Abby and Rimas Miknaitis

Double Baby Shower

2012-01-20T14:34:00.000-06:00

The missionary community threw a baby shower for both Cinthya and me. Cinthya was due 3 weeks before me, both of us with boys. Cinthya had her baby 2 days after the shower - 4 weeks early! She and her baby, Lucas Joel Tumlison, are doing well. I'm very happy (~and little jealous~) for her.

Cinthya 2 days before having baby Lucas

The shower was a fun time to hang out with everybody. I couldn't believe how many people came! Thanks to everyone for all the generous gifts and well wishes!

Little brother onsie, big sister shirt, and I love my aunt bib - Thanks Rachael

. . . . or 2

party favors

Aliyah enjoyed testing out (playing with) all of her brother's new toys

Lucas Joel Tumlison

Our plans are still to return to the Chicagoland area around February 1st for our February 24th due date. So far the baby is doing great. My body has not handled this pregnancy as well as the last one though - so please keep praying I stay healthy for 5 more weeks and for a smooth delivery!

Busy few Weeks!

2012-01-16T11:13:00.000-06:00

Aliyah is getting bigger by the day. She is generally very well behaved and a very happy kid.

She's constantly on the move, exploring, playing, eating, and trying to be helpful. She loves to be involved in whatever we are doing - cooking, cleaning, hanging laundry - and is very curious.

Abby's mom and dad came down to visit for the last two weeks. It was great having them down, but we wanted to take advantage of their expertise and so their days were packed with work. Abby's mom spent most of her time taking care of Aliyah and helping in the eye glasses clinic. It was great to have her here!

The first week Abby's dad spent his days working on a bunch of little projects in the various missionary homes. We fixed cabinets, repaired water heaters, ferreted out electrical problems, etc. The second week was primarily spent building badly needed storage shelves for the laboratory. We were going to paint them white to match everything else in the lab, but the wood looked so nice, Christine, who heads up the lab, decided they would look nice just varnished instead.

After a very busy but productive two weeks, it was time for Abby's parents to leave, but not before Aliyah decided to help pack up. She was very interested in the suitcases, but not quite sure what they were for.

Year End Newletter

2011-12-24T20:12:00.003-06:00

I know this is a bit small to read but click here to read it on our website. You all should have been emailed our newsletter too. If you're not on our mailing list - sign up here at the bottom of the webpage.

Funds needed for new RN educator/public educator/nurse supervisor position

2011-12-22T13:27:00.002-06:00

Nursing Educator Project

Funds Needed: $5,400

For: The amount needed to raise is the difference between the hospital funds available to hire a LPN and the needed funds to hire an RN with the potential to expand our hospital services to include public education, nursing education, and a Honduran-held nursing supervisor position.

Proposal:

Hospital Loma de Luz hosts Honduran social service nurses who come and volunteer a year of their time in order to graduate nursing school. Recently, we have had a particularly bright nurse in training that will be finishing her social service year in April, 2012. The hospital currently has an open position for an LPN ($4,600US/yr. salary) but not an RN ($10,000US/yr. salary) due to lack of funds. This nurse has the potential ability to be a nursing supervisor, nurse educator, public educator and, overall, generally raise the level of care at our hospital. This nurse would also work the standard number of shifts of a full-time nursing position.

One of the long-term goals of Hospital Loma de Luz has been to gradually work towards educating, discipling, and gradually giving more responsibility for the work of the hospital to national (Honduran) hospital employees. Hiring a nurse with this potential would transfer responsibilites currently being handled by an overwhelmed American missionary nurse and increase our ability to start new programs. Our goal is to raise the difference in funds between an LPN and RN to supplement the hospital funds and hire this RN rather than another LPN for one year. We hope to keep this nursing position filled long-term with the possibility of renewing this project annually.

Goals of Proposal:

1. To begin desperately needed public education in:

-Pre-natal classes:

~education on pre-natal health related topics (diet, vitamins, when to see your
doctor etc)

~Tour of hospital labor and delivery and OR

~education of birthing/stages of labor/pushing techniques

~Breastfeeding education (dispelling rumors from formula and baby food
companies that have a tight hold on the people who can't afford to but are
compelled to buy these products)

-Diabetic education classes

~Diet education

~How to care for your body and prevent complication

~Education on lifestyle changes

-Intro to solids for infants

~Dispelling the myths of formula and baby food companies. (Some families
spend 1/4 of their monthly salary on formula alone!)

~How to introduce solids to your infant and how to know when they are ready
(hopefully lowering the amount of coffee and coca-cola drinking toddlers)

~Education on a healthy diet (with hopes of lowering problems with chronic
illnesses and poor weight gain seemly more common here)

2. Continuing nursing education and raise overall level of care in our hospital

~Basic Life Support, Neonatal Advanced Life Support, General nursing education
(Medications, treatments, etc)
~Will shift responsibilities from missionary staff to Honduran staff

3. Possibility of this nurse becoming nursing supervisor with time and demonstration of good leadership
~Will shift responsibilities from missionary staff to Honduran staff

How to Donate: If you would like to donate funds towards this project please send all donations to:

World Medical Mission

Attn: Post-Residency Program

P.O. Box 3000

Boone, NC 28607

* Please write "Miknaitis/Project Code 003656" in the memo.

****Please be sure to mark this donation for the Nursing Educator Project****

http://www.doctorandpilot.com/_/Donate.html

We NEED you! - Calling all doctors and nurses!

2011-12-07T20:16:00.000-06:00

WE NEED YOU!

Calling all doctors and nurses!

Hospital Loma de Luz, on the beautiful, warm and sunny beaches of northern Honduras, really needs some extra medical help during the months of December and January. If you're a physician or a nurse, come volunteer your time, change lives, and be changed and moved by God. Come enjoy the beaches, the sun, and the waterfalls while your friends shiver in the cold!

Email me for more info: abbyandrimas@yahoo.com (10+ days work best. The logistics of a week or less are a bit difficult)

Pregnancy in Honduras has some perks . . .

2011-12-07T20:14:00.000-06:00

This, my pregnant Stateside friends, is my 28 week glucose challenge test. No nasty orange syrup to drink here! We get to do the test the common sense way. It's supposed to be a 50g sugar challenge with a blood glucose level 1 hour later. So, I was able to choose 50g of sugar of my choice. My A&W was only 45g so I added a fun-sized Butterfinger that was another 8g. My results: 91 which is all good and means more A&W's in my future!

I was pretty excited about this pregnancy test since I had to drink the nasty orange drink with my pregnancy with Aliyah. I just don't get why the labs in the States insist you drink some sickening sweet thing that tastes awful and probably costs 50x the amount of my sweet little A&W.

We went to Roatan - Finally

2011-11-28T09:57:00.002-06:00

Abby broke her tooth a couple of months ago. One of her molars had a big crack in it, though, surprisingly it didn't hurt.

There are a lot of inconveniences about living here and even though we live at a hospital, finding a dentist when you really need one is hard. There are some good dentists in Honduras, I'm sure, but we live almost in the middle of nowhere and finding one proved to be very difficult. After many emails and asking around, we heard about a retired American dentist who volunteers at a clinic on the island of Roatan, which is about 40 miles off the coast from where we live. We had to find a way to get there.

We waited several more weeks until Abby was able to re-arrange her schedule so we had a stretch of four days where she didn't have to work at the hospital. Then we drove into the city and boarded the ferry to Roatan.

The boat trip is less than $30 per person and takes just over an hour to get to the island.

Aliyah enjoyed it too, though it was a struggle to get her to go to sleep when it was time for her nap.

Here is the clinic - Clinica Esperanza - where we were welcomed in and given a tour.

It turns out, Abby's cracked tooth was just a fairly large piece of filling that had cracked off. The dentist repaired it without needing any novocain and was all done in less than 15 minutes - all free of charge!

Since we were already on the island, we took the opportunity to stay for a couple of days.

Roatan is probably Honduras' most famous tourist destination. Cruise ships regularly dock throughout the week for people to do a little shopping, enjoy the beaches, and learn about the island's colorful pirate history.

We visited a small "butterfly museum", which didn't really have many butterflies, but did have a lot of other interesting animals native to the area.

Aliyah giggled away as she fed some plants to the island deer.

We took a walk down a path to the beach where Aliyah played with shells and bits of coral.

Finally, we took the ferry back to the mainland and drove home. It was a very nice few days - the first time on Roatan and probably the last for quite a while.

By the way, it looks from these picture like I'm possibly a single father. Definitely not true. Abby always remembers to bring the camera and take pictures, while I remember hardly anything. Abby's always thinking about how we can keep people back in the US informed in addition to all the other work being done while I consider being on the ball if I remember to put clothes on the kid. Besides, I ended up carrying Aliyah most of the time since Abby already has another child to carry 24/7. That being said, I'm sorry Abby isn't in more pictures. It's my fault.

Aliyah is 1 year old!

2011-11-15T21:43:00.000-06:00

Aliyah turned 1 year old on 11/11/11. It was a pretty big deal to her. She enjoyed the extra attention and all the new toys to play with. We knew it would take her a while to open presents and so we started the night before and continued all day the next day opening 1 or 2 in between naps and before bedtime.

Birthday-eve present opening . . .

My sister gave me this idea to take pictures of Aliyah every month as she grew for the 1st year. I printed out the pictures and made a poster for everyone to see at her birthday party.

Aliyah - 1 year of pictures - month by month

I asked a missionary friend Chrysti to make her cake since she has a talent more making decorative cakes. She made Aliyah a basket cake with cupcake flowers sticking up out of it. There were 2 other plates of flowers too to share with everyone. Aliyah ate the ladybug.

Basket cake with ladybug and flowers.

I had brought a change of clothes for Aliyah thinking that she would make a total mess eating her cake. It's tradition, right? Instead she ate it slowly with 2 fingers and never made a mess of her clothes.

1st taste of cake

Aliyah was pretty excited to get new toys since we don't have many and most are for little babies like rattles and things.

More presents from Grandma and Grandpa Kohl!

