back to Haiti!

It's true.

Lots of big changes happening around here. All good things, all in His good timing. For the extent of my little adventure here in Nashville, I have been working in a faith-based, not for profit, primary care clinic that serves patients who are working and do not have health insurance. I can't begin to tell you what an incredible blessing this job has been. From the way the job just sort of fell in my lap, the family of people I have come to love working with, the patients whose lives I've had the privelege to be a part of, to the many lessons I have learned that make me a better nurse, God has more than provided. And for that, I am eternally grateful.

With a heart full of bitter and sweet, my last day at this job is quickly approaching. In the back of my mind I have always known I would pursue an advanced practice degree, but about a year ago, I began to prayerfully consider a Master's program that would combine all of the things I loved about my current job, and the things I loved about what I get to do in Haiti. I went through all the fun stuff you have to do to go to grad school, turned in my applications and left for Haiti the next morning last November. I think I literally threw my hands up in the air and said "God this is all You." And I didn't spend another second worrying about it. Three months later I got a letter in the mail saying I had been accepted to the Vanderbilt University Family Nurse Practitioner and Midwifery (ya, get used to that fun little word) program. It was a good day.

Sooooo come August, this girl is going to be a full time student again. For two whole years. I'll be 26 when I'm done. Totally not freaking out about that. I'm trying to remind myself that this is not college round 2. Do you know how much I loved college? Because I really did. Anyway, I'm just excited. I love, and I mean reeeeally love my life here in Nashville and I'm thankful I get to still do life here and pursue my dreams of Family Practice and Midwifery (there's that word again).

Now how does going back to Haiti have anything to do with all that? Well, I'm taking the summer off. I'll be in Texas for 3 weeks for weddings and family va-cay. Then back to Nashville for a few days before heading to Haiti until mid August. I am overjoyed at the thought of spending extended time with my girls Lori & Licia, snuggling with all the sick little ones in the RC, helping out in the clinic, checking in on that whole cholera thing and praying nothing insane happens totally holding down the fort while Lori goes to the States for much needed R&R.

So, who wants to help me pack? Here is the current list of what I need to bring, I'll be updating more as we have needs:

Reli-ON glucose monitor strips - Confirm/Micro (can be bought at Wal-Mart)
internet cord - from box to computer
24 G catheters for IV use
burrete chambers for the preemie babies-the micro drip tubing
A& D ointment
triple Antibotic ointment
feeding tubes-size 8
Multivitamins
preemie clothes


Email me (cctigner at gmail dot com) and I'll send you my address if you want to mail me donated items, money or gift cards. Got stuff you think we could use? Questions? Thoughts? Comment or email me.

Y'all are stellar. Thanks in advance for the encouragement and support. It counts more than you can know to help the ones you aren't able to go to.

And some favorite shots, just because.















Love y'all.

Oh my word(s)

* I started this post two days ago but just got the chance to finish it.

We have had such a bad day here. I don't think I could possibly recount everything so I am going to give you some specific things to pray for tonight.

This couple came in a few minutes apart and they husband was in super bad shape. In between gasping breaths he said he was worried about his wife who was coming behind him and he thought she was worse. They had walked 5 STINKING HOURS with cholera. After we got him stabilized a visiting doctor went out to meet the wife on the road and she was able to walk the rest of the way up. They stayed two days and went home happy and healthy today! I passed the wife on the road and she ran up to me and gave me a big hug of thanks!

All he kept wanting was his wife next to him in bed, it was so sweet.

What do you do when you need to warm a patient up and have no electricity? That would be use hot water from MRE kits to warm the IV fluid. So degaje.

All in this horrible day, Lesseo's stomach blew up. Thankfully, it was just a fluid overload and it went down in a day, but I was super worried.

This is Darlens, who many of you know because he has been here so long and is so loved by everyone, especially Anna. I wrote this post when he was first here after the EQ, he was one of the worst kids I haver ever seen. He and a few other kids seem to have caught this bug that might be a flu, starts out with vomiting and diarrhea and then dehydration, lethargy, then respiratory symptoms and a high fever. He is such a fragile little child and went really bad on us on Friday. Licia and Jess flew up the mountain with him to me and Lori up at the cholera house so we could look at him. All of us, including the nannies who have taken care of him for so long began to sob, knowing that he just wasn't going to make it. With nothing else to do we came back down to the clinic so we could put him on oxygen and miraculously he is still alive today, and seems to be maintaining. Please continue to pray that Darlens would survive this!

