Enter Seattle...USA

Yes, I made it safely to Seattle...wierd hw I am in America now...why am I not in the Philippines? So far, the hardest part is not speaking Visayan and saying yes by raising your eyebrows affirmatively. It's going to be hard to adjust..so meanwhile enjoy it while you can! ;)

It was nice freshening up and for the first time all trip, we actually have a little bit of time to kill.
See everyone soon!

In Seoul!

So I write this aboard the 777 airplane (or is it a jet?) where I sit btween two Korean women-ne bound for Seattle to visit her sister and the other Oregon-bound. Seoul is an hr ahead of the Phils making it five pm August 30. we will be arriving in Spokane at 4pm August 30 PST.

they served a meal on the last flight...real Korean food...hot and so delicious!!!

My ears are doing okay lang for which I am grateful.
Been funny because I keep saying Visayan wordds instead of English and being Korea....well they dont know Visayan!;) lol
Gutennacht!! (oops! thats German!!!) lol

The flight will be a little over nine hrs to Seattle.

Coming Home

Just about to leave Manila for Korea. . . I have a longer post but i need to put my kindle away. Please pray that my ears will not cause me problems!

Day 79: Hematocrits

Krys asked me to take a 2 hour swing shift today for the second years so they could go to a 'good bye' party at her house, and though I was pretty tired from previous shifts, it was great fun.

It was a pretty dead shift, and some how the conversation turned to how I bruise really easily, and was having some bleeding issues. So we decided to practice hematocrit testing. It took 3 pokes to get enough blood to fill the tube, and after spinning it down, we found that I had a hematocrit of 41 (35-40 is normal), so that didn't really give us answers...however, it was a new adventure, and "fun"... ;P

It also happened to be my little brother's 15th birthday!!! Happy Birthday David!! I love you!!

Day 73: Swing Swift/Jennings Visit

This afternoon, I went with Sylvette to the Jennings home (the family who started Nehemiah Teams) to drop off some camping dish supplies and books we borrowed for the Nehemiah Team outreach we went on. It was neat meeting Mrs. (Wendy) Jennings, after spending some time with her daughter and the American outreach teams they put together..

After we got back, I had swing shift. I had a baby check and got to do my first Newborn Screening. I was really nervous, as you can't make ANY mistakes, otherwise you have to use a new form, which is really expensive (550 PHP or $12.00).

Had to share a funny story that happened:
Lyric (one of the guards) came in needing to ask Vania a question, and since she was involved in a suturing job, I relayed the message. I thought he said he wanted to know if he could go buy a chicken for "all of us", but when I relayed the message, Vania asked confusedly "Dead or alive? What??" (Sometimes, the guards buy dinner for the Filipina midwives, but as it was 4:23pm, it was too early for that.)
So.....upon clarifying the question with Lyric, I found that he was wanting to buy OXYGEN!! lol That was pretty funny. :)

Day 72: Clinic/Swing Shift

Had a busy Clinic/Swing shift today, with 10 prenatals including my continuity patient. Jordan caught her 7th baby, which happened to be her first lalaki (boy)!!! Michaela also caught a little girl, and wow, it was a perfect birth!!

All the new girls got here tonight and visited the clinic (and left 2 minutes after Michaela's baby was born, so she couldn't go with them...), but Julianne and Heidi came over to say hi! It was fun to se Julianne again...she is so sweet! I really like her..

Day 69: 6th Handle!!

NOTE: To get the most out of this blog, pay attention to times and names. This will give you a real glimpse of how Birth Shifts can be sometimes....and most all of these birth were without complications....

I have heard about 'crazy shifts', but never until today, did I get to experience one to the fullest dramatic effects like I did today (though that breech birth a few weeks ago, was the next best).

I worked Swing Shift, which, though it technically starts at 2 PM, everyone is supposed to assemble for endorsements at 1:45 PM. Our team today, was Ate´Suse (JR), Hannah (HC), Lincey (LK), me (SP), and a Tecarro student-Ann (MAG). Well, today (thankfully, we were all on time), we had all barely gotten in the door, when we were immediately endorsed a pushing laborer #6- Narlie. Hannah delivered a baby boy-Rezal John (no tear) at 1:57 PM. Her attendants were JR (super), me (assistant), LK (charter), and the patient's mom.

The board at almost the end of the night......oh yeah, we had a labor walk in too.

We were then endorsed 4 postpartum patients: 1 immediate and 3 continued care, and 1 labor - Jazmin. (Just to add to the story, FYI, the Day Shifts patients gave birth at: 8:03 AM, 9 AM, 10:10 AM, and 12:39 PM.) How fun!!

