Wednesday, March 25, 2009

In the case of an actual emergency

I don't know what to do. I have a lot to post from our two week trip up country, and I don't know if I should post it in order, "back post it" according to the date of the event, or just put it up as finalize my thoughts on the trip. However, my heart isn't in any of those right now. Instead, I want to write about Isaiah's past week and a half and the reach of God from the hot and salty places to the cold and snowy ones.

On Friday, March 13, (around 9 am) we were packing up to leave the prayer retreat in Kalacha (a town in the Northern Frontier District of Kenya) when I decided to take Isaiah, Olivia, Grace, and a friend to a duka to buy some drinks. It was a longer walk than "just across the airstrip," like I had imagined. So, on the way back, the girls shared the load of drinks, while Isaiah rode on my shoulders. I can usually get him to laugh by nodding my head up and down quickly. My hair scratches his belly, and the giggles spill out. As we crossed the airstrip, something was different. He wasn't laughing, and wouldn't laugh for another nine days.

"Hey, how are you doing up there, buddy?"
"Good" he replied, but it sounded forced. I figured he got up too early, and maybe was almost falling asleep.
A few minutes later, Breanna felt his head and said he was burning up. Some friends had a thermometer, and we took his temperature: 104F. He was looking out of it. We put damp cloths on him and got some Ibuprofin / Motrin / whatever else it is called in him, and it seemed to help.
The Land Rover was loaded with a sheep and a goat amongst the luggage on the roof. We couldn't wait too long without the animals overheating, so we set off. The trip went well across the Chalbi salt desert. We backtracked once because we followed the wrong tire tracks, we stopped to bag some of the salt on the surface of the desert, then we stopped for a lunch in a little "cafe" along the way. Isaiah was stable, and was sleeping most of the way.
The chalbi desert was the first part of the drive and very hot. We kept Isaiah cooled down with wet fabrics.

My GPS had said were close to Kurungu, and the house we were temporarily staying in. Kurungu is where our awesome hosts (Rick and Carrie) live and where we lived for our upcountry stay. Suddenly, Isaiah let loose everything he had eaten that day. Rick stopped the car, and I held Isaiah outside for a bit. Breanna was completely soaked, but as we looked at each other we realised there was nothing we could do here.
Rick asked us: "Do you want to keep going? Kurungu is about 20 minutes still. Of course, that may feel a lot longer, now!"
We agreed, slowly.
The rest of the weekend Isaiah couldn't go for much more than an hour without losing food or drink one way or the other. Unfortunately, in order to pack light, we only packed enough diapers for him to wear for night time. In Kalacha, we were camping, and also in a lot of sessions, so using the bathroom was a tough option. Isaiah hasn't really mastered potty training, so we used up a lot of diapers there.
Now a lot of underwear was getting dirty, and Breanna was trying to keep ahead.
We found out from Carrie that we could ask a pilot, who was doing a scheduled run right past Kurungu, to drop off some diapers for us. It seemed like a great solution, so Rick contacted the pilot and put the order in. There wasn't time to go through the proper channels for procurement, but the pilot was very willing to go shopping in Nairobi for us and take them on the plane.
On Sunday, when Isaiah had the runs, blood began to appear. We knew he was miserable. He did not want to sit down, and preferred to lean over the edge of a chair or bed with his feet hanging off. A couple of times he said he wanted to go potty outside, and crouched over a grate in front of the front door. I think he was trying anything to fix the problem.
Carrie mentioned that the flight on Monday was probably pretty light, and they might have room to take Isaiah to Gatab. That is the town where the pilot is based and also where AIM has a clinic complete with a lab.
Was this really a big enough deal to do this? Surely this bug would work itself out of his body. However, Carrie was a pediatric nurse, and so her input was backed by experience. It seemed like something we should consider.
My entire time in Kenya so far has shown me that I am a complete newbie. This land we were in up north is not really forgiving. A simple car problem combined with bad planning could kill you. It is a rugged beautiful land, and it doesn't have an emergency exit close by. I also realized the invaluable gift of seasoned fellow workers and the value of playing it safe until I can join their "seasoned" ranks.
So we requested Isaiah and Breanna be picked up (and the diapers would go with them) and taken to Gatab.
A broken water pump for a nearby ministry was nice challenge to work on and help get my mind off the sickness.
Syphoning water into the tank for the kindergarten. Multiple hoses speed up the process. Again, a welcome distraction while Breanna and Isaiah were away at Gatab.