Playing with her new fridge magnets that keep her busy while we're cooking.

A penguin punching bag toy from Aunt Julie, Uncle Nathan, and Mollianne

For lunch on her birthday she was able to have some leftover cake from the party from night before.

We are so blessed to have little Aliyah. She's so full of energy, smiles, kisses and all around such a sweet little kid!

Visiting CRNAs Gail and Karen

2011-11-15T21:19:00.000-06:00

Last week we had 2 CRNAs (certified nurse anesthetists) visiting us to help with a week booked full of surgeries. They took everything in the stride and learned how to practice anesthesia with flexibility such as hand bagging the patient or using different drugs than they were used to or just plain doing without lots of things we ordinarily use in the States.

Starting a case for shunt for a hydrocephalus patient

Here's another example of how things just don't always go as planned. When changing the CO2 tubing to the monitor during a surgery case, the end broke off inside the machine. After a little fiddling with it and having no success of fixing the problem, we invited Josh, our maintenance guy into the OR. He wore his plain clothes instead of scrubs but we at least made him wear a hat and mask. That kind of thing happens in the States too, right? He takes one look at it and says "Of course, we just need a easy-out". To which we (girls) reply, "Of course! Why didn't we think of that?" We're still not totally sure what it is but it gets things unstuck in hard to reach places!

Josh fixing the monitor in the OR during a case.

It was great to have them - Thanks Gail and Karen!

Veteran's Day

2011-11-11T11:03:00.000-06:00

To all the veterans in the Armed Services- both past and present - happy Veteran's Day.

Thank you for your service to our country.

And to my two favorite veterans: We miss you guys. Come visit us soon!

Three Brothers, Three Marines

Container

2011-11-07T20:36:00.001-06:00

The 40-foot container full of supplies the hospital receives once or twice a year finally arrived a few days ago! On the morning of it's arrival we got word the driver had left La Ceiba and was on his way here. Iain and I rushed out to meet him half-way since the main road through one of the towns here was all torn up and under construction and we had to find him an alternate route through before he got stuck. The plan was to lead the semi through some narrow side streets while I rode between the cab and the trailer pushing low electrical cables up and out of the way with a long broom. The driver was a master at weaving between wires, missing most by just a few inches. The rest were easily pushed up and out of the way as we drove by.

This is the best I picture I could get as I was busy watching power lines and making sure I didn't fall off.

The Dole semi - backed up to our warehouse receiving area and ready to unload. Conveniently, we also live directly above the warehouse in the middle apartment of our tri-plex.

Below are some pictures taken of the unloading process:

Our once-empty bodega now completely filled with boxes and equipment. There's Abby standing in the back helping with inventory.

Hurricane Rina

2011-10-25T14:07:00.001-06:00

The rainy season is here. Gone are the scorching days in the 90's with almost 100% humidity.
For about a week now it's been raining more than not. Our days and nights are between 71 and 75 degrees. Everyone now wears jeans, sweatshirts, coats and hats. Though this is a normal seasonal change, much of our current weather has to do with hurricane Rina. This storm has been sitting just to our north for a week now, getting stronger and getting ready for a run at Mexico's Yucatan Peninsula. But the rain bands have been bringing us cold weather, showers and very breezy days - a very welcome change for now.

Hospital Farm's Rice Harvest

2011-10-24T19:39:00.003-06:00

Right before the rainy season started (about 5 days ago) a one-acre test plot of rice was harvested from the hospital's west field.

Harvested Rice Field

Everything is done by hand - from the planting to the weeding to the cutting, drying and threshing.

Boards used under the tarp when threshing

The last remaining rice to be cut

Here's an action shot of Don Quijote (not his real name) explaining to us how the rice is harvested.

Our personal tour guide explaining the process

Once the rice has been cut and dried in the hot sun for a few days, a large tarp is laid out and the rice is threshed onto it and then the straw is discarded.

Rice drying and waiting to be threshed

The threshing (whipping the rice against those boards to make it fall off into the tarp)

Below is about half of the harvest from the one-acre field. Each bag weighs over 100 pounds. We were very impressed with the amount and we were told this will provide enough rice to feed both the Children's Home and the hospital for the coming year.

The rice still has the hull on it making it brown. Once de-hulled, it will look like the white rice you're familiar with.

Aliyah - 11 months

2011-10-14T10:12:00.000-06:00

Aliyah is now 11 months old. She's walking with a walker toy, standing momentarily without something to balance on, eating what seems like everything under the sun, and exploring a lot, especially the cabinets and drawers. Her hair is finally long enough to put in pigtails but she definitely has my type of hair because it only stays that way for about 15 mins before the hairband slides out.

Hanging out with her dad on the hammock

Aliyah's crazy silly face.

When she's really happy she scrunches her nose up and laughs or yells. It's quite funny and cute to us. You can tell here that she's still toothless. Yep, 11 months and no teeth yet but they seem like they're right there . . . but I've been saying that for months.

Pig Farm

2011-10-11T19:03:00.000-06:00

Lately we've been getting out more. For various reasons. It's been nice to visit with some of the friends we've been making here. It helps our language skills and it demonstrates that we are willing and trying to become part of the larger community. It's also a lot of fun.

This past weekend I helped some friends buy a pig for the holidays by donating the use of our vehicle. Actually, I drove cause it sounded like an interesting trip. First we drove to the owner's house and chatted with him for a while. Then we got a guide - the owner's son - to drive with us to the pig farm which was up in the mountains a ways and show us the pigs.

I don't know if the breeze was right or if they keep the place really clean, but there really was very little smell - nothing like that awful smell when you drive past a pig farm in the States.

There were several stalls like the ones in these pictures. I never counted, but I would estimate there were at least 50 pigs there.

Once the pig was chosen, it was put in a sack and put in the back of our car. It seemed to be pretty content to just be left alone in the sack. I heard a rumor they were going to name it Christmas.

Update on Milagro - Aliyah's Milk Sister

2011-10-06T11:19:00.001-06:00

Remember Milagro? She was the little baby who came in 10 days after being born at 30 weeks in January of 2011. They were delayed in getting to the hospital because there had been so much rain making the rivers too swollen to cross. Her mom had a uterine infection and Milagro did not have enough of a suck reflex yet to breast feed, so while her mom was getting well and re-establishing her milk supply with a pump, I donated my breast milk. In this case it was so important because we didn't have premie formula and Milagro needed all the immunity from infection she could get so breast milk was her best chance at life. She would not likely have survived had she acquired an infection while that little.

Heres' my initial blogs about her:

http://abbyandrimas.blogspot.com/2011/01/wet-nurse.html

http://abbyandrimas.blogspot.com/2011/01/wet-nurse-day-2.html

http://abbyandrimas.blogspot.com/2011/02/patient-updates.html

Milagro in January 2011

The odds were really stacked against her. I sent out a facebook and blog request to pray for her. Well . . . . LOOK AT HER TODAY! I think she weighs more than Aliyah who's 2 months older.

Milagro in September 2011

Her mom still remembers me and stops me in the hallway when she's here for a check-up. She remembers that I told her that when 2 babies share a milk source that they're called milk sisters. She just loves that Milagro has a sister (Aliyah) even though she's still an only child.

Milagro with her mom Maria Jesus at her check-up

I can't tell you how we hoped and prayed for this baby. Her head circumference was so small when she was born it was off the charts for even premies. At her check up several months ago, Dr. Sharon (our pediatrician) was concerned she might be blind so we took up a collection to send her to a good eye doctor in the city but all is normal. She is developing perfectly like all 10 week premature babies and making all her milestones!

Past blogs about Milagro when she was in the hospital:
http://johnandpennyalden.blogspot.com/2011/01/jesus-and-milagro.html

Baby #2

2011-09-19T19:45:00.000-06:00

Baby #2 is due February 24th, 2012. Rimas insists he (yep, it's a boy) will come February 22nd (2/22/12) since Aliyah was born on 11/11/10. Since I was induced 4 days past Aliyah's due date, I'm a little worried this baby will be a leap year baby and end up being born on the 29th. Anyway, you'll notice the countdown is up on the right. We'll be traveling back to the Chicago area about 4 weeks before my due date and will stay about 6 weeks after the baby is born until we have his passport and can return home to Honduras.

We're in need of a car to borrow for any portion of February, March, or the beginning of April if you know of anyone with one to spare. If anybody is thinking about selling their kids clothes (0-2T), let me know since we also will need boy clothes. We come back in the dead of winter when there are no garage sales just before the baby is born so it'll be hard to find a whole wardrobe in time.

Crazy Hot

2011-09-06T15:00:00.001-06:00

Weather at a Glance

Weather Station

La Ceiba (MHLC)

Elevation

10 ft

Station Select

Now

Scattered Clouds

Temperature

88 °F

Feels Like 100 °F

Wind(mph)

Sunrise / Set

5:35 AM

5:56 PM

Moon

Waxing Gibbous

More Astronomy

Today

90 °F

T-storms

60% chance of precipitation

Tonight

75 °F

Chance of T-storms

40% chance of precipitation

Tomorrow

90 °F

Chance of T-storms

40% chance of precipitation

Today's forecasted temp 88 deg but with humidity feels like 100 deg.
Today's actual temp 96 deg but with humidity I feel like dying.
I don't think I've seen them come within 5 deg of ever matching. Looking at the forecast makes me hopeful until I remember it's never right.

At least 1 month and counting of ridiculous heat here! Come on rainy season . .

Everyday from about 10am to 6pm it's just so hot here we don't get much done. Everyday I have grand ideas of what I'd like to do until the sweltering heat comes on. This is one of two hottest times of the year. Coming out of rainy season and going into rainy season it's still hot but the humidity rises to 80%+ and makes the real feel temperature 115 deg+. We spend the day stuck to our clothes and wiping sweat from our foreheads.

At least that explains the lack of posting. Any week now, the rains should start up and cool us off for a few months. We can't wait.

Spring is in the Air!