At 1:55pm (2 minutes before Birth #5), JR admitted pt. #7-Marites.  Ann (the Tecarro student) was given the endorsed labor (#6-Jazmin) at 2:25pm. Then, JR went on a roll and did the pt. #4 PP check, and did 2 IEs on pt. #6 and #7. (pt #6 was found to have head visible, at which time, Lincey and I both quickly finished up our duties with pt. #5, and then scurried over to help Ann with charting and assisting. (I charted, LK assisted).

Meanwhile (while pt. #6 was pushing), JR admitted pts. #8-Joy and #9-Ruvelyn into Mercy and did IE's on both of them at 2:48 and 2:50pm. She then assisted pt. #4 to the continued PP from the Birth Room, before coming back to supervise Ann's birth at 2:59pm (a baby girl-Rivera). JR did the 1st immediate pp check at 3:22pm, before going to make her rounds again.

My baby---Hanz Dayll...he loved covering his face for pictures!! Crazy kid!!

At 3:40pm, Lincey left assisting to go check on pt #7, and shortly found that there was 2 cm head visible (there were no initial vitals done either, except those that were done when she came in early this morning.... :D) At 3:45pm,  I finished charting, and went to help Lincey with her patient. At 4:16pm, her baby was born-a little boy-Andres Miguel. I charted, Hannah assisted, and JR helped as necessary.

At 5:07pm, I finished my duties as a charter, and went out to see what needed to be done next, and found more than a couple charts with IE's done on the table (I think we sent 2 or 3 gals in early labor home, after Ate´Suse  checked them. :D...if they weren't close, they didn't stay, and the ones that did, got to labor out in the hall, because we had no bed space for them in the Birth Room!!)

Proud mommy and daddy!!

I grabbed a chart, and did the initial vitals for pt. #8-Grace Joy, a G2P0, 19 year old girl (her first baby was miscarried)...this will show you how busy we were: Joy's IE was done at 2:48pm showing 4cm, but she didn't get checked into Mercy completely until 5:22pm!! Good thing I grabbed her, because I had barely finished Vitals, when her water broke (not SROM yet though),and right before I had gotten her, she was standing out in the hallway, eating dinner, laughing, and carrying on with her bantays!! At 5:50, Joy got an urge to push and had SROM.

Tired but happy midwife...and baby is tired too!! lol

At 6:11, head was visible, and at 6:17, head was out with a double nuchal cord, not extremely tight (thank you Lincey for helping me with my handle!!), but tight enough that when little Hanz Dayll was born at 6:18pm, we suctioned him well and immediately administered O2 to him. His Apgar Scores were 6 and 8 and he was very floppy. We continued O2 until he was nice and pink.

Joy's whole family came.....She is the 3 youngest of 4 girls...first grandbaby.

Joy tore slightly, but there was no need to suture. Her EBL was 450cc, and so we did active management to stop complications in their tracks. Hanz weighed 6 lbs 12 oz, and was 21" long, with no complications afterwards.

During my patient's labor, between 5:45-6:14pm, JR bathed 2 babies and discharged pts. #1, #2, and #3 patients, and then made her rounds to all the other immediate postpartums as well.... Also, Hannah admitted pt. #9 at 5:45pm. At 8:05, pt #4 decided to go home, even though she hadn't met the end of the stable hours left...she was very reluctantly discharged. Hannah's patient gave birth at 8:51pm to baby Alexandra, with just Hannah and Ate´Suse  attending.

This probably was just a blur of activity, that didn't make sense to you....but then, in some ways it didn't make sense to us either..... Here is a timeline which may help you understand a little more...

TIMELINE:
8:03am   1
9am        2
10:10am 3
12:39am 4
1:45pm-new shift approximately came on
7 1:55- JR admitted patient
1:57pm:  5-HC, SP, LK, JR
6 2:25 Mag admitted patient

4 2:35 JR checked pt-bb nursing
7 2:37 JR did IE

6 2:42 JR went to do IE, found that head was visible
5 2:43 LK left to assist # 6, I followed shortly after finishing assisting to chart # 6 (head visible)
8 2:48 JR did IE
9 2:50 JR did IE
4 2:55 JR assisted patient to to Cont'd. PP
2:59pm   6-MAG, LK, SP, JR
6 3:22 JR did first pp check
6 3:40 LK left around then to check on pt. 7
6 3:45 Finished charting and left to help LK with pt. 7
7 3:50 LK came in and found 2 cm head visible (no initial vitals)
4:16pm   7-LK, HC, SP, JR
7 5:07 I left birth-charting (finished) and admitted 8 (see below)
8 5:22 I admitted her and did initial vitals
1 5:45 d/c by JR
9 5:45 admitted by HC
3 6pm-bathe baby by JR
3 6:05 d/c by JR
2 6pm-bathe baby by JR
2 6:14 d/c by JR
6:18pm   8-SP, LK,  MAG,  JR
4 8:05 d/c w/o blessing
8:51pm   9-HC, JR
What I Learned/Highlights:
- Lincey and I were both at 3 of the 4 births
- Hannah delivered 2 babies-the first and last of shift
- Ate´Suse is the epitome of a multi-tasker...she is AMAZING!!!

