I've had a conference call of prayer with Robin Jenkins and Becky Williams in Boone, and everyone who passes us on the grounds here asks how Scottie is doing. They tell me they're praying for him, and they actually are! People are telling me how "God is a God of order" and that "God has a plan." And where else in the world would the entire OR stop before a surgery or procedure and pray over the patient?! Everywhere I walk, there's scripture on the walls and as Scottie woke up this morning (after a much needed long sleep!) he said he heard singing in the background. Yes, it's a developing country and the resources are limited, but they do sterilize the equipment and apparently, there is more resistance to staff infection here than in our hospitals back home, consequently, it's less prevalent. Are we concerned? Absolutely. We're out of our "comfort zone," but are we confident that the Lord brought us here for a reason. It is scary, but surgery is always scary. Did God give Scottie his worst bout he's ever had of this thing as we're headed to Tenwek hospital? Yes. His reason, we're not entirely sure, but we are confident that we are in excellent hands, arguably better than what we'd get back home, and certainly more spiritually. The Lord knows what He's doing, and it is up to us to trust in Him.

As I watched the doctors (yes, I watched) perform the procedure on Scottie last evening, I periodically turned away (a little much) and read the scripture on the wall beside me. It's from Isaiah 30:26. It reads, "The Lord binds up the bruises of his people and heals the wounds he inflicted." I wondered, as I stood there reading those words though my tears, why God would bring us all this way for Scottie to help heal others, but then to put him immediately on the operating table as a patient. I then thought of Luke in the Bible. He too, a physician. In Luke 4:23, God tells Luke, "Physician, heal yourself! Do here in your hometown what we have heard that you did in Capernaum." It is unclear to us now, or perhaps God wanted Scottie to feel what it's like on both sides of the table. Regardless of the circumstances, we are surrounded in God's love and by His people, we will be healed. Please pray for Scottie's recovery and our safety. It is clear that once again, we will gain much more than we bring with us to give. In His Name, Avery