2011-08-22T20:23:00.000-06:00

At the end of August?
Well, it's started to rain more - almost every day now. The afternoons are starting to cool off a little more. And there are baby animals everywhere! Lots of birds have hatched around our home and are turning into little fledgelings learning to fly. Some Collared Aracaris, in the Toucanette family, have been using a hollow tree in our backyard as a nest and it's been fun watching these beautiful birds come and go. As not so stormy Tropical Storm Harvey blew past us, one of these young birds fell out of the tree and we happened to be there to care for it overnight. We let it go the next morning and the parents immediately started taking care of it again.

The Howler Monkey troop has a bunch of new additions as well. This afternoon they were hanging around our front porch and we thought it would be a good opportunity to take a video to share with you all.
Enjoy!

Aliyah 9 months

2011-08-21T09:54:00.000-06:00

Aliyah was 9 months old on the 11th and lately has been learning new things everyday. This week she learned to open the cabinets and it's now her favorite thing to do. I'm not sure where we'd find those kid proofing locks so if anyone has any old school ideas of child proofing a house (cabinets, drawers, doors etc) let me know!

At a waterpark about 40 mins away

She previously has shown no interest in the steep tiled stairs leading up to the loft until one day when I took my eye off of her for 1 min. I found her on the 2nd step! She climbs well but then she likes to take a break and sit down right off the edge. We're designing a gate of sorts to block them for now.

Add caption

She also loves to go outside. She's learned she can push against the screen doors and they open a bit. Unfortunately they're on gas springs and so they come back and can catch her little finger in the door jam. So, they remain locked most of the time now.
She talks a lot more now but the repetoir still only includes mama, baba, mmmm. She's learned how to open and shut her books. She crawls so well that she's not very interested in walking. We try to walk her with just holding her hands everyday but she soon gets mad and just wants to crawl. She's occasionally seen standing by herself not holding onto anything for a second or two.

Visiting her friend who is actually a month younger but almost double her weight!

She eats lots of different stuff now and feeds herself a lot of it. Chicken, grapes, plums, kiwi, squash, green beans, carrots, spinach, apples, pears, garbanzo beans, and potatoes. She still seems to get a diaper rash from bananas and avocados which is a shame since both are growing in our yard right now.
She loves animals, especially dogs. She enjoys singing at church, bath time and car rides when we allow her to ride in the front seat on my lap (only around the hospital and the farm).

She's growing fast!

Car ride home from our weekly town trip (a little over an hour each way)

A Baby Week

2011-08-21T09:49:00.001-06:00

This week we had our first emergency c-section since our new OB/GYN, Dr. Vance Pirkle, arrived. A women arrived in clinic with low amniotic fluid levels and was 2 weeks past due. She was induced knowing it was about a 50/50 chance she may need a c-section. She progressed well throughout the day until she started pushing. The baby was almost out when it just didn't move anymore and using suction didn't help. The baby didn't like the suction and it's heart rate started to drop prompting us to rush her to the OR. I made a quick call on the radio for some extra help from John (our NP/midwife) and Penny (a nurse and nursing educator), everything went smoothly. Within a few minutes we had a baby! Mom and baby both did well. The mom had a small lower uterine tear from having to remove a baby from so low in the uterus but it was easily repaired.

Our usual missionary who does anesthesia is in the States for 2 months so I was the one running the anesthesia for the surgery. Being new to the OR and unfamiliar with all that was in it, I wasn't keen on doing general anesthesia and having to breath for the patient during the surgery. The patient weighed near 300lbs and I was a little worried about a difficult intubation too. Dr. Vance had a few years of experience as a missionary doctor in Africa prior to coming here and has done over 100 c-sections with a drug called Ketamine. I was very familiar with Ketamine from residency (thanks Dr. Omori) and so with a little fentanyl and a stiff dose of Ketamine we were in business. Next c-section, I hope that it's not nearly as rushed and maybe we'll have a little time to do spinal anesthesia.

Penny as baby nurse.

Dr. Vance and NP/midwife John

Dr. Vance with his first delivery here at Hospital Loma de Luz.

2 days after the c-section, on my call day, the nurses radioed me that we had a women show up in labor with her 9th baby. I didn't ask too many questions knowing that with a 9th baby this patient could probably sneeze and it would come flying out. I notified our OB/GYN and rushed down to the hospital. She progressed quickly and had her baby without complications. She had 7 boys and 1 girl at home and was hoping for another girl (they don't get predictive ultrasounds here so it's always a surprise). Well, to her and her husband's delight, it was a girl!

Baby #9 - A girl!

What a day . . .

2011-08-21T09:38:00.002-06:00

Yesterday (well actually a week ago now that I've delayed posting this) we finally were able to buy some chickens for laying eggs. We had been searching for anyone who would sell us some for about 6 months. Apparently, there are two things that might contribute to this: A chicken mafia is believed to exist that controls the market preventing people from selling egg layers to preserve the market for people to buy their commercial eggs from. The more likely story is that Hondurans don't put an emphasis on breeding the chickens to get fertile eggs to produce chicks and therefore don't have many chickens to sell and keep them all to feed their own family.

In any case, finally yesterday we acquired chickens. We put them in the chicken tractor (outdoor grazing cage) and one escaped through a hole we didn't know about. We spent the rest of the morning hopelessly chasing a chicken who could not be caught and eventually couldn't even find her in the jungle where she escaped.

Next, we got in the car to make our 2hr + round trip to town for groceries and to pick up our friend Monte, from Samaritan's Purse, at the airport. About 10 mins away from the hospital we blew a tire. While trying to fix the flat we realized we had everything but the bar that ratchets up the jack. We called one of our missionary friends, Brad, who came to help (mighty fast, might I add). While changing the tire the shock fell apart because all the threads were stripped.

The flat.

Yeah, I took this from the safety of my air conditioned car . . . poor Rimas - It was HOT!

Brad, our neighbor, to the rescue . . .

At that point, Aliyah was over an hour past her nap time and was crying during this whole ordeal. We returned to the hospital and Rimas took Brad's truck while Aliyah and I elected to cut our losses for the day and stay home.
Then the day got a little better. The lost chicken came home, another missionary (Joel) happened to be in town and picked Monte up from the airport on time (since Rimas was way late at this point). Rimas found replacement shocks in town on a Saturday, which was great because usually nothing is open on the weekend - and he found some at a decent price as well!
What a day!

More Bugs!!

2011-08-19T11:29:00.000-06:00

Leaf Hoppers, to be exact.
Here in the tropics, there is no end to the variety - and size - of the creepy-crawlies here. But these little guys in particular are completely harmless and most are extremely small. I don't have a whole lot to say about them, other than it's interesting to compare the differences in shape and color.

Okay, this one's a spider. but it's teeny-tiny and thought it would fit well here.

About a quarter of an inch long with crazy colors!

These guys have see-through wings and like to hang out in the mango trees.

What can I say? Crazy! I found this one standing on top of one of my bamboo plant sticks.

Tropical Storm Eight!

2011-08-19T06:41:00.001-06:00

Yea! We're excited for the cooler weather and a few days off from watering the garden. It doesn't look like the storm will be anything too dangerous at this point. So far, it's provided a beautiful light rain and cool morning today. Being that we don't have TV, I didn't spot it on the internet news until this morning. What a great surprise.

La Ceiba Garbage Dump

2011-08-16T10:04:00.000-06:00

Lisa, one of the missionaries here, has a ministry at the La Ceiba garbage dump. It provides a meal for the kids there and allows for an opportunity to minister to them. I went along with her one Tuesday recently and thought I'd share some pictures. The video was well put together by Elizabeth, the daughter of one of the missionary doctors here.

Singing songs and reading Bible stories

A few eager early birds

Twins x2 Part 2

2011-08-07T15:42:00.000-06:00

These twins (Adam and Eve) came to a clinic held by our NP midwife way up in the mountains. They are estimated at around 11 months old and only weigh about 8lbs each. Their motor, social, language, physical development had been clearly stalled from malnutrition. They were hospitalized here for over a month and received lots of great food (including a very nutritional Moringa powder - more to come on that one!) and social development/therapy. They gained weight and many new motor skills while here. They've been blogged about by the other missionaries who volunteered to do daily therapy with the twins. Visit their blogs to see more pictures and stories of these two.

Their arrival:
http://pirklesinhonduras.blogspot.com/2011/06/meet-adam-and-eve.html
http://johnandpennyalden.blogspot.com/2011/06/cheekie-and-chispa-adam-and-eve.html

Them going home:

http://pirklesinhonduras.blogspot.com/2011/07/happy-but-sad.html

"The Truth Comes Out in Honduras" : Coup? - I think not!

2011-07-30T17:31:00.002-06:00

Typically we try to stay away from politics on this blog but since the American media has given so much mis-information about the political goings-on in Honduras, we just couldn't let this one pass.

The article quoted at the bottom is from the Wall Street Journal found at:
http://americasforum.com/content/truth-comes-out-honduras
for all those who don't pay to read the WSJ.

It summarizes the findings of a recent report or truth commission investigating the 2009 "coup" of the then Honduran President Manuel Zelaya.

If you all remember, at that time it was plastered all over the news that there was a "coup" in Honduras and the president was picked up in the middle of the night "in his pajamas" and deported to Costa Rica for trying to change the constitution to allow him to stay in power past his 4 year term. The truth was and is that Zelaya broke the law and when confronted and warned by the Honduran supreme court, continued to break the law. The supreme court acted according to the constitution and correctly took Zelaya out of power. By very definition, this was not a coup - "a sudden decisive exercise of force in politics; especially :the violent overthrow or alteration of an existing government by a small group (Webster's Dictionary). The Honduran Vice President Roberto Micheletti (from the same political party as Zelaya) took office when Zelaya was thrown out as mandated in the consitution and the existing government stayed in place. This was hardly a coup.

Our US president Obama and Secretary of State Hillary Clinton immediately demanded Zelaya be put back in power and continued to incorrectly call this a coup and demanded restitution of constitutional power (funny, because that's not what reinstating Zelaya would be!) The US withdrew aid to Honduras, Honduras was suspended as a member of the OAS (Organization of American States), and not allowed to attend UN meetings.