Text From the Bukid:
God said: I am with you and will watch over you wherever you go...I will not leave you until I have done what I have promised you. ~ Genesis 28:15

Day 67: A Quiet Day

I worked Night Shift last night. I was given a postpartum and also charted for Lincey's birth....a baby boy was born at 5pm--John Roy, weighing 3500g.

I have spent a lot of my spare time this week talking to my family, and it has been SO wonderful...Praise God for Skype!!!

Texts from the Bukid:
Psalms 63:1 O God, You are my God, early will I see You, my soul thirsts for You: my flesh longs for You in a dry and thirst land where there is no water. Let's pursue an increasingly closer walk with God. Good morning!!

Sometimes, I get tired and pressured of many things in this world but I thank God, for He reminds me about the purpose of our time on earth. It is not primarily about acquiring possessions, attaining status, achieving success, or even experiencing happiness. Those are just secondary issues.
LIFE is all about Love with and for God and other people. You may succeed in many areas, but if you fail to learn how to Love God and Love others, you have basically missed the reason God created you. Good afternoon!

Day 66: Bukid Texts

Today, nothing significant happened (that I can remember), except 2 things:
1) I had a baby check for Maricel Mental's baby (my 2nd handle). He is HUGE!!

2) I received the following texts from some Filipino friends, which were precious....and God used them to minister to me....I hope they do the same for you:

Romans 6:18 - Having been set free from sin, you became slaves of righteousness. The Great Physician holds the cure that kills the virus of our own sin; it's by His own atoning blood that we're made whole and pure within...Sin is the disease, Christ is the cure....good morning! Have a happy and blessed day!!

Carrying a lamp into a forest night doesn't guarantee you'll see all the trees...It only means that you can see a few steps ahead of you. Far enough to keep your footing sure. .
Likewise, as the LORD lights your path, HE may not shine all the answers to the shadowy questions in your mind. . but He will give you all the light you need to scale life's obstacles with faith and confidience. . Let us thank God for what He has done in our life today. Good morning!

My friendship with us is written in Proverbs 18:24. (A man that hath friends must shew himself friendly: and there is a friend that sticketh closer than a brother.)
If you've done wrong to me, this I'll give you: Mark 11:25 (And when ye stand praying, forgive, if ye have ought against any: that your Father also which is heaven may forgive you your trespasses.)
And when I miss you, remember: 3 John 1:3 (For I rejoiced greatly, when the brethren came and testified of the truth that is in thee, even as thou walkest in the Truth.) Good day!!

In this life, God stands behind, silently loving us .. Reaching out His hand when we've fallen...Assuring us when we're in fear....Understanding us when none others do...Pointing us to the light when we're in the dark...God deserves our time, our focus, our appreciation of a hearty "Thank you!" because we're wrapped in a beautiful truth that we're loved without measure!!

Day 65 - Spider!!

Definitely the most interesting thing that happened today, was finding a S-P-I-D-E-R in our house!!!!
This was not just any old spider....it was a B-I-G SPIDER!!!! Like 3" in diameter!!!

I had only been awake for a little bit, when I heard Chantal and Jordan yelling and screaming "SPIDER!!!" Of course, I had to check it out, and it was a little intimidating....

However, even though this spider was huge and intimidating, it is perfectly harmless, and is actually our friend, because it eats all the nasty little bugs that we have.

I worked Swing Shift today. Since I just handled a birth yesterday, I was at the 'bottom of the totem pole' today, so I got the Fresh Postpartum...meaning I got to do practically everything for her postpartum....that was fun.

Texts From the Bukid:
He is there!! Psalms 139:1-12: Oh Lord, You have searched me and known me. You know when I sit and when I rise; You perceive my thoughts from afar. You discern my going out and my lying down. You are familiar with all my ways. ...... and I am forever grateful knowing that the Lord assured me when He said I will never leave you nor forsake you. Beautiful Morning!! :)

Great friends are a part of memories time can never erase. When life is blessed with friends like you, sweeter memories are there to look back to. God bless! :)

Day 64: 5th Birth!!