I started packing up the house, and trying to stay distracted with Swahili learning, organizing our computer, and helping out with a couple projects going on. Carrie would fill me in with a recent text messaage from Gatab or information over the radio.
Isaiah and Breanna arrived safely and are crashed on the pilot's couch.
They gave Isaiah a blood test.
It's confirmed he has an amoeba, but nothing else. Breanna isn't feeling well.
The next day:
Isaiah is taking maleria medicine. Breanna's malaria test is positive.
I talked to Breanna that evening on a cell phone (you have to stand in the right place in the yard, but even in the middle of nowhere, cell phones work)
Breanna said after Isaiah's first round of medicine there was no improvement. They said sometimes malaria tests aren't conclusive, therefore it's a better bet to start on treatment anyway. Because Breanna wasn't feeling well, they tested her and she came out positive. So she started a treatment plan, too.
After Isaiah's first treatment for maleria, coupled with a stronger dose for the amoeba, Isaiah got up, went to another room and brought back a lego. He was starting to improve!
I felt a lot better knowing both problems were being solved.
On Thursday, our scheduled departure day, and six days after Izzy became sick, I piled our luggage, remaining food, and many Samburu soeveneirs to be ready to go to the airplane. I had started working on adding some extra lights to Rick's Land Rover, which is another story. We heard the Cessna Caravan land, and hopped on the Land Rover to go, and it wouldn't start. Quickly I went throgh every wire I touched working on those lights. After a couple minutes we fixed the problem, and drove out to the plane.
Breanna and Izzy were sitting in their seats, not wanting to move. Isaiah hardly noticed we were there, even after I tried to get his attention. Several sic sacs were used, correctly, on the flight to Nairobi.
Friday, March 20, back at our house in Nairobi, we decided to lay low. We were all feeling a little yucky, and Isaiah was still spending most of his time leaning over our couch, or laying on his knees, face down.
"Hey, look he is praying like a Masai!" Grace said.
Breanna supressed a laugh. "Honey, I think you mean a Muslim."
Our concern was his different personality and his inability to hold anything down, including medicine, and the combined effect that this was now one week. We decided to see what the weekend would bring.
I called the Chief Pilot and explained what was going on. He said that I don't need to feel pressure to start in the hangar on Monday. He said number one priority is getting the family well.
Isaiah had lost his pot belly, his back bone was protruding quite clear, and his eyes were darkened, and looked a little sunken. He was still up for walking to the duka to get some milk, but was more annoyed by the new puppy that came on Friday, than excited by it.
On Saturday, I decided to weigh him on some borrowed bathroom scales. I knew for our flight up he had weighed in on those scales at 18 kg. Now he weighed 14 kg. I did the math. That would be like me losing almost 20 kg in a week (or 44 lbs). When I told Breanna he had lost 9 lbs, she asked if we should take him in to the ER. I didn't know what an ER in Nairobi would be like, and wanted to wait until Monday.
Fortunately, Breanna had finished her malaria treatment was feeling almost normal.
We had heard a ton of advice. Some felt this was normal, and not a big deal. He looks fine, and plus kids can recover just fine.
Others said that we need to make sure that his skin will spring back into shape when pinched, or else he is in bad shape.
We were informed that many others in Kalacha got sick, but were getting over it.
We were frustrated on Saturday because his last dose of Malaria and even the anti-nauseau medicine came back up. Isaiah wanted to be washed off, and by this time of day our water is quite cold. I put him in a cold bath, and he started wailing. My heart was breaking. As I dried him off I said: "I am so sorry. I wish I could be sick, not you."
Our friends knew an AIM nurse living nearby and asked if they could tell her about Isaiah. I didn't realize how concerned they were at the time. They told me a few days later that we didn't see how much he changed because it was a gradual change to us. They were shocked to see how different he looked when they saw him after the trip.
Sunday after church, Isaiah ate some chicken and it stayed. I was optimistic, but it was short lived. It only stayed for a couple hours. We stopped by to visit the nurse. She asked about the details, and looked at him for a little. She commented on how pale he was. She said "You might want to take him to Nairobi Hospital Emergency Room. They have a special pediatric center." That seemed reasonable. A hospital with a pediatric center sounded much nicer than the images I had had in my mind. Plus, this was again the voice of much experience.
Our friends drove us to the hospital (something they have continued to do for these past three days). We waited for about 30 minutes in the children's area. Some nurses had white "pilot type" shirts with epilets on them, but nothing on the epilets, just loops on the shirts. I thought it was interesting.
We walked into the office of on of the shirt type nurses. "Hello baby! What is wrong with you?" She asked Isaiah. Then she held up her hand to excuse herself, picked up the phone and asked a nurse to set up an IV.
When she got of the phone, we explained everything, and she took some notes. She told us because he was in a dehydrated state they wanted to start an IV right away.
They took us to the examination stations for the ER, and pulled the curtain closed. They were all very polite, professional, and knowledgable.
They asked if they could admit him. It would give them time to see how he reacted to the IV and the medicine in the IV. We agreed, then I had to decide on a room. Our insurance covered the general ward, which was a large open room shared with many. It didn't seem an attractive option for one of us to be with him through the night in a large room. For a small price, we could upgrade to a private room with one bed, four chairs, and a sink. However, there was no room in the pediatric ward, so he would be in an adult ward.