Despite all the negative world opinion, Honduras stood it's ground knowing what they did was to protect their constitution and save their country from unlawful socialist political influences. Surprisingly, there were very few deaths at small protests throughout all this time and in the end Honduras is now being quietly praised the way it deserved in the first place. They stuck to their constitution and everything came out alright, well, better than alright!

Of course this isn't making the headlines and I haven't seen President Obama or Secretary of State Clinton publicly apologize for for aiding in the mis-information and demanding Honduras to break it's own law or admit that they were just plain wrong and didn't bother to do any research before calling it a coup. (though I think this had much more to do more with their politics than ignorance)

Okay, off my soapbox. I just had to write about how disappointed I am with our government for not only not helping a developing country maintain its democracy in a time of crisis but instead adding to its problems.

The Truth Comes Out in Honduras

Mary Anastasia O'Grady - Wall Street Journal

July 24, 2011

The Honduran Supreme Court's order to arrest then-president Manuel Zelaya and the military's decision to deport him to Costa Rica in June of 2009 was a blow to international socialism.

Mr. Zelaya had been flagrantly violating constitutional law by trying to prolong his tenure. But his friends—the Castro brothers and Hugo Chávez and their acolytes—called his arrest a right-wing military coup. As the left often does when it loses a bid for power through violence, they demanded a "truth commission," so they could trot out "witnesses" to the injustices they claimed had taken place in Honduras.

A truth commission established under the auspices of the Organization of American States (OAS) released its report earlier this month. But the zelayistas didn't quite get the condemnation they sought. Instead, the report is a solid indictment of the former president as the provocateur of the crisis and a corrupt head of state. Given the intense international pressure to produce something that would save face for Zelaya backers, this can mean only one thing: The evidence against him was overwhelming.

This is not to say that the commission didn't try to assign some blame to the Honduran institutions that upheld democracy in resistance to Mr. Zelaya's attempt to stay in office indefinitely. The report was after all, "balanced," which means it had to offer something for everyone. But the effort to force interim president Roberto Micheletti, the Supreme Court and the military to bear culpability as well is feeble and legally unsustainable.

Associated Press

On June 25, 2009, Manuel Zelaya, wearing a hat, helped his supporters to remove ballots from the air force base where he had stored them in preparation for an illegal referendum.

The commissioners proudly report that they produced "approximately 50,000 pages of documentation." For the record, I did not read them all. But I did read the 52-page summary.

It finds that "the political crisis was set off" in January 2009. That's when officials from the president's office met with congressional members of his own Liberal Party and "threatened them with the rupture of the constitutional order if they did not choose—as supreme court justices—lawyers who were not on the list of 45 supreme court candidates" officially nominated through a legal selection process. According to the full report, Mr. Micheletti testified that U.S. Ambassador Hugo Llorens was party to this pressure on Congress to break the law.

In the year and a half before the crisis, the report finds, Mr. Zelaya had already demonstrated a propensity to abuse power. It says his actions were an "infringement" on the powers of the other branches of government. By June 2009, Mr. Zelaya had made it clear that he planned to hold a referendum to overturn the legal limits on his term in office, even though such a vote is expressly prohibited in the constitution.

Honduran institutions, the report says, "were not effective in resolving the crisis . . . not for lack of actions and resolutions taken but because the authorities' decisions were ignored and were not acted upon by [the president] who personally took the actions required to execute the referendum." The human-rights commission, the prosecutor, the attorney general, the electoral tribunal and the Supreme Court all took measures to try to stop Mr. Zelaya.

The crisis was "detonated" when he fired the head of the army for backing a Supreme Court decision against him, and then led a mob that broke into the air force base where he had stored referendum ballots. The report notes that a vibrant democracy requires that "no citizen, regardless of his office, is above the law. Equality before the law is an indispensable condition of democracy and the rule of law."

The report also says that ahead of the crisis, the international community did nothing to help defend the democracy. On the contrary, the OAS decided to send a mission for the referendum, "despite the fact that every state institution with competency in the matter had issued resolutions that it was illegal and that it should not take place."

The commission notes that it received "ample information" from the federal prosecutor on charges of corruption against the Zelaya government. But when the commission requested information supporting allegations of corruption during the Micheletti government, it was not provided, despite the fact that Mr. Micheletti's critics had been quick to accuse him of wrongdoing.

After all this it is difficult to lay blame on Mr. Micheletti, who as the president of the congress was constitutionally the next in line for the presidency when Mr. Zelaya was arrested. But the "balanced" commission tries, calling his government "illegal." The report also ignores the military's right to the use of "the state of necessity," in deporting him. International law allows such action in a grave situation where lives are at risk. Had Mr. Zelaya been detained in Honduras, where his supporters had already demonstrated their readiness to use violence, the consequences could have been deadly.

In the end, the report is not able to call the June 28 event a "coup d'état" but has to call it "a coup d'état against the executive," which presumably means a seizure of the presidency, not the state itself. In other words, the democracy was upheld while the unlawful president was removed. For most Hondurans this should make Mr. Micheletti, the Supreme Court and the military national heroes.

Aliyah 8 Months

2011-07-29T10:36:00.002-06:00

I forgot to post Aliyah 8 month pictures. She now getting closer to 9 months. She crawls super fast, pulls herself up and walks well along furniture, stands on her knees without touching anything, is into everything before I can get to her, listens to "no" reasonably well for a little thing, loves dogs, and eats everything in sight. She's starting to get a little attached to Rimas and I which makes leaving her with a babysitter hard and us less inclined to go anywhere without her just because it's easier.

8 months old

And she's had enough of the silly entertainment to get her to smile - she's off to explore.

this past week

2011-07-27T06:44:00.003-06:00

We had three babies in a row die over the past week or so.
Number one was born far too premature to have any hope for survival. Number two was a breach baby - at her last pre-natal visit at the hospital the doctors made it very clear that she had to come back to the hospital when she was getting close to labor - the survival of her baby depended on it. She decided to give birth at home. The baby got stuck and died. By the time the family did get to the hospital, nothing could be done.
Finally, a baby girl was born in the hospital apparently healthy. After recovery, the happy family was sent home but two days later - this past Sunday morning - the baby was rushed back to the hospital with no pulse and not breathing. Abby was on call and called the code blue out to the whole community so there would be more hands to help. She got a heartbeat back and was breathing for the baby with an ambu-bag. Abby, along with other doctors and nurses, spent most of the rest of the day in the ER trying to stabilize the baby. About 12 hours after she came in, the third baby died.
This was all exhausting for the healthcare providers here, both physically and emotionally.
We're not going to post any pictures, but please pray for the families who have lost their children.
That same call day, about 2 hours after the death of the last baby, Abby and Dr. Vance (the new OB/GYN) delivered health baby girl:

Here are some other miscellaneous pictures from this past week:

Our neighbor's horse in the rain

Aliyah playing in our big bucket

The monkeys have decided to take up residence next to our apartment for the past few weeks

Mom and her baby

Aliyah with GIANT plantains - they're about four-times the size of a regular plantain

We've been here for almost a year - this is the first time we've ever seen Breyer's icecream in the store - and it's even on sale! For more than $10 a half-gallon!!!

The orchid on our back-porch has been blooming for the past few weeks

Twins x 2

2011-07-19T08:05:00.000-06:00

This post is has been a long time coming. I should have written it a week ago but we've been moving to another apartment closer to the hospital so we've been a little distracted this week.

Niña

Last Monday in clinic a set of twins arrived for a check-up. They were born 2 days prior at approximately 7 months gestation. They didn't even have names yet, which is common here especially when born early and small and have a possibility of not surviving. The little girl (Niña) weighed 3lb 4oz and the little boy (Niño) weighed 3lb 14oz. They were brought in by their aunts who just wanted to make sure they were okay. They said the mom was at home, very weak and not feeling well. I requested that they bring the mom to the hospital and that we would hospitalize all 3 until everyone was doing well. They agreed but had no transportation for the mom except the public bus and the mom was unable to walk through town to the bus stop. Dave Fields, our IT guy, frequently fills in for needs such as this and drove to get the mom and bring her back.

Niño

We only had one incubator (that works currently) so the twins shared it. They had frequent apnic spells (stopped breathing) with is common with prematurity but also can be sign of infection. After some lab work that showed no infection the plan was to keep them in the incubator or next to mom's skin as much as possible to decrease the energy they spend on keeping warm and instead put it towards nursing and growing. From their length, head circumference, and ear and foot features, I estimated them to be about 31-32 weeks gestation or 9 weeks premature. This is about the time their suck reflex starts so although they were nursing they weren't very good at it. Their mom was not producing enough milk and so we started having her pump after each feeding.

They were doing great, gaining weight, nursing better (not great yet), and their mom was starting to produce more milk with the help of the pump. They kept asking about the bill and seemed very concerned about it. Many times, myself, and employees from the hospital finance department told them not to worry about it and that it was much more important that these twins receive care and survive than for them to pay their bill. Friday (4 days later) the father insisted on taking the twins home. Several people stopped by to try to convince them otherwise but he said there has been many twins born in the family and they all have grown up just fine and he didn't see the need for the incubator, oxygen, breast pump or the hospitalization.
They left, supplementing them with newborn formula and all we can do is pray for them. I scheduled a follow up clinic appointment for yesterday but they didn't show up.
The title "Twins x 2" is because we have another set of twins in the hospital that is long overdue a blog post too. Part 2 is coming soon . . .

Hormigas!!

2011-07-12T18:20:00.003-06:00

Or in English....Ants!!

Sorry for not posting anything in a while - we've been having trouble finding the time to devote to posting. Nothing big, mostly just busy daily life right now.

We awoke the other day to swarms of black ants all over our little back porch and pretty much covering the back and side walls outside of our apartment. They also covered the grass surrounding the house. They probably covered about 2000 sq feet between the porch, walls and grass. It was an incredible number of ants.