Sadly, Maurency who has been here for quite sometime and was on the list ready to go home also got this bug and died this morning. It was awful. He had been up at the cholera house so we could watch him closely and he was still having some vomiting yesterday and was super lethargic. When I left last night he had a fever and cough so we gave him some tylenol and told the night shift to keep an eye on his fever and sit him up a lot so he could cough that stuff up. This morning was crazy for the nurses as there was a very bad little boy admitted with cholera so by the time I got up there he had a fever of 102 and really junky lungs. I gave him tylenol and flew down here to the clinic to give him a breathing treatment. I flipped him over several times and beat on his chest, but he wouldn't really cough for me. I checked his pulse ox and it was 85-90% so I put him on 5 Liters of oxygen and he hated it. He was kicking and fighting to get the mask off, super alert, wanting to drink lots of water (not acting like a hypo-oxygenated child). I stayed around until he fell asleep and headed back up to the cholera house and shortly after Licia called to say he stopped breathing. I ran as fast as I possibly could and jumped in where Licia was bagging him and did CPR for about 5 minutes, but he was already gone. I picked up his little lifeless body and sobbed. He shouldn't have died. I bathed him, and put his sweet little white dress on and thanked Jesus that Maurency was healed. I imagined what it is like to hear all of those angels singing and told him there were many days I would trade places with him. I have been here for the death of more than two dozen kids and doesn't get any easier to bury them. Life is just so hard here but Jesus promises redemption, and to that I cling.

Shout for joy to the LORD, all the earth. Worship the LORD with gladness; come before him with joyful songs. Know that the LORD is God. It is he who made us, and we are his people, the sheep of his pasture. Enter his gates with thanksgiving and his courts with praise; give thanks to him and praise his name. For the LORD is good and his love endures forever; his faithfulness continues through all generations.

psalm 100

Enelson and Mirlene also have the same bug so we are watching them very closely, please pray.

Filled

We are filled with patients.

We are filled with exhaustion.

We are filled with life.

We are filled with joy.

We are filled with hope.

On this Thanksgiving Day we are filled to the brim.

I can't seem to think of a title for this post. I have a huge lump in my throat and I'm fighting back big tears. In all of this cholera stuff, I haven't spent much time with the kids in the Rescue Center and as I seem to do when I'm at home, I just kind of block it out (I'm sure you psych people would tell me it is a defense mechanism). And then two little boys quickly brought back that flood of emotions tonight. Maurency and Lesseo are very sick from what seems to be some GI bug other than cholera. Both have bad diarrhea and vomiting and are super dehydrated. To look at a very sick child who has overcome severe malnutrition and now is fighting this is so painful it hurts me in deep places. I look at these kids who are away from their parents and in the care of some great nannies and would give anything to take their pain from them. I would take it all on myself in a heartbeat. And they aren't even my children. I don't have kids yet and sure don't look forward to the day that my very own flesh and blood is in pain. It sounds cheesy and like Christian blah blah, but seriously it makes me realize how much our Abba Father loves us. It must be awful for him to watch us hurt, but to know He knows these pains, the pains of the dying kids, of heartbroken mothers and fathers, it comforts me. He took them all on himself so that one day, from then to eternity we will never know pain again.

This is Lesseo before we put an IV in.

3 And I heard a loud voice from heaven saying, "Behold, the tabernacle of God is with men, and He will dwell with them, and they shall be His people. God Himself will be with them and be their God. 4 And God will wipe away every tear from their eyes; there shall be no more death, nor sorrow, nor crying. There shall be no more pain, for the former things have passed away." Revelation 21:3-4

On a lighter (?) note. Here are some pictures from today...

Another skeleton without a pulse. This picture still doesn't do justice to how bad they look when they come in.

Squeezing 4 liters of LR as fast as possible. Stay tuned for miracle pictures tomorrow...

Enoch and Licia surprised me and brought the girl who I sponsor in the school sponsorship program!

Enelson is the tiniest patient in the cholera house. He was given prophylactic meds but he then puked them up so as soon as he had symptoms he was sent to the house.

I love this picture of Mireline. Her hands wrapped up in socks isn't stopping her from eating everything in site!

Bullet points

- Moseline went home today, such an encouragement to see her happy and healthy!

- 5 more patients admitted today

- I know this is completely unrealistic, but I never want to see vomit or diarrhea ever again. Ever. 

- Fleurilis is still not better, went with last resort of IV Cipro.

- In reference to above, pushing 50 cc of IV Cipro over an hour on a toddler is so fun. 

- Diueverson went home tonight! We decided he probably just had a little pneumonia from laying in bed for so many days. He did better when he was up and moving around.

