ShankSteps #17
Hello. Louie (The civet living in the roof of the
Shanks house) here to narrate: ‘Behind the Scenes of
ShankSteps’! But first, some messages from our
supporters!
(Boring commercials)
Were back with some exciting news! The electricity
has been on for two days now without going out! A
Shank member has noted they were getting used to
sleeping on the floor because it was cooler. Lets go
over and interview Greg Shank, shall we?
Hello Greg.
“Hello?â€
May I ask you a few questions?
“What does Louie want to know?â€
Yes, well. How do you feel about getting up often
in the night to go to the hospital often? 1:00 and
the like.
“It bothers me less than in the U.S. because at
least the people are really sick when I see them.â€
I see. Thank you Greg. Remember folks, these are
the reel responses! None of that ‘make the people say
what you want them to say’ stuff!
Well, wile I’ve been feasting on lizards, the
Shank family has been eating the rations of a siege.
Pore Shanks. Rice and beans, rice and beans, rice and
beans, all the time! Rice and beans! At least they
have a lemon tree out back! Some of which Sarah will
be selling!
Lets move on to the hospital.
Ah. It’s doing better! But, tisk! What’s this?
Almost out of saline bags you say! Such a shame!
But wait! Good news! Sarah has watched a total
of 4 operations! Her response? ‘You’d ‘a thought it
would be more bloody.’
According to Sarah, you can find out where the
different body parts are by remembering these helpful
hints:
1. The intestines are the things that look like worms
located in the area you grab when you say, “Ow! My
stomach!â€
2. Your stomach is located above the area you say
“Ouch†when you get a stomachache on the left side.
3. You’re heart is the thing that go’s BOOMB BA BOOM,
BA BOOM in you’re chest.
4. You’re throat is the thing that hurts when you’ve
got a cold.
5. You’re bladder is the thing that feels like it’ll
burst in the morning when you just wake up.
6. And the lungs are the things that go up ‘n down
when you breathe.
That’s just great. Very nice! Now, to the rest
of Koza!
It looks sandy and dusty. Highly populated, and
dirty. But it’s got potential! With two doctors, a
peace core worker, and a little blond girl, my
estimate of time until it becomes some thing great,
is, oh, abooouuut, 234 years. Nah! Just kiddin!
But it definitely needs help! Which is where you
come in! One prayer a day from each of you is a BIG
help!
Well. Hasta le vista! Au revoir! See ya! And
tune in next time for, ‘Behind the Scenes of Shank
Steps!
(Credits role)
#19 Cameroon
I walked into the room and the chest tube is half out
of the chest. She was a thin old woman with a cough.
She had come into the hospital with difficulty
breathing and coughing constantly. She had been
coughing for three months. We checked a test for
terbculosis and she had it. She also had fluid
outside her lung and it needed to be removed. We do
not have the normal tubes for this so I put in another
type of tube, and it drained into a urine sac. She
drained off about 800ml of fluid. This is a huge
amount, especially for a very small, thin woman. So
she went about one week and had a lot of pain at the
site of entry to her chest. After a week she demanded
it out. I did not think this was a good idea as I
knew that with the tuberculosis treatment, which I
suspected was the cause of this effusion, she would
reaccumulate the same fluid. But she was very set and
I warned her that she would need it again. So we took
it out and in the next week be needed another tube.
She refused, but accepted a needle decompression of
the site. So I put a small IV catheter into her chest
and withdrew a similar quantity of fluid. I told her
that the next time she needed it she would get a tube
again. So about a week and a half later she ended up
with the same symptoms. Then she got another small
tube. She has stayed with this for a few weeks.
Every so often when I make rounds on that ward I have
to untangle the macramé she has made of the tubing.
About 4 days ago she was having a lot of difficulty
and so I went to see her. She had swelling of her two
arms and also right side of face and her right chest.
So I figured out that her tube was plugged. So I used
a syringue to suck out the clots in it. We got about
500ml more of fluid. She immeadiately started
breathing better.
So today I walk into her room about noon. And I hear
a sucking sound, suck—swish, suck—swish. I see her
breathing relatively calmly and the “chest tube†in
half with a small portion sticking out of her chest
and the rest laying next to her. The tube making the
sound with each breath. So I immeadiatly think I’m
looking at an open pneumothorax with the tube in place
and the characteristic sound. Now the question is
WHAT HAPPENED? Since she was not in visible distress
I asked her. Through the translation I learned that
that morning she was coming back from using the
latrine and her daughter stepped on the tubing as they
walked and she had intense pain in her chest as it
pulled on the stitch holding in the chest tube. The
tube broke in half and she had difficulty breathing.
So then she went to her room and asked her daughter to
get the nurse. The daughter refused and left the
hospital. I think she must have been scared of what
she had done. So the patient sat there for a few
hours till I came by.
I connected the residual tubing to the tube again but
there was still a huge leak. So I occluded the area
with pressure and was able to use a syringe and a
stopcock to withdraw much of the air out from around
her lung (hopefully reinflating her lung). The next
dilemma was when to get the chest x-ray. I had been
trying to convince her to allow me to get one. She
did not have the money for it and so refused.
Normally I would want one now, when the next chest
tube was in and after it was in to make sure that
there were no tumors in the lung. But I am having a
hard time convincing her of one. So I think I will
wait till she has a hard time breathing again, put in
the chest tube, then after a day get the x-ray if she
will let me. I had hoped that with TB treatment that
this effusion would stop but it has not. I may need
to perform a chemical pleurodesis ( a way to
chemically stick the lung to the chest wall so the
fluid cannot collect), but with what?
It seems each day has something new to amaze,
challenge and intrigue us. We have had a number of
children with huge abdominal ascites that we are not
able to figure out the cause of. We have received
generous donations recently which my dad was able to
bring to us. We have used some of this money for
buying reagents to outfit our laboratory with more
tests to attempt to diagnose these children and also
aid in many other diagnostics. We have already used a
large sum of money to buy medications for our
pharmacy. We now have most of the medications we need
that are available locally. We are looking into
making an order from a company in Holland to be able
to get other medications we need that are not
available here. We will also use some of the
donations for Bibles, so that more people here will
have them. There are very few, as none are available
here and they are costly for the local population. We
thank you all SO much for your prayers and support of
the people here and our working amongst them. We
thank you for you emails. We download them at Mokolo
when we are able to get there and then read them when
we are back in Koza and respond at our next trip.
This minimizes our time at the “internet café†(very
loosely said as there are often animals bleeting
outside and various smells wafting through the musty
air inside.) We thank you all so much and feel your
love in Cameroon. In His Service, the Shanks