We really should have taken a video. These pictures just don't do justice to the fast and constantly moving swarm. It was really hard to take these pictures, though, and at the same time stay out of the way so they didn't scurry up your feet and bite and sting. We've been stung by these kinds before - I'm not sure of the exact type, but they're some kind of invading jungle army ant. They're black and much, much larger than the common fire ants here. They hurt a lot.
Anyway, feeling we might be over run with ants in a few minutes, we and our neighbors used some Raid-type bug spray to keep them from coming inside, but then we realized that with a baby in the house we probably needed to wash all the floors and the stuff Aliyah plays with and sucks on that the gas settled on. Even though we only sprayed outside, it smelled so bad inside that we had to leave for a few hours to let it air out.
People here say that if these ants invade your house (which usually happens once or twice a year) it's best just to leave for the day. When you come back, they will be gone and the whole house - inside and out, floor to ceiling - will be completely bug-free, supposedly even the spider webs are gone, though I'm not sure I believe that.
I think we may actually do that next time. It probably healthier and easier than coating our place in pesticide.

Mischief Maker

2011-06-29T07:09:00.001-06:00

Now that Aliyah is cruising the house she seems to be able to get into trouble when we turn our back for 15 seconds. I thought you'd all enjoy to see this weeks messes. I also included a small video of her crawling last week. She's gotten quite a better at it since then but I haven't taken anymore videos yet.

Getting into the stuff on her changing table

She found a little sample packet of diaper cream I used after her bath last night and forgot to pick up. I wonder how that tastes!

My first baby delivery here

2011-06-26T07:26:00.000-06:00

Occasionally, when other doctors leave for visa trips or vacation I'm the only one here to deliver a baby. So, I thought it would be wise to deliver one with our NP/midwife John so I would know where all our supplies are etc.

This week we delivered a beautiful baby boy (the mom hadn't named him right away).

You can see by the amount of blood on my pant leg . . .

And the amount of blood on John . . . that I need a little more practice!

Rollover Accident

2011-06-24T18:42:00.001-06:00

Yesterday two women, about 50 years old, came into the ER. They had been injured in a rollover car accident. Suddenly, during an already full clinic day with the hospital hallways already full of people, we had 2 trauma patients and all the family that came with them packed into the ER. Handling even one trauma patient is difficult for the clinic nurse, who is already triaging, evaluating, and shuttling patients through the process to been seen by 1 of the 4 clinic doctors working that day. Good thing it happened during the day when there were extra hands around to help out.
The first woman had a broken radius (forearm bone) and a pretty big gaping hole through her hand at the base of the middle finger. She had crushed the base of that finger bone and severed several tendons in her 2nd and 3rd fingers. It was obvious it would need to be repaired in the OR so I hooked her up to the monitor, gave her some good pain meds, and temporarily bandaged up her hand. She went for surgery by the end of the day.

The hand surgery by Dr. McKenney and Rosanne

The second lady was complaining of shoulder pain. Her x-ray showed a fracture of her upper arm bone near the shoulder (humeral neck) and she was actually moving on her own. The patients here are tough as nails and rarely ask for or need pain meds. Of course, I gave her some good pain meds too. She also had a headache and vomited a few times in the ER and we don't have a CT scanner to check for head injuries so I decided to keep her overnight to make sure she was alright.
They both did well overnight, not even asking for pain meds and I sent them home today . . . with a few pain med pills . . . just in case they needed them.

Aliyah 7 months

2011-06-23T06:58:00.001-06:00

Well, she's actually now 7 1/2 months old but these are pictures over the last month.

~She just started saying "mama" yesterday and it seems to be the only thing she says. She woke up this morning yelling "mmmmmaaaammaaa, mama, mmaaammaa . . ." Now to work on "dada"

Outdoor bathtub at Grandma Miknaitis'

~She started getting up on her hands and knees and rocking when we left for the States at about 6 1/2 months. We figured it would be awhile until she got to crawling but with all the cousins demonstrating it, she started officially crawling at Great Grandma & Grandpa Tippetts' house at just about 7 months. Now at 7 1/2 months she crawls well, especially if there's something she wants across the room. I'll have to take a video and post it later.

~She has now completed her first series of shots. We won't be home again for a long time so we'll probably just wait on the MMR, varicella shots and do them late.

~She has always laughed a bit but never been a big laugher. Recently she has begun to laugh hysterically.

~She has been standing next to furniture for several months now but recently she has started actually pulling herself up to standing and walking along the furniture.

~She eats like a pig! We feed her 3 meals a day in addition to nursing and she scarfs down as many cheerios and rice chex as we'll give her.

~She's learning to drink from her sippy cup but can't do it well by herself yet.

This one is for my brother & sister-in-law who gave her the JD onsie

It does feel a bit hot today . . .

2011-06-20T16:54:00.001-06:00

I looked up the weather today at AccuWeather.com and saw the "RealFeel" temperature says 107 but the actual is about 88. I guess it must really be humid today. It definitely doesn't feel like 107 though.

Monday

Cloudy with a thunderstorm or two

RealFeel®: 107°F

High Temperature: 88°F

Low Temperature: 70°F

Our Last VISA Trip!

2011-06-20T10:43:00.003-06:00

We received our temporary Honduran residency cards just before we left on our last trip back to the States! For anyone who hasn't heard, unless you are a Honduran citizen or have some form of permanent residency, you are not allowed to stay in Honduras for more than 90 days without leaving the country. The residency process can be expensive, overwhelming, frustrating and can sometimes take years to complete. But being forced to leave the country on a regular basis is just as bad or, in our opinions, worse.

The process went smoothly for the most part. We are very happy and impressed with our Honduran lawyer and as much as we enjoy visiting friends and relatives back in the States, we are very happy not to have to make very disruptive, exhausting and expensive trips back to the U.S. anymore.

The trip also gave us a chance to finish up Aliyah's early vaccinations. Here she is with her pediatrician just as happy as can be - before her shots!

It was springtime in Chicago. Everything was green, unlike hot and dry Honduras, and for us, most days were cold - a few days reached the 90's, but many more were in the low 60's! That's more like the dead of winter where we live now!

While we were back, Jim, Abby's dad, let Rimas practice moving dirt around with the tractor - skills that can be very handy down here in Honduras. It takes a lot of practice and technique and definitely a bit different than flying an airplane.

Rimas thinks this is much more his speed.

Below are just a few more pictures of some of the people we saw, though not nearly all of them.

We apologize to anyone who wanted their picture on our blog and didn't get one.

Finally Some Rain and Lobster!

2011-05-31T07:56:00.001-06:00

It's only rained once since the end of February and we have had a desperate need for it. It's been unusually dry here in the tropics. When we drive down the dirt road to the hospital we leave behind a billowing trail of dust. We drive much slower this time of year so we don't "smoke out" anyone walking or biking on the side of the road. The dust from the nearby road has been coating everything in our house too. The palms on the hospital's farm (read about the sustainable agriculture farm here on the Browning's Blog) also needed water. So, everyone was very excited when we finally got rain Friday night and again Sunday afternoon. About this time of year, it starts to rain every afternoon so we're hoping this is just the beginning.

The rain also cleared the air and ocean a bit creating good conditions for snorkeling and spear fishing. Rimas came home with 2 small lobsters. We cooked them up that night along with some plantains and they were great!

Hand-me-downs!

2011-05-28T11:24:00.000-06:00

Hammy-downs or Hand-me-downs? I couldn't settle that one on google.
Anyway, I pulled out Aliyah's stash of 6 month clothing. It's fun to have all new (new to me) clothes to put her in every few months. It's also a little sad to put away the ones that she's grown out of. There are some really cute pieces in this next size set. Kid clothes are expensive. I'm so grateful for the hand-me-downs! Aliyah cousin Kate has provided her with most of her clothes which has been such a huge blessing.

Hand-me-down we bought from the Lent's garage sale. Thanks Amy for Anna's cute clothes!

I'm kind of excited to go to garage sales while home for her future sizes. With no plans to travel back home again anytime soon we'll have to be looking for clothes through 2T just to be safe.

Our LAST Visa Trip!

2011-05-26T10:52:00.001-06:00

We'll be in the Chicagoland area one LAST time! Why? Because we have our Honduran residency now! We're super excited because this means we no longer have to leave Honduras every 90 days. Although it's been great seeing family, friends and supporting churches, it's expensive and quiet disruptive to our ministry here to leave every 3 months.

Since there is a Central American Union creating open borders we were required to travel further than just a neighboring country. Fortunately for us, Chicago is one of the cheapest airline tickets (about $400) one can buy from San Pedro Sula, Honduras - an airport about 4 hours from us.

We're very grateful we received our residency paperwork in record time! In the past, it has taken missionaries here several years and lots of money to obtain residency. Through trial and error, a fantastic Christian lawyer and lots of prayer, we were able to navigate this confusing and difficult task in about 4 months!

All that to say, if ever you were thinking you wanted to see us without having to travel all the way to Honduras, now is the time! We'll be in the Chicago area June 6-16th.
Also, if you're interested in getting involved in our work here in Honduras either in a short-term work trip or financially, we have a lot of new opportunities of our expanding ministry here. More details to come of course.

The Hospital's Lab

2011-05-23T19:13:00.003-06:00

This is Christine. She runs the lab here at Hospital Loma de Luz.

This is what she's so excited about: Strongyloides stercoralis

Actual picture from her microscope - cool huh?!

She's excited because she's seen it in the textbooks but never in a real live stool sample. She's happy to have an answer for Dr. Joel about why his little 11 month old pediatric patient has had diarrhea requiring hospitalization. It's a intestinal parasite that replicates in the patients lungs then gets coughed up and re-ingested into the intestines to re-infect over and over again.

Christine's latest goal is to replace our electrolyte machine. We haven't been able to order the basic of all basic electrolyte labs for over a month now and they're desperately needed. She is currently trying to raise $3,600 for the new machine which will then cost $1 a test to run. This machine would have been very helpful in treating the little boy mentioned above when he came in with profound dehydration.