Isaiah was on a drip, and not very happy. Everytime he looked at the tubes, or his arm, he would start to tear up. Breanna strategically placed her hand over the wrap that held the needle in place, putting it out of sight.
"Are you ready to go for a ride on your bed?" She asked him with way more enthusiasm than she felt. He just looked at her.
They pushed him facing backwards and he could see both of us walking beside and behind him. He stayed calm the whole time.
Breanna decided she would stay the night with him that night. Our friend, Steve, came to pick me up, and I said goodbye to Isaiah.
Monday morning Steve took me and the girls to the hospital at 10:30. I called Breanna to tell her we were on the way. I also talked to Isaiah. When I asked him how he was and that I missed him, he started crying.
After spending the first night in the hospital. The IV worked wonders. Isaiah was already filling out, but was still not acting like himself. Breanna looked very cute, especially for having spent a night in a hospital room!
When we got to the hospital, the doctor was looking at Isaiah. She was wearing a miniskirt with vertical stripes, had an eyebrow ring, and a lot of make up. Nothing said doctor on her clothes.
The charge nurse was also in the room, and barked at us when we walked in.
"You can't be in here. What are you doing bringing kids here. This is a hospital. They could get sick. Wait outside!"
Shocked by this, we rushed back out, thinking something big was happening. After the nurse left, I walked in, and found the doctor there. She seemed much friendlier. The nurse came back and gave me another lecture about kids coming to the hospital.
"Those are his sisters. They want to see him." I explained.
"It does not matter. I am saying this to protect them!" she replied.
Steve took the girls into a courtyard that bordered the room. They said hello through the window.
Test results had come in: the amoeba was gone, but the blood test showed signs of infection. The doctor told Breanna he had sepsis.
I stayed with Isaiah that afternoon. I got him to laugh when I read our DVD titles to see which ones he wanted to watch. Some movies have two discs, because of bonus features or aspect ratio. I read the discs like they were laid out.
"Monsters, Inc. Monsters, Inc The Little Mermaid The Little Mermaid"
He thought this was funny, and laughed. That sounded sooo good!
A nurse came in, and I tried to get more answers about his condition. I also asked about a cot for Breanna or I to sleep in.
She was somewhat vague and said "because he had an infection in his stomach, we need to keep him on the IV a little longer."
This confirmed what we had been told about health care here. Very little is passed on to the patient. I remembered the girl from the worship team at Nairobi Chapel that died suddenly in the hospital from stomach problems. No other details were given.
Meanwhile, our cell phones were going crazy. As people found out Isaiah was in the hospital the activity increased. A pastor told me they prayed for Isaiah at chai (tea) time in the hangar this morning. The prayer line sent out a text message to everyone to pray for him. Our e-mail program was very problematic, but the e-mails we saw were from friends in Africa and the US saying they were praying.
Two familes (by a miscommunication between Breanna and me) brought food on Monday. Many others offered help. The frustration I felt on Saturday was completely replaced by overwhelming support everywhere we turned. The chief pilot made sure I understood there was no pressure to start at the hangar, which was such a nice reminder to hear.
Breanna came by Monday evening just to check in on us. Isaiah wouldn't let her leave. He had eaten a good breakfast, but not much at lunch, except ice cream, and hardly anything at supper. He had slept 3 hours, but still looked very tired. Whenever anyone spoke to him, he looked away.
So, Breanna was going to spend another night sharing the bed with Isaiah. They had offered to move him to the pediatric ward, which had one opening, but it was a suite, and quite pricy, so I turned it down.
After I left, another room opened up, and they moved there during the night.
The next morning I could not wake up. I felt very very tired. I tried to call Bre, but realized my cell phone was out of credit. I didn't hear from her, either. Finally I got up and wen to the duka to buy some phone credit. When I called her she said that her phone credit had run out, too.
The new room had a fold out chair, which was much better to sleep on. Unfortunately the new room had bad cell reception, so I couldn't hear very well. I told her Steve offered to take me to the hospital after he got back from lunch. Steve's wife, Angie, said she would watch the girls.
Two hours later Angie called to say that they were running late, and I needed to be ready to go right when they arrived. I found out when they got to the house they had been hit by a matatu (bus) which dinged the bumper. The matatu didn't stop. Regardless, he was still OK taking me to the hospital!
When I walked into to the new pediatric room, Breanna said "Daddy's here!" Isaiah looked up and started laughing!
He was himself again. He had a pot belly, a twinkle in his eye, and the giggles were spilling out!
So, tonight I thought about what to write from our two week trip. We learned so much, and there is so much I want to share. But, this is formost on my mind right now: I don't know how serious Isaiah's condition was, but I realize we are in very good hands. Not just the hands of pilot's willing to go out of their way for a three year old, or nurses willing to give advice on their day of rest, or the families who cooked and offered cars and transportation, or even you who prayed for him and wrote us to encourage. It was the reality that no distance beyond civilization can seperate us from God's love. His love reaches to the heavens, and His body spans the deserts, the Kenyan heights, the congested cities, and the entire globe.
So tonight, I am sleeping peaceful, and tomorrow, I was told, Isaiah's coming home.


The Fletcher Family said...

Praise God!

FordeFam said...

Wow!!! We ave been praying for you guys!!! We'll continue to pray!!! Praise the Lord that Isaiah is doing much better!