I had Day Shift today. Between taking care of my laboring patient (below), my 2nd handle Lalai came in with her bana and baby Marian for their 3 week baby check.

 I was also endorsed this postpartum, of this VERY sweet mommy and her baby....the "Lola" was a hoot too (and the bana, who is taking this picture was very respectful)....lol

At 8:20am, Allyn Ruth, a 22 year old, G2P2, came back in (she had come in at 4 am, but was sent home to wait for labor to progress). We monitored contractions, and she had a nap in the hall, before we did an IE at 10:45am, showing that she was 5 cm dilated.

At 11:25 am, her whole body started shaking uncontrollably--transition time!! Though Allyn had a low pain tolerance, she sure was good at pushing and breathing....at the same time!! lol After only 2 minutes of pushing....major pushing..the baby was out at 11:39am (we joked that she could have easily pushed triplets out with her volocious pushing. "Eveta Sandy Ruth" was born with a nuchal cord loop around her neck, but it was loose, and easily slipped over her shoulders. She weighed 5 lbs. 9 oz, had Apgar Scores of 8 and 9, and was 19.5" long.

She had a very slight tear, about 1 cm, which did not need suturing (praise the Lord!!) A few interesting birth notes: The placenta seemed very short at the time (actually, it was all caught up), and so we cut the baby's cord before the placenta was expelled. No pulse was felt in the cord, but after we cut it, it was leaking more blood than would usually come in from the cord being cut, so I just clamped it with my fingers, until the placenta was expelled..just kind of interesting....

Another thing, we did "Brent Andrews" with no retraction, and then did CCT. The placenta was born both Schultz and Duncan (1/2 and 1/2 inside/outside) with the whole chorion part of the placenta "trailing inside". We twisted it like normal, but the whole Chorion retained inside, and so we had to go after it with hemostats...then a small piece tore off, and we had to go after it again!! That was pretty interesting....first time I'd had to do that, and thankfully Maria was able to help me... Her total EBL was 300 cc, and we gave her 10 u Pit.

After shift, Sylvette and I went downtown to pick up a package from my Oma and Grampaw that was at the post office, and extend my 59 day Visa. Boy did we have fun!! ...Just like we always have...

I know...it's huge!!! It hung out ALL day yesterday in the Clinic Hall...

When my Oma asked me what I wanted, I told her that anything in a package is good....it's just SO much fun to receive stuff over here!! A touch of home you know.... Anyway, in the box they sent was a writing book and pen, blowing bubbles, some assorted candy, and a little purse that she made herself with butterflies on it (my and her favorites....)...and then, there was the delightful letter from her and Grampaw....It was such a delight, and Sylvette enjoyed it almost as much as I did!!

Another angle...this is a "Swallow Tail Moth" (We saw it in the middle of July in our porch at night..at first the girls thought it was a bat, and boy! did they scream!!! lol

After that, we went to try to find the Visa Extension Office...unfortunately, we got 4 different directions, and spent the afternoon hunting it down!! The best part was when Sylvette was trying to see if this one Jeepney would take us to a certain place, and she asked like 4 times in her own language, and the driver said "yes", and then after taking past any place we might have needed to be by 5-10 minutes, we finally asked AGAIN, and he said "No, I don't go there!!"...boy was she frustrated!! It was pretty hilarious to see a Filipina frustrated at her own countrymen for their problems....glad to know we Expats aren't alone!!! lol

 We finally found it (after ice cream found us...lol...as always..my and Sylvette's mutual downfall :D), next to Victoria Mall, only to find that there were 2 dates on the visa, and it was the earlier one that mattered, meaning I got a late fee.....I wonder if they do that on purpose?!?!?! Oh well!!

This is dedicated to Annie Barnett ;) ...I thought she'd enjoy it......

Good day,...fun times,...going to miss them....

The birth went really well, and I learned a whole ton...it had a lot of firsts too:
1) First Nuchal anything
2) First still slightly pulsing cord after cord cut
3) First Placenta Tear/Hemostat Save :)
4) First 1/2 1/2 Schultz Duncan

I will praise Thee: for I am fearfully and wonderfully made: marvellous are Thy works; and that my soul knoweth right well.

~ Psalms 139:14 ~

One of my handles....Vervilyn or "Lalai" sent me this text today..... "Don't go back to the USA. You stay here in the Philippines because we have many moms who need you."

Oh that we would serve wherever we are......no matter what..what an encouragement it was to get this....all I can say, is Praise the Lord, and may I be able to minister where ever I go.