EasyLyte Plus lab machine (tests chloride, potassium, and sodium)

This new electrolyte lab machine would make a huge difference in how we are able to care for many of the people that come to the hospital, especially our in-patients. In many instances we have not had the lab tests (potassium, sodium & chloride) that we need to help us make a definitive diagnosis. This means we make the diagnosis by the patient's appearance but can't confirm the diagnosis with the lab results. These simple and basic lab tests are taken for granted and are ordered daily for nearly all in-patients in more developed countries. Once we have these available to us we will be able to monitor the condition of patients with burns, kidney failure, conditions causing muscle breakdown (rhabdomyolysis), severe dehydration, diabetes insipidus,adrenal insufficiency, Addison's disease, acid/base disorders, severe diarrhea or vomiting, bowel obstructions and many other conditions with less guess work. Having lab tests like these allow us to preventatively correct and replace the electrolytes (K+, Cl-, Na+) before they become clinically apparent by symptoms the patient exhibits.

If you're interested in helping Christine raise the money for the EasyLyte Plus machine please email her (or me) at christine@lomadeluz.net or abbyandrimas@yahoo.com

Here's Christine's portion of the Equipment/Medical Needs List in case you're interested in other ways you can help her:

Lab/Xray supplies:
* means urgent need
·      *Benzalkonium chloride cleansing wipes for urinalysis collection
·      *Pediatric blood collection bags
·   *Lab microscope: example: Meiji Techno Co. MX4000 series biological microscope

·      EKG paper for the EKG machine brand: Mortara
·      EKG electrodes brand: Kendall Q-trace
·      Hepatitis C testing kits
·      red, amber and purple top blood collection tubes
·      23 Gauge butterfly needles for blood draws
·      sharps boxes for dirty needles
·      2x2 gauze (non sterile)
·      X-ray film: 35x43cm, 24x30cm, 11x14in, 8x10in
·      X-ray film hangers (for hand drying films): 8x10 & 10x12
·      Red lights for darkroom film processing
·      Large yellow envelops for storing X-rays
·      cotton balls
·      Isopropyl rubbing alcohol
·      Urine collection cups
·      stool collection cups
·      Microscope slides
·      22x22mm cover-slips for microscope slides
·      sterile cotton swabs
·      heel stick lancets for babies
·      amber and purple top pediatric blood collection tubes
·      urine collection bags for babies
·      plastic disposable pipettes
·      pregnancy tests
·      QBC Accutubes from QBC Diagnostics #423406
·      Alcohol lamp burner, wickless
·      Alcohol preps
·      5ml syringes with needle
·      anaerobic and aerobic culture swabs
·      pH paper
·      INR test strips (Roche CoaguChek XS, 2x24 per box, #04625315160,
NDC 65702-0128-10))
·      Glucose test strips (Abbott Freestyle Lite)

Hives: Day 7

2011-05-21T08:48:00.000-06:00

Today is the 2nd day I've been hive free! I actually feel quite normal again. I will continue to take a tapering dose of steroids and the antihistamines for another 8 days. I'm excited to be done with the steroids since last night was my first sleepless night on them. Supposedly they're the cause of that. Also, while on them, I have to pump and throw away breast milk 4 hours after taking them everyday.
Thank you everyone for praying for me and your emails of advice. My allergic reaction seemed to finally turn the corner that same day we asked for prayer.
In a few weeks when I'm well passed this event I'll spot test mangoes and sulfur (separately) to see if we can figure out which is the actual allergen. I'm not really looking forward to that but it'll be nice to know if I need to avoid one of those like the plague!

First mangoes of the season

2011-05-19T10:21:00.002-06:00

We are very fortunate to have 3 beautiful mango trees next to our apartment. They have been growing loads of fruit for several months now and just this week have been ready for picking. Up until the other day when my allergic reaction started we have been having so much fun picking and eating them.

The first mango of the season.

For now, until I know exactly what caused my reaction, I can't touch or eat the mangos or be near the tree. I don't think the mangos caused the reaction but I'm not willing to risk it right now. Rimas can still pick them and cut them up for freezing and dehydrating and hopefully I can enjoy them later once I can eat them again.

Aliyah loves to stand. She's very good at standing against furniture but doesn't quite know how to walk along it yet.

Hives: Day 4

2011-05-19T09:29:00.000-06:00

It's been great to hear from all of you who are praying. My inbox has been full everyday with well wishes and advice. I've received advice from an internist visiting the hospital this week and two dermatologists via email as well as from just about all 7 full-time missionary docs here. The consensus seems to be to keep with the current treatment:

-60mg prednisone every day for 5 days (make need to take longer, we'll see)

-10mg loratadine (Claritin)

-150mg ranitidine (zantac - another form of histamine blocker)

-Benadryl for itching relief

I found out benadryl topical spray can cause an allergic reaction so I promptly quit that since I don't need any more allergic reactions for a while.

After taking the above meds on day 2, the hives started to fade after about 3-4 hours. They started to return about 11 hours later. Throughout that night I began to break out again even on benadryl and the next morning was covered again. On day 3, I took the same meds with the same response - fading and again returning but this time (this morning, day 4) I'm less covered with hives than the previous morning. I'm hopeful that each night the severity of the reaction will lessen until it completely resolves.

With a severe allergic reaction like this my immune system may respond to it for 5-7 days. The steroids and anti-histamines are symptomatic relief and don't make my body stop responding but rather just block the response.

I'm seeing a little improvement and think we're on the right track now.

Thanks again for all your prayers and kind emails. I'll keep the blog updated with my progress.

So why all the posting today?

2011-05-17T19:20:00.001-06:00

Well, I'm stuck in my bedroom with a bad case of hives. It's the only room we have with air conditioning for special occasions like this or for Aliyah's naps on those super hot killer days.

Chigger bites

Well, it all started Sunday when on a short morning walk I happened to get one of the worst cases of chiggers I've seen in a long time. I had them from my ankles to my neck - hundreds of them. They itched like crazy and I need to kill them asap.

The little red dot on the washcloth is a chigger. Just barely visible to the naked eye.
So I took some sulfur powder mixed in lotion, that I've used many times in the past to prevent chigger infestations, but this time I put it on my whole body. Even though I showered within the hour, shortly thereafter I began breaking out in hives.

Little hives

At that point I began using hydrocortisone cream which seemed to help with the itch but did nothing to stop the spread of the immune reaction. I took some benadryl that promptly knocked me out but again slightly slowed the reaction. The next morning it was worse than ever, so I consulted Dr. Jeff, Dr. Joel, and Dr. Renee (my neighbors and the founder of the hospital who has the most experience with problems caused by the creatures of nature here). After a bit of marveling at the site of my allergic reaction, I promptly received a shot in the butt of steroids. Everything cleared up for about 6 hours before returning with a vengeance.

Big coalescing hives (they're all merging together). This one is probably 3x 6 inches.

Today my body looked like one giant hive on my abdomen and another on my back. There were large wheals on my arms and legs too but the worse was the hives on my face, scalp, and ears. My lips started to swell too. It was getting worse despite the hydrocortisone cream, benadryl, zantac, and a big shot of steroids . . . so, it was time to put out the ABP for prayer (thanks World Medical Missions!) Rimas tried to convince me to take one of those medical textbook pictures of my body with this impressive show of hives but the best you get are these close ups. For goodness sake, I just had a baby, you don't want to see much more of me:)

After consulting with the pediatrician and the OB nurse practitioner and reading a lot about which drugs were safest for Aliyah since she still is nursing, we came up with the follow regiment:

-60mg (hefty dose) of prednisone (steroid) every day for 4 more days

-5mg of Claritin (antihistamine)

-150mg of Zantac (different type of antihistamine)

-topical spray on benadryl

-pumping and dumping the breastmilk 4 hours after taking all these meds everyday when the concentrations are highest in the breastmilk.

My bedside nightstand is becoming an arsenal of immune-suppressing meds

About 4 hours after taking these meds today (and friends/family beginning to be worried enough to start praying) I began to see my trunk clear of hives. After about 6 hours my face isn't swollen anymore and my lips feel normal again! I still have some on my extremities but I'm feeling much better. The big test will be to see if the meds will hold them off all night until my next dose tomorrow.

So, why the reaction? Well, it's documented that chigger bites themselves can cause this, but it could obviously be the insane amount of sulfur I rubbed over my entire body too. Also, our 3 beautiful mango trees have just started to produce ripe fruit this week. Although I've never had an allergy to mangos in the past, I never picked them fresh before either. The tree is related to poison oak, poison ivy, and cashew tree - all of which are highly allergenic to humans. When we pick a mango the milky sap from the stem sprays everywhere. Many people who are allergic to mangos can eat the fruit but just cannot touch the fruit skin, tree leaves, or the milky sap found in the stem.

Hopefully I'll have some good news in my next post...

A Patient Story

2011-05-17T16:41:00.002-06:00

Recently we've been writing a lot about everything but the patients I care for. I guess I just find it hard to write about their personal stories in the day and age of the WORLD-wide web. Although internet is still not readily available out here in the campo (as well as flushing toilets and running water), there are some who have access and for all I know, read this blog. Even a Honduran friend of mine here facebook friended me last week! So, I always hesitate because I want to maintain the privacy of my patients as I would want if it was regarding my own health or family. That being said, I'll still share, just probably not the more private of information and their names will be changed. As always, I asked their permission to use their photos.

Kaya and her dad

Kaya is a little 4 year girl who lives up in the mountains about a 6 hour trek from the hospital. She received 2nd degree burns to the left side of her chest, back, neck, and arms totaling about 12-15% of her body when a pot of hot water was accidentally spilled on her. Her parents immediately took her to the public health clinic, the only health facility available nearby, who promptly spread a butter like substance over all the burns. They then began the long journey to Hospital Loma de Luz to seek further treatment. (*side note: never spread butter on a burn. It creates a nice bed for bacteria to grow rampant and doesn't help the burn at all) Dr. Renee, who was on call that night, gave me a call on the radio seeking advice on how she might scrub this butter-like substance off the burns. I looked on the internet but couldn't find any advice on the matter. So, I suggested the only thing that made sense, Dawn dish detergent. It worked well at cutting the grease and cleaning the burn. The burns were still covered with blisters at this point and Dr. Renee took her time to not break even one of them in the scrubbing process!
Kaya became my patient the next day when Dr. Renee had to leave town for a few days. This little girl was none too happy to be in the hospital and would completely melt down when it was time to change her dressings. The first 2 days she received a sedative (Ketamine) to knock her out for the dressing changes but we knew we couldn't do that for the remaining several weeks she would need them changed.