- I got to see one of the earthquake patients (the one with the baby whose arm was crushed)! They passed through the clinic today.

- My skeleton from yesterday was bad again this morning. She does not seem to understand the concept of DO NOT PUT ANYTHING IN YOUR MOUTH BECAUSE YOU WILL VOMIT. We are working on it...

- Please pray that I would get good rest to gear up for another day (or night? i'm confused) tomorrow (or today?) 

God is good, thanks for all of the encouragement!

Giant exhale.

We made it through another day. Me and lori and all the staff and all of the patients. It was such an emotional roller coaster. Dehydrated kids might be some of the scariest patients I have taken care of. What beats a sugar of 29? That would be a sugar of 24. They are so hard to manage when you have very few resources to assess their status. Then they are up and playing and acting great so you finally give them their antibiotics to treat the cholera and they projectile vomit ALL OVER THE PLACE. It's awesome. Sometimes things were totally under control and I had time to do some charting and then Lori leaves me for 2 hours and I promise I will only call her if it is and absolute emergency. Well it was.

I am alone with the staff, with whom I can hardly communicate with and someone knocks on the gate. I run out to see a crowd of people with a patient lying on a bed. Words cannot describe to you what I saw. This girl looks like a skeleton with skin draped on it. Her eyeballs were so sunken in her head that her eyelids were detached from them. Her tongue was completely furled and her toes and fingers looked like she had been dead for hours. I didn't even give them time to bring her inside I just started working on her right inside the gate. I could not find a single pulse in her body. Absolutely one of the scariest moments in my life. Her veins were so flat and fragile that it took me about 8 sticks before I could get a line in. It had a small leak but I didn't care I just had someone squeeze the bag and get in as much as they could. Then she projectile vomitted about 1000 cc of yuck ALL OVER THE PLACE. I got another line started in the same hand and by that time Lori had run all the way up the mountain to rescue me. She got another line in at the same time and we pushed 4000 cc of LR in about 30 minutes. Y'all, I will never be able to describe to you what happened over the next hour. This 15 year old girl came back to life. She opened her eyes and was able to talk. She even kept telling us how hungry she was. Of course, we did not let her eat :) Lori and I sat down to watch her and we refueld with a diet coke and laughed at the thought of trying to tell anybody about these things.

I didn't get a chance to take a picture of her but here are some shots I took during some down time today.

There are several patients who need serious prayer tonight.

This is Mireline, who I wrote about yesterday. She had a better day, but still isn't great. Continue to pray for her healing.

This is Fleurilis. I briefly wrote about him above, bad sugars, super vomitty and can't keep anything down. I am really worried about him tonight.

Diueverson (sounds like Jefferson) has been here for 4 days and is hardly making any progress. We have tried almost everything but it is not really clear what is going on with him. He continues do have diarrhea and now having difficulty breathing. Please, please pray that God would give us wisdom with his treatment and that he would be healed!

Two older girls, including the one who came in this afternoon are having continued vomitting and cannot keep anything down.

And praise Jesus for another great day with Moseline! One of her older sisters came to visit and they had a great time.

"He will swallow up death forever.
The Sovereign LORD will wipe away the tears
from all faces;
he will remove his people’s disgrace
from all the earth.
The LORD has spoken.

⁹ In that day they will say,

“Surely this is our God;
we trusted in him, and he saved us.
This is the LORD, we trusted in him;
let us rejoice and be glad in his salvation.”

Isaiah 25:8-9

Sunday re-cap

I came downstairs to use the computer and write a post about today but then Lori and I had to help a lady who delivered last night and has an very yucky tear. She has a bad infection and can't urinate. We gave her some Rocephin and cleaned her up and sent her home with a catheter. She'll come back for follow up over the next few days. 

Here are the bullet points from the Cholera hospital:

- Moseline is doing FANTASTIC today! I even got a few smiles out of her. She has six sister and they have been crying for her the past few days, hoping they will come visit tomorrow!

- 5 more patients admitted needing IVs

- a few more were observed and just needed oral rehydration

- 2 of the 3 kids from the Rescue Center who are up at the cholera house are doing great, one little girl  is suffering from n/v/d on top of kwash. She has an ng tube but no IV because she is swollen from kwash fluids. She is in so much discomfort and cries most of the day. Please pray for her tonight. 

This is her when she was admitted two weeks ago with severe malnutrition.

And just a few days ago, on the opposite end of the hydration status.

- I got picked up by a cholera patient today. I'm blaming the delirium from dehydration. Please ask me to tell you the story next time I see you :)

Off to bed to rest up for another big day! Thankful to Jesus for health and strength.