Kaya with her new improved dressing

By day 3 she was becoming active enough during the day that her non-stick dressings were moving and the cotton covering would then stick to her burn. So day 3's attempt at doing an awake dressing change ended abruptly when no amount of saline soaking would unstick this piece of cotton from the burn. I gave up and just gave the Ketamine. This time I MacGyver'ed a better dressing that was little tighter using Coban (a type of ace bandage that sticks only to itself) that worked a little better at keeping the bandages on a squirmy 4 year old.
Day 4 I was hopeful for an awake dressing change. I gave her a little morphine beforehand and cut the bandages off carefully. Kaya admitted she was not in pain but was crying because she was scared. So, the mom in me immediately just started singing. We sang Jesus Loves Me, If You're Happy and You Know It repeatedly in English and Spanish. We even played a little patty cake. When we'd sing, she would stop crying, if I got distracted and stopped, she'd start crying. All in all, I consider day 4 a success!

On day 5, Kaya was not in need of hospitalized care anymore but surely wasn't ready to go back to the mountains being that they're too far away for routine check-ups and lack of running water and ability to keep the dirt out of her wounds. Our Children's Home, one of the many ministries here at LDL, came to the rescue. Liz, co-director, spoke with Kaya's father who agreed that having Kaya and her 10 y.o. sister, who had been by Kaya side night and day for the whole hospitalization, stay in the children's home would be best. Her sister could provide her with familiar company and help care for her. Kaya was not super thrilled with the new change but did seem pretty happy to not be cooped up in her hospital bed.

The Children's Home kids greeting their new guest

Kaya's dad was eager to find local work since his presence was required here but he still has his wife and 6 kids to provide for. He inquired of one of our doctors here if we knew of anyone that had a job for him. Our maintenance department, another great ministry here, at once knew they could provide temporary work for him. He works hard and is extremely grateful for everything. He was concerned about what kind of bill he would receive for his daughter's stay in the children's home. Of course their room and food was free but he asked 3 times before he half-way believed it.

Today, day 6, she began daily whirlpool baths to debris the burns. Considering how traumatic the dressing changes have been for her, I had been dreading this day a bit. She took the bath like a champ, a little scared at first but eventually fell asleep in the nice warm tub.

Showing Kaya and her sister (in blue) their new bed.

Kaya could use your prayers. Although at this point it looks like she'll stay another 2 weeks for daily treatments, she is blessed to not need any skin grafts. Please pray she finds friends and comfort in the Children's Home and begins to smile a little too!

Meet our new niece and nephew (#6 and #7)

2011-05-17T15:19:00.004-06:00

Introducing Mollianne Kohl (Abby's brother's first child) and Ryan Miknaitis (Rimas' brother's 3rd child) our new niece and nephew.

Julie, Nathan (Abby's brother); Mollianne

Mollianne - and yes we bought her that ridiculously sized monkey!

Kelly (Rimas' sister-in-law) and Ryan Miknaitis

Teething?

2011-05-06T09:52:00.004-06:00

My brother asked us the other day if we only post pictures of Aliyah smiling or if she's always that happy?

Well, she's always that happy.

But for the past several days she's been unhappy and whiney. We think she's teething. Nothing has poked through her gums yet, but that's our best guess since she's getting plenty of food, rest, attention and she's not sick.

It's a little blurry, but the classic "lip" shot was too good to pass up.

On another note, after several months here and working on it little by little, we finally have the "baby's room" decorated and arranged to our liking. A special thanks to the Tumlison family for the temporary use of their beautiful crib. We use the exercise ball as a way to rock Aliyah to sleep before bed. It's a space saver since her room is about 7'x9' - not much bigger than a walk-in closet.

The crib tent was another generous gift from Abby's mom to help keep out the numerous creepy crawlies we get here in the tropics from time to time. Curtain rods are super expensive and they have a pretty poor selection here - so we got creative with some bamboo. The curtain rod holder for the closet is just some looped up ribbon left over from a baby gift that we screwed into the wall. Same with the animals on the wall. They were glued as decorations on a baby gift and the ribbon is left over from a diaper cake my sister made.

HAPPY EASTER!

2011-04-24T21:09:00.001-06:00

This Easter Aliyah is now 5 1/2 months old. She's usually a very happy girl. Of course she got a few eggs to play with which she seemed to really enjoy.

Abby was on call today so she had to go into the hospital before church and check in on a patient who came into the ER.

The missionary community had an Easter potluck lunch and Rimas volunteered to make the center pieces. The vases were made out of extra bamboo we had laying around and the flowers grow all over the place around here.

These are the tables and place-settings just before we sat down to eat.

After lunch and Aliyah's afternoon nap, we decided to take a walk down to the farm and look at the animals. There were a bunch of eating chicks (as opposed to egg-laying chicks) which will be ready to eat in about four to five weeks.

So cute! And tasty!

There was also a little black sheep named Reggie. He's a cute little guy who bleats all the time and likes to but his head into your fist if you hold it out for him.

Aliyah was fascinated by all the animals and really liked feeling the lambs soft wool.

Happy Easter! We hope everyone had a wonderful time celebrating our risen Savior.

Back from the Mosquitia

2011-04-19T22:26:00.001-06:00

It was time for a detailed inspection on one of the missionary aircraft stationed out in the Mosquitia - Rus Rus, Honduras, to be exact. We flew out to the remote village, located just on the other side of the river from Nicaragua. It was a beautiful flight that took us over miles of jungle, numerous mountains and lazy rivers.

As soon as we landed, we unpacked, had lunch, and started the inspection.

The hospital, just getting back into operation, was a very busy place during the Contra-Sandinista War in the 1980's.

The typical house in Rus Rus as seen out the door of the hospital.

The missionary pilot's family stationed here has a pet monkey named Jack. He's a very sweet little monkey, but I had to take a lot of pictures to get one where he's more than just a blur.

After a few days the inspection was finished. We woke up early the next morning and flew back home.

Visa Trip & Aliyah Pics

2011-04-16T15:35:00.000-06:00

We just got back from a whirlwind of a trip back to Chicago. We had to leave Honduras because without being citizens or permanent residents, we are required to leave the country every 90 days. Except for a few minutes of fussiness, Aliyah did great on the airplanes, both coming and going.

'almost' always a happy girl!

Aliyah's very interested in what Grandpa Kohl has to say

Aliyah & Cousin Kate

Aliyah and other cousins - Sofi, Ayla & Keenan

Aliyah and her cousins - now Judah decides to get in the picture

We decided to start introducing Aliyah to solids while back in Chicago - though I don't know if I would consider rice cereal a "solid"

Aliyah and her first swing - she loved it!

Aliyah this morning - here in Honduras. She had a good time in Chicago, but she's glad to be home and sleeping much better.

It was great to see some friends and all the aunts, uncles, cousins, grandparents, etc., but we sure are glad to be back, sleep in our own beds, and settle back into somewhat of a routine.

Not Cool...

2011-04-07T19:12:00.000-06:00

I was working on a project out on our back porch earlier this week and Aliyah was happily playing next to me in her bouncy chair. I glanced down and saw two little scorpions running up the wall under my feet. After about an hour on my hands and knees with a pair of tweezers, I think I was able to find the whole family in the yard, including the much larger mother!

It's a really good thing we found them - their stings have quit a punch and there's about twenty of them in the jar.

On another note, we were cleaning out a woodpile outside and I found the biggest cockroach I've seen so far. Harmless, but really big - and they fly!

Patient pictures

2011-04-05T18:07:00.000-06:00

This little boy fell and broke his arm. When he came in he had it all wrapped up with a strip from a white bed sheet. After I had it all unwrapped I noticed his arm was covered in salt instead of dirt like I expected from a kid playing outside. When I asked, he looked at me like I asked what color the sky was and said because it helps treat the pain. Oh! . . .Why didn't I think of that! :)

Dr. Shaw and Tomas casting his arm while he was sedated for the reduction.

One call day I saw several independent machete wounds. In fact that whole week had more machete wounds than normal. Since the machete is used in just about any job a man has here, it kind of makes sense. I've heard stories about how one local man died falling off a tractor onto his machete. Just today a guy came in who almost cut is whole hand off with his machete.

Well, the man in the above picture fell on his machete walking to work in the morning and just about sliced his ear off. He had cut through all of the cartilage and only had a tiny bit of skin connecting the outside rim and his ear to his head.

It took a while to sew since you can't just throw stitches through cartilage but rather sew the thin membrane on top of it and then also stitch the skin on top closed.

He had to wear a whole head dressing for a day to keep the ear tightly compressed to his head so blood didn't collect under the skin and give him that wrestler cauliflower ear look.

Blood transfusions

2011-04-04T16:58:00.001-06:00

There is no blood bank out in the rural area where the hospital is located. So when a patient needs a blood transfusion the missionaries and employees who have been tested for blood-borne diseases and able to give blood, donate it. We have a list with the blood type of each missionary so that when the patient's blood is typed and crossed the appropriate missionary can be called in to get poked with a giant 14-gauge needle.

This is our latest missionary victim, Norma, our nursing supervisor. She didn't even flinch when they got her with the garden hose needle!

Walks in the Mountains

2011-03-28T14:14:00.000-06:00

It's been a few weeks since Abby's parents were here to visit. In addition to working on a whole list of projects, Abby's dad, Jim, and I went for several walks up into the mountains. The following are samples of the places we walked and the people we met:

son of a family who lives a three - four hour walk from the nearest road.

At the summit of a nearby mountain called "El Torro"

A hand-made wooden sugar cane press most of the way up a mountain. The top of the machine has a beam used to attach a horse or cow to in order to turn it.

A wider view of the press

Women from a nearby town making taffy. They continually throw it over a nail in the post, pull it, fold it, and pull some more.

One of the many roads, passable only on foot, or an athletic horse.

A woman and her son coming down the mountain from picking beans in their field.

Another nice overlook with a great photo opportunity.

Aliyah is 4 months old

2011-03-24T15:42:00.001-06:00

Aliyah is 4 months old now . . . well she's actually now 4 1/2 months old, but it took a while to get these pictures up.

Despite the look of those chubby cheeks Aliyah is actually underweight. I guess I don't care so much about how much she weighs compared to other kids her age as much as comparing her weight from last month to this month. She dropped from above the 50% to just above the 10%. So, we had to start supplementing her with some formula. In one week she gained 6.5 ounces which is normal weight gain (1 ounce a day). We're hoping this week she gains more than that so she can make up some ground. We'll probably start solid foods in 2 weeks at 5 months of age too. She a much happier baby since we stared feeding her more and makes many more dirty diapers too.

She's gaining new skills by the day. She's been standing well (supported) since about 3 months but now she sits on her own for a few seconds at a time and for a few minutes at a time if she has something to hold on to. She holds her own toys and entertains herself now too. She tries to grab all of our food out of our hands. She even successfully snuck a piece of tortilla and chocolate chip cookie into her mouth before we could get it. She really didn't know what to do with it once she got it in her mouth though.

Sporting her Illini onsie for all you U of I fanatics

In her jeans and sweatshirt on the one cold day here this month

doing the I'm hungry dive

Chilling with us at breakfast at 3.5 months . . . no we're not feeding her solids yet

This is the easiest way to drive with her around the hospital grounds. She loves to watch out the window and see everything go by

Our cloth diaper baby

Lorenzo's (a hospital employee) wife -to be fair, Aliyah was ready for her nap.

Aliyah sleeps in the pouch I wear when we're out and about

The new EML list is here!

2011-03-23T12:54:00.000-06:00

LDL Equipment/Materials Needs

*Urgent need

(Items can be sent to Mississippi for the next container shipment or sometimes bought in La Ceiba if funds are provided for a specific item. Please email Abby at abbyandrimas@yahoo.com for further information on what to do with your donated item)

Medical Equipment:

· *digital x-ray machine

· *GE 2010 ultrasound vascular probe – 8L-RS, 9L-RS, or 12L-RS (about $5,000)

· OB ultrasound machine

· * Arterial Blood Gas (ABG) lab machine

· *Ventilator (with adult/peds/cpap/bipap capabilities or multiple machines for each setting)

· I-Stat chemistry analyzer (about $10,500) and cartridges for individual tests (about $500 for 24)

· Hot light for viewing x-rays

· IV pumps (must take universal tubing)

· O2 saturation monitors with pediatric sensors (kinds that plug in but can run on batteries would be best, but any would be great)

· Patient monitors (preferably with EKG print out capabilities)

· St. Jude pacer programmer

· Tympanic membrane thermometers

· 2 full crash carts

· Gooseneck lamps

· Pediatric bronchoscope with operating heads

Medical Supplies:

· blue chuks

· knee braces, ankle braces/supports, slings

· small gloves

· assorted adult sizes soft type slip on shoes like Crocs for diabetic feet and/or good shape diabetic velcro shoes

· Zerofrom gauze with 3% bismuth tribromophenate

· cotton tip swab sticks

· auto-transfusion chest tube sets

· ABD bandages

· Stylets for endotracheal tubes of all sizes

· Ear wicks

· central line kits

· disposable scalpels

· pre-padded fiberglass splinting supplies

· 2x2, 3x3 & 4x4 gauze

· Silver nitrate sticks

· Inspirometers

· dermabond skin adhesive

· reading glasses with the numbers 3.00, 3.25, 3.50, 4.00

· EKG paper:

- Mortara 3-channel thermal paper, 8.5x11 inches, cued Z-fold with header,

12/case, #9100-026-50

- RisingMed EKG #903, 80 mm 3-channel Z-fold

· Storage units for eyeglasses (Holland Optometry - 10 @ $38 each)

Lab/Xray supplies:

· EKG paper for the EKG machine brand: Mortara

· EKG electrodes brand: Kendall Q-trace

· Hepatitis C testing kits

· *Pediatric blood collection bags

· red and purple blood collection tubes

· 23 Gauge butterfly needles for blood draws

· sharps boxes for dirty needles

· 2x2 gauze (non sterile)

· X-ray film: 35x43cm, 24x30cm, 11x14in, 8x10in

· Large yellow envelops for storing X-rays

· cotton balls

· Isopropyl rubbing alcohol

· Urine collection cups

· stool collection cups

· Cleansing wipes for urinalysis collection

· Microscope slides

· 22x22mm cover-slips for microscope slides

· sterile cotton swabs

· heel stick lancets for babies

· amber and purple top pediatric blood collection tubes

· urine collection bags for babies

· plastic disposable pipettes

· pregnancy tests

· QBC Accutubes from QBC diagnostics

· Alcohol lamp burner, wickless

· Alcohol preps

· 5ml syringes with needle

· anaerobic and aerobic culture swabs

· pH paper

· INR test strips (Roche CoaguChek XS, 2x24 per box, #04625315160,

NDC 65702-0128-10))

· Glucose test strips (Abbott Freestyle Lite)

· QBC tubes (AccuTube #423406)

Medicines:

· Polyethylene glycol (Go-Litely; Miralax)

· Augmentin tabs/liquid

· EMLA cream or other topical anesthetic for IV's, etc.

· 3rd generation cephalosporin - tabs and liquid

· Nystatin Powder

· Zinc oxide ointment (Balmex-like)

· Prempro ( Estrogen/Progesterone combo)

· Oral and IV benadryl (diphenhydramine)

· Atopic dermatitis meds: cetaphil lotion and cream, Lubriderm, etc

· Otosporin otic drops or comparable meds for otitis externa

· Over the counter cold meds in liquid and tablets Prefer:

- 1. combo of antihistamine/decongestant

- 2. combo of antihistamine/decongestant/dextromethorphan

- 3. OTC cough meds like a. dextromethorphan b. guafenisin (preferably not combo of both in the same preparation)

· Hydroxyurea

· Azithromycin

· Vancomycin

· Zosyn

· Any –sartans (losartan, telmisartan, candesartan, etc.)

Misc:

· sewing machine for the missionary community (pending donation)

· medium sized chest freezer for storing chicken/goat meat about 15-20 cu. ft.

· hands-free/foot controls for sink at nurses station

· foam hand sanitizer

· wall mounted rack for latex glove boxes

· hot water bottles

· 2 new dorm size fridges

· 5 new or newer regular size refrigerators, preferably energy saving (3 for short term staff housing, 2 for replacements of permanent staff housing)

· 2 new or newer full size stoves (replacements for permanent staff housing)

· 5 new stand up fans

· 15 new medium firm bed pillows

· 5 years or newer used glasses of any prescription with no scratches

· 5 years or newer reading glasses 2.00 and higher

· new-good shape glasses cases with no scratches

· new or like new carry on luggage

· digital camera for wound care documentation

· scissors

Community Transformation (Mountain & Costal Ministry):

· 20 used laptops for the villages

· Backpacks with standard pencils, pens, notebooks for the schools

· French Bibles with which to train Honduran missionaries...French/Spanish side by side

· French Rosetta Stone DVDs or Standard Deviants DVD

· printer for the missions training class with Pastor Felipe in LaCeiba

Agriculture:

· 60 horse power utility tractor with rear hydrolic remotes and a 540PTO and a loader

· Bullet 2 (2) and Bullet 2hp (2) Wireless Amplifier/routers (http://www.ubnt.com/bullet)

· *used or new laptops for clinic rooms

· Network Switches. 6 small 4 port switches.

· Wireless routers / wireless access points / omni-directional antennas / 2.4ghz 802.11b/g stuff

· Wireless pager (Doctor would carry the pager on his belt) paging system with 24 pagers.

· Ethernet network cable and RJ45 connectors

· 10 laptops per year. Windows based - good used condition is fine.

· Ethernet based ip security cameras and a DVR based recording system.

· Type N, Type TNC coax cable connectors.

· Warning lights for towers (red flashing warning lights for outdoor towers that are 100' tall)

· Cell phone repeaters for 850 MHz cellular systems that work with external antennas

Additional Staff:

· nurse anesthetist or anesthesiologist

· nurses, nurses, nurses!

· surgeon

· administrators

· teachers/tutors

Maintenance:

· Skid Steer with tracks and a trailer

· Generator for LDL housing (red house)

· commercial car battery charger

· Single axle dump truck that could pull the skid steer and be loaded with it

· Hospital service truck

· Generator/Welder combo

· Porta-band hack saw

· Portable hoist engine puller

· 6 ton long neck floor jack

· Port a power with lots of attachments

· Core drill with 2”, 4” and 6” bits

· Sheet metal brake

· Small metal lathe

· End mill

· Commercial wood planer

· Band saw sawmill

· 6 VSR 3/8” corded drills of good name brand

· 3 SDS rotohammer drills

· Airless paint sprayer

· 6 heavy duty 10 gauge extension cords

· Rebar bender and cutter

· 6"wood jointer

· Wood lathe

Toys for Orlin - Update

2011-03-18T15:30:00.003-06:00

Orlin has been in and out of the hospital his entire short life. As has been mentioned in previous posts, he has had numerous health issues and when he first came to the hospital fifteen months ago, he wasn't expected to live more than a few weeks. Read more about Orlin on The Browning's Blog here.

At just shy of two years old, little Orlin died and was buried yesterday. His funeral and burial were attended by a very large crowd of people who knew Orlin, and more kids than I've ever seen at a funeral before. That made me realize something I hadn't thought much about before - here in Honduras death is usually an idea that is confronted at a much earlier age than in the States.

The drive to the cemetery

"God's power has given us everything we need to lead a Godly life"

2 Peter 1:3

Psalms 136:24

Orlin Omar Vasquez

9 May, 2009 - 17 March, 2011